The Association Between Different Levels of Suppressed Viral Load and the Risk of Sexual Transmission of HIV Among Serodiscordant Couples on Antiretroviral Therapy: A Systematic Review
Bibliographic record
Abstract
The risk of sexual transmission of HIV in serodiscordant couples when the partner living with HIV (PLHIV) uses antiretroviral therapy (ART) and maintains a suppressed viral load (VL) (< 200 copies/mL) is estimated at 0.00 transmissions per 100 person-years (95% CI 0.00-0.10). A recent review reported an almost zero transmission risk for VL < 1000 copies/mL but lacked quantitative risk estimates. This systematic review aimed to quantify transmission risk across VL levels. A literature search (November 2023, updated January 2025) identified 152 studies, with 9 included in the analysis. Seven possible transmissions occurred when the PLHIV had a VL of < 1000 copies/mL at the last measurement before the estimated time of transmission. However, VL at the exact time of transmission was unknown and VL > 1000 copies/mL cannot be excluded. This review suggests sexual transmission is very rare with recent VL < 1000 copies/mL however, future research is required to establish precise risk estimates.PROSPERO Number: CRD42023476946.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".