August 10, 2012


Edwin J. Bernard and Louis Gay at a panel debate about HIV
and criminalization during AIDS2012 in Washington.
- Safest to have sex with an HIV positive on treatment
Jim Høyen
Published 08/10/12
(transelated by Louis Gay)

Louis Gay has been on AIDS2012 in Washington. He came home with new knowledge in the suitcase, and shares it happily with the Gaysir readers.

- Over half of those who test the first time have so low CD4 counts that they probably have been HIV positive for many years. These have since a long time perceived as HIV negative. The probability that they have infected many on their path is big, starts Louis.

He says that this example was a topic at the conference in Washington, which he attended in July. This was used as arguments in the debate of decriminalization and the importance of higher test rate among people.

A healthy person has a number of CD4 cells between 400 and 1600 cells per cubic millimeter of blood. Is the number of CD4 cells between 200 and 500 it may indicate that the immune system is weakened. Late-stage HIV infection usually don’t begin before CD4 count falls below 200.

- From the conference "HIV in Europe", in Copenhagen earlier this year, it was conveyed that HIV infection in more than 50% of the cases is transferred from one that does not even know he is HIV positive. Therefore, you can ask the other part as much as you want, you will not get an answer that is 100% trustworthy. Not because the other part is lying, but because he is of the opinion that he is "well," says Louis Gay.

Leaving their own protection in the hands of others

Louis is a bit upset about the ongoing discussion between HIV positive and HIV negative about who has the responsibility.

- Many HIV negative reserve themselves the right to unprotected sex. They expect and demand that people with HIV should inform about their status. When no one says anything, or they receive information that the other party is "healthy", then they are "safe." But then they ignore a large and dangerous picture. They leave their own protection in the hands of others. They trust and believe that others take care of their health. I think very many people think that way, and it is "dangerous".

Louis stresses how important it is that anyone who picks up someone in London pub, visiting the sauna or "hook up" on Gaysir, reflects on this.

- Everyone wants to fuck, but no one wants to have HIV; between the two thoughts are a number of personal choices. Therefore it is important to get people to understand that they must take care of their own health. It's very scary to leave the whole responsibility to those who know they are HIV positive.

Louis thinks it is safest to sleep with an open HIV on successful treatment. He says recent research presented at AIDS2012 support him in this.

- The person is then probably on medication. But equally important is that you more easily communicate the challenges and take precautions to ensure that infection is not transmitted. We mostly want to take care of each other.

- It's probably far more risky to go with a handsome and likeable guy home from the city, which says he is "well" and then be tempted to make unwise choices.

- Most people see themselves as HIV negative until a test confirms otherwise. A lot may have happened in the meantime. Especially if you do not get a primary infection - which is an indication that something is not as it should be.

"Hard core" group

- There is too much focus on the "hard core" group. Those who use a lot of drugs and deliberately are practicing unprotected sex. Louis says that the "hard core" group was also discussed at the conference in Washington.

- They are found in almost all countries. But they only represent a very small group among those who are HIV positive. This group is almost impossible to get to. The conclusion among researchers is: - find them and get them on medication. This group does not explain the high infection rates in Norway.

- Everyone should take a collective responsibility and make sure to test themselves. Get those who are struggling to cope with their diagnosis on medication. The Public Health Institute says that nearly 10% of Oslo's gays are HIV positive. They talk about an epidemic.

Medication more important than condoms

Centers for Disease Control and Prevention (CDC) presented the latest research on "HIV transmission risk" during the conference in Washington.

"Different factors can increase or decrease transmission risk. For example, taking anti-retroviral therapy (ie, medicines for HIV infection) can Reduce the risk of an HIV-infected person transmitting the infection two another by as much as 96%. Consistent use of condoms reduces the risk of getting or transmitting HIV by about 80%. "

- It is interesting that they say that unprotected sex with an HIV positive on successful treatment is safer than sex with a condom with an HIV positive not on treatment.

- New research has led to that we want to get more newly diagnosed on medication immediately. In Norway, there has been an attitude that medication should not begin until the CD4 count has dropped to a certain level. But now medication has so few side effects that it is best to start immediately, said Louis.

Eradication of HIV - a question of money and politics

- It is claimed by many, including Frank O. Pettersen physician in infectious medical department at the Oslo University Hospital, we have the tools needed to eradicate HIV and AIDS.

“By thinking on the treatment also as a preventive measure, increases the ability to limit, perhaps even stop the epidemic”, Pettersen wrote on HivNorges website in January.

- It's really just a question of money and politics. If HIV is detected earlier by, for example easier accessible testing regime and treated with medication immediately, the infection rates eventually will go down naturally. But it requires international efforts.

- Condom use is nevertheless the most important thing to communicate. One thing is for HIV infection, but there are also other sexually transmitted infections (STIs) that affects health. Virus resistance is also spoken about. Therefore it is important to see sexual health as a whole, and not just focus on HIV.

“International research shows that a newly diagnosed woman of 25 years, starting with the medication immediately, will have a remaining life expectancy of 52.7 years. An HIV negative 25-year-old woman has about 53.1 years left.” It shows how well the medicine has become.

Anthony Fauci, head of the U.S. preventive Institute (NIAD), is a capacity for research on HIV and AIDS. Listen to what he has to say:

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