Medicated AIDS patients are increasingly passing on the virus to male partners, Israeli researchers discover after combing through data.

HIV infection

Rising HIV infection rates have been blamed on risky sexual behavior of medicated AIDS patients.

An alarming rise in HIV infection rates over the past decade among gay men has been connected to medicated AIDS patients, according to Israeli researchers.

Prof. Zehava Grossman of Tel Aviv University’s School of Public Health and the Central Virology Laboratory of the Ministry of Health, working with top AIDS clinicians and epidemiologists across the country, reported in a recent issue of Clinical Infectious Diseases that an astonishingly high number of newly diagnosed homosexual men were found to have contracted the virus from infected, medicated partners who are already aware of their HIV-positive status.

These findings, consistent with similar observations in other parts of the world, indicate that the public health approach toward HIV counseling and education needs an overhaul, particularly in the homosexual community.

Grossman tells ISRAEL21c that the yearlong study concluded in January looked at all the data Israel has collected in the three decades since the AIDS epidemic, which is caused by the HIV virus, began in Israel.

The number of new HIV cases diagnosed each year in the last 10 years among homosexuals increased almost 500 percent compared to the previous decade. The trend is also reported in other developed nations, including the United States, sparking a worldwide hunt by AIDS researchers for the cause.

“The strength of this study is that it was the collaborative work of all those involved in AIDS research in Israel,” says Grossman. She is in Bethesda, Maryland, through December, continuing to study the molecular epidemiology of HIV infection with American researchers at the US National Institutes of Health.

“I was fortunate that so many people collaborated with me — in addition to my colleagues at the Central Virology Laboratory, the head physicians from the seven Israeli AIDS centers and senior public health researchers. Its other strength was its use of several databases together, and modern tools for their analysis.”

Molecular analysis, not questionnaires

Researchers had suspected that the rise in infection rates was due to a change in social behavior, but polling people about their habits wasn’t the best way to obtain conclusive evidence.

“The uniqueness of the study is that we used the virus to prove the facts — not questionnaires,” says Grossman. “It’s hard to achieve a representative sampling in such studies, and people do not always tell the truth regarding their sexual behaviors. Instead, we used databases derived from clinical and laboratory approaches to which we applied advanced statistical and molecular analysis.”

Grossman and her colleagues at the Central Virology Laboratory, which is directed by Prof. Ella Mendelson, focused on the virus itself. The findings regarding the molecular characteristics of the virus in different patients were combined with information about patients’ diagnosis and treatment and about sexually transmitted diseases contracted along with HIV.

A large number of new cases were found to involve HIV strains that had already developed resistance to existing drug therapies. Because the virus can only become resistant if previously exposed to medication, this result indicates that the new patients were infected by an HIV-positive partner already receiving drug therapy. Additionally, more often than in the past, HIV found in different patients could be traced back to a common source.

“People see proof of why it’s happening”

Though this research was conducted using Israeli data, Grossman says it can be assumed to reflect the situation globally.

“The study is catching quite a lot of attention. One senior commentator suggested in the same issue of Clinical Infectious Diseases that the situation in Israel may be an early picture of the eventual transformation of the HIV epidemic among homosexuals in other high-income countries,” she says.

While people are generally aware of the risks of unprotected sex, it appears that an increasing number of homosexual men, including those under treatment for HIV, are likely to engage in risky sexual behavior. Grossman hopes the study will encourage public health authorities, educators and activists to evaluate how to better ingrain the message about risks and consequences within the gay community.