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Study Confirms Viral Load Most Important Predictor of HIV Transmission

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Joe Parton

What is it with every article on transmission of HIV slipping in "oh yeah and cut off half the skin of the dudes penis"? Seriously? HARRT reduces transmission, condoms reduce transmission, but just in case let's mutilate the penis as good measure. I've commented before on articles and will say it here again -- male circumcision will do more harm than good. After undergoing the torment of genital mutilation men will then be less likely to see the need to use a condom which work nearly 100%.

April 29, 2012 San Francisco

jecinta mwikali

nice and educative article. God bless the poz team for updating us

January 24, 2012 nairobi

Tim Horn

Brent, remember, this study only involved those not on ARV treatment, thus nobody had undetectable viral loads. Basically, this study looked at risk of transmission in UNTREATED heterosexual serodiscordant couples.

Zinger, this is actually an analysis from a study looking at the effects of herpes treatment of HIV transmission. The study wasn't conducted to look specifically at viral load and transmission. You're right. We knew this. And we used data from this study to confirm it.

January 20, 2012 New York


The viral load in the original infected partner was the main driver of transmission, with the risk increasing 2.9 times for every log increase in viral load.

So what is the rate for those with no detectable VL? Notice they never say what the transmission rate is. It's the dirty little secret of the HIV/AIDS prevention community. I understand why they hide the truth but it does not generate a lot of faith. Maybe the new CCR5 studies will make this moot.

January 17, 2012 Washington,DC

Tom Tobin

The easiest way to keep down the viral load is not circumcision. It's using a condom. Condoms are measurably more effective. If you use condoms, there is no need to lose 60% or more of the nerves of the genitals of a male. Circumcision has not been demonstrated to prevent a single disease.

January 15, 2012 MA


Wow, medical science is pedantic! How much money did we waste proving the obvious this time?

January 14, 2012

Mark Lyndon

In 6 African countries, men are *more* likely to be HIV+ if they've been circumcised - Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. If circumcision really worked against AIDS, this just wouldn't happen. The one RCT into male-to-female transmission showed a 54% higher rate in the circumcised group btw. ABC is the way forward. Promoting circumcision will cost African lives, not save them.

January 13, 2012

Ronald Goldman, Ph.D.

Many professionals have criticized the studies claiming that circumcision reduces HIV transmission. They have various flaws. The absolute rate of HIV transmission reduction is only 1.3%, not the claimed 60%. Circumcision causes physical, sexual, and psychological harm. Other methods to prevent HIV transmission (e.g., condoms and sterilizing medical instruments) are much more effective, much cheaper, and much less invasive. Please see for links to literature.

January 13, 2012 Boston, MA USA

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