EDITORIAL COMMENT on a paper by Van de Ven et al. in the same issue of AIDS (AIDS 2005, 19:179-184) which reported on the sexual behaviour of 119 Sydney gay men in HIVserodiscordant regular relationships, where one partner was HIV-positive and the other HIV-negative. The editors discuss the Van der Ven results in the light of other work: the Van der Ven results suggest that having a reduced viral load may trigger risky sexual behaviour among HIV-positive gay men, supporting other previous research. However Van der Ven et al point out that other studies including one of their own have found no association between viral load and sexual risk behaviour. In the light of these disparate results, the editors reprise the data from a systematic review of HAART and sexual risk behaviour by Crepaz et al . This metanalysis covered 25 papers (1996 - 2003) and determined whether: (1) being treated with HAART; (2) having an undetectable viral load; or (3) holding specific beliefs about HAART and viral load were associated with an increased likelihood of engaging in unprotected sex. The conclusion of the Crepaz study was that HIV-positive people with an undetectable viral load were no more likely to engage in unprotected sex than those whose viral load was detectable. This absence of an association did not vary by risk group, country of study (USA or non-USA).
Elford, J.; Hart, G. HAART, viral load and sexual risk behaviour. AIDS (2005) 19 (2) 205-207.