Is Safe Sex With an HIV-Positive Partner Possible?

Background: It is generally accepted that a viral load of Objective: To elucidate the risk of sexual transmission of HIV in such individuals. Design: Systematic literature review. Methods: This review was conducted as part of a larger project on virological failure, disease progression, drug resistance, and HIV transmission. The authors searched multiple databases and conference abstracts between 2010 and 2022. Content experts were consulted to expand the search. Studies had to include a comparator group, an intervention, viral load information, and specific information on HIV transmission. Results: Only 8 studies of 241 candidate studies addressed sexual transmission of HIV at low viral loads. Each is reviewed in some detail. A total of 7762 couples, serodiscordant for HIV, were enrolled. Only 2 possible transmissions occurred with a viral load of Conclusions: No definitive evidence of HIV transmission was found when viral loads were Reviewer's Comments: The authors did not address more...