1. Undetectable= Uninfectious? Community Response To “The Swiss Statement” Women’s perspective Silvia Petretti Positively Women, Community Development Manager BHIVA Autumn Conference, London 9 th October 2008

2. Consultation: Positively Women Case Work Team and staff Taking Part members Positively Women Islington Support Group PozFem UK Str8talk

3. Cons Confusing after so many years of condom promotion Makes negotiating condoms more difficult Assumptions on the sex heterosexuals have… Not encouraging a holistic approach to sexual health Problems with chronic herpes How does it apply to drug users? Sense of false security

4. I find it really difficult to know what to think. Over the 16 years since I was diagnosed, I have been so strong on always using a condom, to protect my husband from HIV and to ensure that at least one of us remains alive for the children. So now what do I think? On the one hand, my husband is keen for us to try to have unprotected sex again[…]but I am pretty sure that if for some reason my viral load rose and he became positive I would just feel so overwhelmed with guilt[…]What would happen, for instance, if we stopped using condoms and then 10 years from now my husband turned out to be HIV positive and he or his relatives charged me with transmission? Where would I stand then? Poz Fem member, September 2008 Yahoo group discussion

5. Pros Supports existing practices Easier to conceive Motivating to improve adherence Decreases pressure to use PEP Decreases fear of condom breaks Issues for discordant couples to the forefront Informed risk taking Supports increase access to treatment and VL testing in less developed countries

6. ‘I think that after all this time of using condoms […] it does give me a degree of tranquillity and ease in my sexuality –I can relax more because I feel protective and protected also […] If a condom broke I would probably feel a bit easier thinking about the Swiss guidelines.’ Poz Fem member, September 2008 Yahoo group discussion

7. Stigma and discrimination Challenges the view of PLWHA as vectors of infection and potentially dangerous However… General public and many PLWHA haven’t heard about it It can reinforce stigma of those groups it doesn’t apply to or who fail to achieve undetectable VL