Condom no more?: A controversial report argues that heterosexual couples were one partner is HIV positive do not need to use a condom if antiretroviral therapy is working effectively.

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GENEVA: A controversial Swiss report has claimed that AIDS patients who take effective antiretroviral drugs do not pass on the virus even through unprotected sex.

Couples were one partner is HIV positive do not need to use a condom to prevent transmitting the disease, as long as antiretroviral therapy is followed regularly and has suppressed the virus in the blood for at least six months, the Swiss Federal AIDS Commission said in a report this week.

The patient must also be free of any other sexually-transmitted disease, they said.

Sparking concern

"These findings come from four different studies," said Bernard Hirschel, co-author of the report and an HIV/AIDS specialist at Geneva's University Hospital.

However, the claim sparked concern amongst AIDS charities who noted that the scientific research is focused on heterosexual couples and vaginal rather than anal sex.

One of the research studies was carried out in Spain from 1990 to 2003 on 393 heterosexual couples where one person was HIV positive. The results showed that none of the HIV negative partners was infected by a patient taking antiretrovirals, according to a paper published in the Swiss Bulletin of Medicine.

Another study in Brazil found that out of 93 couples where 43 were HIV positive, only six people were infected and this was due to their partners not following their treatment regime. Two other studies, one in Uganda and one on pregnant women, arrived at the same conclusions, Hirschel said.

However other health authorities and AIDS charities reacted with
scepticism and alarm to the news.

Inconclusive evidence

"The real thing missing (from the Swiss advice) is about anal sex and getting a new sexually transmitted infection," said Roger Peabody of the Terrence Higgins Trust AIDS charity in London, England. "We don't feel the scientific evidence is conclusive and there are some key issues that are not covered in this advice.

French AIDS charity Act Up said that only a small number of HIV patients would be affected by the findings, and that 40 per cent of retroviral patients still carry the virus residually despite following their treatment to the letter.

The HIV virus has developed some resistance to many antiretroviral therapies, meaning that the drugs are not totally effective in every case.

France's National AIDS Council warned that the findings were not robust enough to extrapolate wider conclusions from the individual cases cited.