Increases in condom-less sex in the Swiss HIV Cohort Study. Open Forum Infectious Diseases
Kouyos et al. assessed the long-term changes of the occurrence of condom-less sex in HIV-infected individuals enrolled in the SHCS. The frequencies of reported condom-less sex were stable for 2000-2008 and increased significantly from 2008-2013 for stable relationships among heterosexuals and men who have sex with men (MSM) and for occasional relationships among MSM. The changes may be partially explained by the “Swiss statement” that has been endorsed in 2008, advocating that individuals on effective antiretroviral therapy are non-infectious and thus do not need to use condoms.
The study shows that indeed HIV-infected people in stable partnerships have taken up this message but not only as evidenced by less frequent condom usage also in MSM with occasional relationships. The observed patterns of condom-less sex in occasional partnerships may have driven the recent rise in sexually transmitted infections and the emergence of a sex-associated transmission-route for hepatitis C virus.