As result of antiretroviral (ARV) treatment, poz men who have a fully-suppressed viral load (as determined by blood testing) also have an undetectable viral load in their precum (pre-ejaculatory fluid).  Researchers in the United States studied 60 sexually active males with HIV who were on a stable antiretroviral regimen for at least three months.  All participants provided precum, semen and blood samples. 

     Aidsmap.com reported that the researchers (who published these recent findings in AIDS, the official journal of the International AIDS Society) stated, “’Our study provides the first evidence that pre-ejaculatory sexual secretions in men on ART (antiretroviral treatment), unlike those from untreated men, do not contain detectable HIV’.”

     There is now overwhelming evidence that those who are on a stable ART regimen that suppresses HIV in their blood to undetectable levels are extremely unlikely to transmit the virus to their sexual partners.  However, persistent HIV replication has been detected in the semen of men on treatment that suppresses the blood’s viral load.

    The virus has been detected in the precum of infected men not on ART.  Pre-ejaculate is considered to be a possible source of HIV transmission. According to Aidsmap.com, the researchers “wanted to see if HIV-replication persists in pre-ejaculatory fluid in the context of treatment that suppresses viral load in blood and also to establish if there is a relationship between detectable viral load in semen and viral shedding in pre-ejaculate.”

     Of those 60 sexually active men participating in the study, eight had detectable viral loads in their blood (a range of 80-640,000 copies/ml); therefore, they were excluded from the principal analysis.

     The remaining participants all had blood viral loads below the limit of detection (40 copies/ml).  Their median age was 43, 96% reported sex with other men, and 44% stated that they had engaged in insertive unprotected anal sex within the past three months. 

     And of the 52 males with undetectable viral loads in their blood, ten (19%) had low level HIV replication in their semen (59 to 800 copies/ml). However, none of the men’s precum contained the virus.

     The conclusion:  “’Our study provides the first evidence that pre-ejaculatory sexual secretions in men on (ART), unlike those from untreated men, do not contain detectable HIV’,” stated the researchers.