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Kalichman presented findings on research into the question of whether ART would prevent the spread of HIV at the 3rd Social Aspects of HIV/Aids Research Alliance (SAHARA) conference held in Senegal.

He said assisting people living with HIV to reduce their risk behaviours is a global public health priority. Across many studies done in different places in the world, it was found that one in every three people who know that they are HIV positive, continue having risky and unprotected sex, placing themselves and others in danger of further infections.

'Prevention in a pill'?
ART improve the health of people with HIV, but the question was whether the therapy would also automatically offer 'prevention in a pill'. Drawing on various studies, Kalichman said although the viral load in blood plasma drops dramatically during treatment, it does not mean that the same happens in semen.

Men on ART who have frequent unprotected sex can still get sexually transmitted infections (STIs). During acute STIs there are breakthroughs in viral shedding in semen which is undetected when measuring the viral load in blood plasma.

Results from intervention studies on risk-reduction for people living with HIV/Aids in STI clinics in South Africa, in partnership with a team led by the Human Sciences Research Council of South Africa, showed that ART should be integrated with safe-sex intervention counselling to have a strong preventative effect.

Counselling and messages that emphasise the risks or negative consequences of unsafe-sex can help reduce risky sexual behaviour in HIV-positive patients with initially risky profiles. Kalichman said VCT offers a window of opportunity during which brief risk-reduction counselling can have the necessary effect of both treatment and prevention. – (Ina van der Linde, HSRC)
 

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