The Tenth Anniversary of the Swiss Statement

Ten years ago, in January 2008, the Swiss National AIDS Commission issued a statement for doctors in Switzerland about the safety of HIV treatment to reduce transmission. The document initiated by Dr. Pietro Vernazza was soon known as the “Swiss statement”.

The main statement was an HIV positive person on effective HIV treatment (ART) cannot transmit HIV through sexual contact.

The document was produced because HIV positive people were being criminalised if they had sex with HIV negative partners, even if both people consented. It was also produced so that heterosexual couples could have children naturally – where one partner was postive and the other was HIV negative – without facing legal charges.

• Several conditions were included for the statement.
• The HIV positive person needs to be good at taking their meds and routinely seeing their doctor; and
• Their viral load needs to be undetectable for at least six months (for example, less than 40 copies/mL); and
• That they have no other sexually transmitted infections (STIs).

Although scientifically no risk can ever technically be zero and there was little evidence to prove the statement – this risk was compared to the risk of transmitting HIV from kissing,

The document also said use of sperm washing was no longer needed if the man was positive and on effective ART.

Since 2008, several important studies have produced evidence that support the Swiss Statement.

• In 2011, the HPTN-052 study reported that ART dramatically reduced the risk of HIV transmission in sero-different heterosexual couples. The study was so effective that it was stopped early so all participants could use ART. The single transmission was in a couple where the positive partner had just started treatment. This meant viral load would not have been undetectable.
• In 2014, the PARTNER study reported no HIV transmission after serodifferent couples had sex without condoms more than 44,000 times.
• In 2016, the publication of the final results of the PARTNER study reported no transmissions after more than 58,000 times that couples had sex without condoms.
• Also in 2016, HPTN-052 reported that the early protection reported continued for years afterwards.

The results is that while the Swiss Statement was controversial when first published, it is now established as an effective was to protect again HIV transmission. Also, any risk that might exist is so small that national health guidelines call this risk negligible

Together this evidence should:

• Stop legal cases where HIV positive people are criminalised for consensual sex.
• Enable serodifferent couple to have children without the worry of HIV.
• Help HIV positive people develop relationships without the fear of infecting their partners.
• Enable HIV negative people to stop worrying about HIV if their partner is HIV positive and on effective ART.

The Swiss Statement started as an initiative to protect HIV positive people in Switzerland. It has since became a leading document that improved the quality of life for millions of people living with HIV and their partners.

In early 2016 "Undetectable = Untransmittable" (U=U, UequalsU) campaign was launched by a group of people living with HIV who created a groundbreaking Consensus Statement with global experts to clear up confusion about the science of U=U. That Statement was the genesis of the U=U movement that is changing the definition of what it means to live with HIV. The movement is sharing the message to dismantle HIV stigma, improve the lives of people living with HIV, and bring us closer to ending the epidemic.

In 2017 UequalsU was awarded as the Best Media Campaign for People Living With HIV: "Perhaps the most discussed and rapidly shared message to hit the HIV arena in years, UequalsU is prevention literacy for people living with HIV. It is also the single, precise message of Prevention Access Campaign, which collaborates with nonprofits, government agencies and HIV prevention advocates interested in creating their own materials to share it,” wrote the POZ Magazine

A few days after, Bruce Richman, the founder of Prevention Access Campaign and the powerful leader behind the UequalsU movement, was named the Healthline HIV Influencers Honors Person of the Year.

In October 2017 Russian-language campaign UequalsU was launched by Life4me+ in Eastern Europe and Central Asia countries. "We’re thrilled about the launch of the UequalsU campaign for Eastern Europe and Central Asia region. It is very important to educate about HIV and fight HIV stigma especially in countries where transmissions continue to grow. This is an important step to ensure Russian speaking people living with HIV, healthcare providers and policymakers can get accurate information about how treatment keeps people with HIV healthy and stops new transmissions. This goes a long way toward eliminating the HIV stigma which has been one of the greatest challenges to ending the epidemic," said Bruce Richman.

Within the framework of the campaign, regional professional organizations joined the Consensus Statement.