{"id":9207,"date":"2019-05-05T15:06:27","date_gmt":"2019-05-05T19:06:27","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9207"},"modified":"2019-05-08T16:00:58","modified_gmt":"2019-05-08T20:00:58","slug":"latest-published-study-on-hiv-treatment-as-prevention-is-deja-vu-all-over-again-but-some-news-is-so-good-it-never-gets-old","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/latest-published-study-on-hiv-treatment-as-prevention-is-deja-vu-all-over-again-but-some-news-is-so-good-it-never-gets-old\/2019\/05\/05\/","title":{"rendered":"Latest Published Study on HIV Treatment as Prevention Is D\u00e9j\u00e0 Vu All Over Again, But Some News Is So Good It Never Gets Old"},"content":{"rendered":"<div id=\"attachment_9210\" style=\"width: 180px\" class=\"wp-caption alignright\"><a href=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-9210\" class=\" wp-image-9210\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain.jpg\" alt=\"\" width=\"170\" height=\"256\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain.jpg 1194w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain-199x300.jpg 199w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain-768x1157.jpg 768w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2019\/05\/1953_Bowman_Yogi_Berra_public-domain-680x1024.jpg 680w\" sizes=\"auto, (max-width: 170px) 100vw, 170px\" \/><\/a><p id=\"caption-attachment-9210\" class=\"wp-caption-text\">Yogi Berra, putative author of &#8220;d\u00e9j\u00e0 vu all over again&#8221; and other profundities.<\/p><\/div>\n<p>Even if you&#8217;re not an ID or HIV specialist, there&#8217;s an excellent chance you&#8217;ve heard of the PARTNER2 study, <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(19)30418-0\/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">just published in <em>The Lancet<\/em>.<\/a><\/p>\n<p>If not, the title could not be more descriptive:<\/p>\n<p style=\"padding-left: 40px\">Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy<\/p>\n<p>And, in case you&#8217;ve just awoken from a <del datetime=\"2019-05-06T23:12:57+00:00\">Rumpelstiltskin <\/del>Rip Van Winkle-length sleep, here are the results:<\/p>\n<p><em>The risk is essentially zero.<\/em><\/p>\n<p>This is far from the first time we&#8217;ve heard this information, either from <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2533066\" target=\"_blank\" rel=\"noopener noreferrer\">this<\/a> or other (<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1600693\" target=\"_blank\" rel=\"noopener noreferrer\">HPTN 052<\/a>, <a href=\"https:\/\/www.thelancet.com\/journals\/lanhiv\/article\/PIIS2352-3018(18)30132-2\/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">Opposites Attract<\/a>) studies.<\/p>\n<p>The formal publication of PARTNER2 therefore has a <a href=\"https:\/\/en.wikipedia.org\/wiki\/Deja_Vu_All_Over_Again\" target=\"_blank\" rel=\"noopener noreferrer\">d\u00e9j\u00e0 vu<\/a> quality to it, one which prompted\u00a0Myles Helfand, the indefatigable and entertaining Executive Editor of the terrific HIV resource <a href=\"https:\/\/www.thebody.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">TheBody<\/a>, to post the following:<\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">Breaking: A fact we&#39;ve already known conclusively for about three years <a href=\"https:\/\/t.co\/YYML1z8igh\">https:\/\/t.co\/YYML1z8igh<\/a><\/p>\n<p>&mdash; Myles Helfand (@MylesatTheBody) <a href=\"https:\/\/twitter.com\/MylesatTheBody\/status\/1124337056237412352?ref_src=twsrc%5Etfw\">May 3, 2019<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p>&#8220;Breaking&#8221; indeed. Ha. To Myles, and to many of us, this is old news. The <em>publication<\/em> of the paper after years of comparable findings from this and other studies may seem anticlimactic, no big deal.<\/p>\n<p>He&#8217;d no doubt cite that even this particular study was <a href=\"https:\/\/programme.aids2018.org\/Abstract\/Abstract\/13470\" target=\"_blank\" rel=\"noopener noreferrer\">presented first at the AIDS 2018 conference<\/a> last summer in Amsterdam. That&#8217;s over 8 months ago! Ancient history!<\/p>\n<p>But here&#8217;s another take from Claire Farel, an ID doctor from the University of North Carolina (and, full disclosure, a wonderful graduate of our ID fellowship program):<\/p>\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\">\n<p lang=\"en\" dir=\"ltr\">Another boost to our conviction that <a href=\"https:\/\/twitter.com\/hashtag\/UequalsU?src=hash&amp;ref_src=twsrc%5Etfw\">#UequalsU<\/a> and hopefully to the fight against <a href=\"https:\/\/twitter.com\/hashtag\/HIV?src=hash&amp;ref_src=twsrc%5Etfw\">#HIV<\/a> stigma. Discussing U=U with patients has been a gift, leading to some of the most profound conversations I\u2019ve had in medicine. Also, there\u2019s never enough Kleenex.  <a href=\"https:\/\/t.co\/jC7iMhSQZ8\">https:\/\/t.co\/jC7iMhSQZ8<\/a><\/p>\n<p>&mdash; Claire Farel (@claire_farel) <a href=\"https:\/\/twitter.com\/claire_farel\/status\/1124124126954840064?ref_src=twsrc%5Etfw\">May 3, 2019<\/a><\/p><\/blockquote>\n<p><script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n<p>(For those not in our field, that &#8220;U=U&#8221; stands for <a href=\"https:\/\/www.positivelyaware.com\/articles\/undetectable-equals-untransmittable\" target=\"_blank\" rel=\"noopener noreferrer\">&#8220;Undetectable = untransmittable.&#8221;<\/a>)<\/p>\n<p>First, I am in complete agreement that telling people with HIV that their treatment prevents viral transmission is a &#8220;gift,&#8221; leading to profound and anxiety-relieving responses. It&#8217;s just as good as informing patients that if they take their HIV meds, they will not die of AIDS &#8212; and both pieces of information are equally true.<\/p>\n<p>Conveying this information elicits such relief that yes, tears of happiness are often part of the mix, if you&#8217;re wondering about that Kleenex reference.<\/p>\n<p>Second, the publication of a study in a peer-reviewed journal still lends far greater authenticity to scientific data than conference presentations or abstracts. This is particularly true when the journal publishing the paper is a prestigious one, such as <em>The Lancet.<\/em><\/p>\n<p>(I have cleared it with the Editorial Office that we&#8217;re allowed here at <em>NEJM Journal Watch<\/em> to write that <em>The Lancet<\/em> is prestigious. Note I didn&#8217;t say <em>MOST<\/em> prestigious.)<\/p>\n<p>Don&#8217;t get me wrong &#8212; I agree that conference presentations play a critical role in rapidly getting important new data into the public domain. But there&#8217;s still room for distribution the old-fashioned way, in a journal, which is why I posted both Myles&#8217;s and Claire&#8217;s responses to this publication.<\/p>\n<p>Before we leave this study, we must linger for a moment on the most unintentionally amusing sentence from PARTNER2.<\/p>\n<p>It&#8217;s this:<\/p>\n<blockquote><p>In total, couples reported having condomless anal sex approximately <strong>76,088<\/strong> times during eligible couple-years of follow-up.<\/p><\/blockquote>\n<p>Something about the precision of that estimate &#8212; are they <em>sure<\/em> it wasn&#8217;t 76,089? &#8212; makes me smile every time.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Even if you&#8217;re not an ID or HIV specialist, there&#8217;s an excellent chance you&#8217;ve heard of the PARTNER2 study, just published in The Lancet. If not, the title could not be more descriptive: Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy And, in case [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,4,8,10],"tags":[464,2851,944],"class_list":["post-9207","post","type-post","status-publish","format-standard","hentry","category-health-care","category-hiv","category-patient-care","category-research","tag-hptn-052","tag-partner","tag-treatment-as-prevention"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/9207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=9207"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/9207\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=9207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=9207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=9207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}