Op Aidsmap een interessant onderzoek over serodisco stellen en preventie. De conclusie: het promoten van 100% condoomgebruik zou niet de meest geschikte hiv-preventie strategie voor serodisco stellen hoeven te zijn.
Er was onder de 38 stellen echter geen groot besef van andere methoden van het voorkomen van hiv-overdracht, zoals PEP of de impact van de viral load op infectiositeit.
“There was a very low awareness of the availability of PEP, a short course of antiretroviral treatment that is taken after exposure to HIV to prevent infection. Only 16% of HIV-negative partners and 32% of HIV-positive partners were aware of its availability. Only one couple reported ever having used PEP.
Nor was there an understanding of the impact of viral load on infectiousness.
Nevertheless, the couples did report the use of some strategies to try and reduce the risk of HIV transmission. In gay couples, this included the HIV-negative partner being insertive, and most HIV-positive men reported never ejaculating inside their partner when having unprotected sex.”
Over het algemeen bleek de hiv-positieve partner meer bezorgd dan de negatieve over het risico op hiv-overdracht.
“Emotional reasons were a key factor, with individuals reporting that intimacy and trust were important reasons for unprotected sex.”
Sommige stellen hadden onbeschermde seks met elkaar. Reden hiervoor was het niet houden van condooms, die vaak ook staan voor een herinnering dat hiv in de relatie aanwezig is.
“A blanket healthcare message of safe sex seems inappropriate for all HIV serodiscordant couples,” comment the investigators, “provision of an open discussion of risk and identification of barriers to condom use may be more meaningful than promoting a 100% condom approach.” The investigators suggest that the statement by leading Swiss HIV doctors in early 2008 that, in certain circumstances, individuals taking antiretroviral therapy with an undetectable blood viral load were not infectious to their sexual partners offered one possible approach.”
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