Of these 28 infections, 27 -- or 96 percent -- occurred among couples in which the HIV-infected partner did not start antiretroviral therapy immediately.
Cohen cautioned that the findings don't apply to all HIV-positive people. "Our couples had big advantages," he said. "We enrolled couples who probably have a low overall transmission [HIV] rate," he said.
The researchers also made sure that the patients were taking their antiretroviral medications. And, the medications were carefully selected. "The drugs are important," Cohen said. "We didn't use any combination possible -- we used ones we thought would sterilize the genital tract," he said.
Commenting on the study, Dr. Alexis Powell, an assistant professor of infectious diseases at the University of Miami Miller School of Medicine, said that "it's nice to finally have evidence-based information that clearly shows that earlier treatment with antiretrovirals can benefit the individual who is HIV-positive, but also protects sexual partners who are HIV-negative."
Most doctors would like to treat HIV patients sooner, Powell said. "We clearly understand that patients benefit with earlier treatment," she said. "And this is another reason to start early."
Powell said she'd like to put HIV patients on antiretrovirals as soon as they are diagnosed, but there are barriers. They include criteria for treatment set by insurance companies and lack of funding to treat those without insurance, she said.
"When you start talking about the dollars and cents of everyday clinical practice, that's when we are really going to see what we are going to be allowed to do," Powell said.
Another barrier is convincing some HIV-positive people to take the drugs. Some are reluctant to start taking medicati
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