Pietro Vernazza (file photo)Following on from the debate on the Swiss Statement held during the XVII International AIDS Conference in Mexico, Professor Pietro Vernazza, President of the Swiss Federal Commission on AIDS was invited by ASHM to Australia to debate the statement as part of a panel.
Aside from Prof. Vernazza, on the panel was, Phillip Keen, Health Promotion Officer with AFAO, Professor Sue Kippax from the National Centre for HIV Social Research (NCHSR) and Dr. David Wilson, from the National Centre for HIV Epidemiology and Clinical Research (NCHECR).
Since publication the main debate has focused on the ‘zero risk’ implication made by the Swiss doctors.1This aspect of the debate remained polarised with both Vernazza and Wilson debating the efficacy of the models applied to the question. Vernazza stated the Swiss Statement was an ‘expert assessment of current biological, epidemiological and ecological evidence’,2and that the statement had not been intended for an international audience – instead it had been intended for Swiss doctors – the message to be delivered by these doctors to their patients.
David Wilson’s presentation relayed the finding of his recent paper published in The Lancet3. He and his co-authors estimated the accumulated risk of HIV transmission based on the data used by the Swiss. They challenged the Swiss claim of ‘zero risk’, stating that although heterosexual risk may be low it is not zero risk, and that the risk of HIV transmission between men is ‘high over repeated sexual exposure’.3
Sue Kippax provided an interesting overview of the debate, commenting that other preventive measures such as circumcision and PREP had attracted far less criticism by the international community than the Swiss Statement. She supported the Swiss researchers as responsible in making this statement, while also acknowledgingthat there were a number of caveats required to support the statement. Further to this Kippax noted that many people living with HIV are actively adopting a number of strategies in order to protect their partners.
Philip Keen provided a measured argument and discussed the difficulties of delivering complex health promotion messages. He queried whether the message was useful in an Australian setting.
References
- Vernazza, P. 2008. Background and Rationale – Normalizing Sex in Stable Serodiscordant Relationships. 20th Annual ASHM Conference. Perth, Australia 17 – 20 Sept 2008. ASHM: Sydney.
- Australasian Society for HIV Medicine. 2008. Joint Australasian statement developed in response to the Swiss report, Australasian Statement on HIV Antiretroviral Therapy and Infectiousness Available at: http://www.ashm.org.au/news/334/11/ Accessed 9, Oct, 2008.
- Wilson, D, Law, M, Grulich, A, Cooper, D, Kaldor, J, 2008. Relation between HIV viral load and infectiousness: a model-based analysis. The Lancet, 372 pp 314-320.
