amfAR-Funded Study Examines HIV in Serodiscordant Couples

When one sexual partner is living with HIV and the other is not (a serodiscordant relationship), to what extent does antiretroviral therapy (ART) taken by the infected partner reduce the risk of transmitting the virus to the uninfected one? That's what researchers at the Instituto de Pesquisa Clinica Evandro Chagas in Rio de Janeiro, Brazil, are aiming to find out as part of the Opposites Attract Study, an ongoing international study that explores the effectiveness of 'treatment as prevention' in gay male serodiscordant relationships.

"The AIDS epidemic in Brazil is disproportionately concentrated among gay men and other men who have sex with men, and reducing the spread and impact of HIV among this key population will require that we implement HIV interventions that are truly effective," said amfAR Chief Executive Officer Kevin Robert Frost.

Instituto de Pesquisa Clinica Evandro Chagas (IPEC) is one of 16 clinical sites participating in the Opposites Attract Study, which started in 2012 and is being conducted by Dr. Andrew Grulich, professor and head of the HIV Epidemiology and Prevention Program at the Kirby Institute for Infection and Immunity in Society at the University of New South Wales. The study has 14 sites in Australia, and recently expanded to recruit gay male serodiscordant couples in low-to-middle-income countries, adding sites in Thailand and Brazil.

amfAR, The Foundation for AIDS Research, is providing funding for the study in Brazil, the largest single study site in the Opposites Attract network. It will be led by Dr. Beatriz Grinsztejn, director of the STD/AIDS Clinical Research Laboratory at IPEC, who will monitor as many as 70 gay male serodiscordant couples in Brazil and examine HIV treatment, viral loads, and HIV transmission to find out if HIV incidence is associated with whether the HIV-positive partner is on antiretroviral therapy.

Strong scientific evidence exists on the benefits of 'treatment as prevention' for serodiscordant heterosexual couples. A landmark clinical trial known as HPTN 052 showed that relatively healthy people living with HIV who received early treatment with ART were 96 percent less likely to pass on the virus to their uninfected partners.

"While studies already exist on heterosexual serodiscordant couples, the importance of research into gay serodiscordant couples is just now emerging, " said Dr. Beatriz Grinsztejn. "With amfAR's support, the Opposites Attract study will help us measure the impact of HIV treatment, and answer critical questions about preventing HIV transmission among this at-risk population."

While HIV infection rates have begun declining in many countries, cases have been slowly rising in Brazil, with the sharpest jump among GMT and young people aged 15 to 24. According to UNAIDS, there are approximately 730,000 people living with HIV/AIDS in Brazil, including 44,000 who were newly infected last year.

amfAR has supported several community organizations in Brazil dedicated to curbing the HIV epidemic among at-risk populations, including Rio de Janeiro-based Pela Vidda, Sociedade Viva Cazuza, and Grupo de Trabalho em Preven��o Posithivo (GTP+), and Articula��o e Movimento para Travestis e Transexuais de Pernambuco (AMOTRANS) in Recife. These organizations have used amfAR funding for a wide array of projects, such as promoting HIV testing and interventions that maximize the benefits of HIV medications, as well as providing treatment, housing and other assistance to people with HIV/AIDS.

amfAR, The Foundation for AIDS Research, is one of the world's leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested close to $400 million in its programs and has awarded more than 3,300 grants to research teams worldwide.