A report that HIV-infected people who consistently take their anti-retroviral drugs and maintain a nutritious diet are unlikely to infect their partners could offer hope of a normal sex life to thousands living with Aids.

The report, published by UNAids, the Joint United Nations Programme on HIV/Aids, shows that 76 per cent of people on anti-retroviral therapy in sub-Saharan Africa are unlikely to transmit the virus to their sexual partners because they have achieved viral suppression, that is they have a very low level of HIV in their blood.

Dr Peter Muiruri, the manager at the HIV Comprehensive Care Centre at Kenyatta National Hospital in Nairobi, says viral suppression does not mean one is free of HIV.

“You aren’t cured. There is still some HIV in your body. But lowering the amount of virus in your body with medicines can keep you healthy, help you live longer, and greatly reduce your chances of passing HIV to others,” he said.

Even if no virus is present in the blood, HIV infected cells may remain in the body and the virus could replicate if antiretroviral therapy is stopped.

“Patients should continue taking their drugs as prescribed unless the prescription is changed by the doctor,” Dr Muiruri said, adding that the findings should encourage HIV patients to consistently take their ARVs, eat healthy foods and avoid alcohol and smoking cigarettes.

“The antiretroviral therapy has been successful in prolonging the lives of people living with HIV; in high-income countries, life expectancy of a person living with HIV who achieves and maintains viral suppression on antiretroviral therapy is now similar to that of a person who has never acquired HIV. The trend of decreasing HIV incidence among younger adults is shifting the proportion of disease burden to older age groups,” states the report.

The 2013 United Nations Programme on HIV/AIDS Gap Report, released on July 16, analysed HIV/Aids data from countries in sub-Saharan-Africa, Caribbean, Asia and Pacific, Middle East and North Africa, Latin America, Western and Central Europe, East Europe and Central Asia.

According to Sobbie Mulindi, the deputy director of the Kenya National Aids Control Council, the country has already commissioned a study under the National HIV programme to establish the number of people on HIV treatment who have reached suppression level.

“We do not have exact data. The study will help us register HIV patients who have achieved suppression level, and we will advise them appropriately,” said Dr Mulindi.

In 2013, of the two million Kenyans living with Aids, 656,369 were on antiretroviral therapy, which translates to 41 per cent.

“If we are not suppressing the virus as much as we thought, then we are not preventing and reducing the likelihood of HIV transmission,” says Dr Mulindi.
He said that even those who have reached viral suppression level should avoid unprotected sex.

Dr Andrew Kambugu, Uganda’s head of prevention, care and treatment at the Infectious Diseases Institute, said the findings by UNAids should be treated cautiously because some people may have achieved suppression level but still pose a risk of infecting their partners.

“Even if the transmission levels are negligible, the use of condoms should be encouraged,” said Dr Kambugu, adding that only tests done and confirmed by a clinician can confirm that the HIV-positive patient has attained viral suppression level.

He said the centre has been conducting studies on HIV-positive people every six months.

“Last year, we found that more than 80 per cent of those taking their ARVs religiously had achieved suppression level,” said Dr Kambugu. “These are patients who follow their ART regimes as prescribed by the doctor, are on good nutrition, and don’t use alcohol and drugs.”

According to UNAids data, for every 10 per cent increase in ART coverage, there is a one per cent decline in new infections among people living with HIV. The Gap Report looks at why certain populations are not accessing HIV services, and calls for urgent action to address their specific needs.

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Globally 19 million of the 35 million people living with HIV do not know their status.

“Ensuring that people living with HIV in these countries have access to HIV treatment services is especially critical,” says the report.

Ten countries account for 81 per cent of all people living with HIV in Africa. Kenya accounts for five per cent of the 35 million people living with HIV in the world; Uganda and Tanzania account for four per cent each.

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The others are Ethiopia, Malawi, Mozambique, Nigeria, South Africa, Zambia and Zimbabwe: Half of those are in two countries — Nigeria and South Africa.

The HIV prevalence is estimated to be 28 times higher among people who inject drugs, 12 times higher among sex workers, 19 times higher among gay men and other men who have sex with men, and up to 49 times higher among transgender women than the rest of the adult population.

In sub-Saharan Africa, adolescent girls and young women account for one in four new HIV infections.