Viral load dynamics in plasma and semen when ART is initiated during early HIV-1 infection.

We assessed HIV viral load in plasma and semen during primary HIV infection using serial samples of semen and plasma during the first 24 weeks after diagnosis in untreated participants and those who started ART immediately at diagnosis. In the absence of treatment, semen VL was >1,000 copies/mL in almost all specimens (83%) collected between 2-10 weeks after the estimated date of HIV acquisition and remained >1000 copies/mL in 35% of untreated participants at the last observed time point. Thus, in the absence of ART, semen VL remained at a level consistent with transmissibility throughout primary infection.