How The Study Worked
The study focused on HIVpositive French men who requested sperm washing from 2002 through 2011. All men were heterosexual and had a stable relationship with a female partner. All men were taking combination antiretroviral therapy.
The researchers measured virus in paired blood and semen samples from each man. The tests used to measure HIV could detect as few as 40 copies of HIV RNA per milliliter of blood and 100 copies per milliliter of semen.
In one third of the men, the researchers also used more sensitive tests to measure HIV RNA in blood and HIV DNA in blood cells. HIV DNA is the form HIV takes when resting inside cells that it infects. These sensitive tests could detect 1 copy of HIV RNA per milliliter of blood and 5 copies of HIV DNA per 150,000 blood cells.
When Your Viral Load Is Undetectable
Eventually, you want to have an undetectable viral load — one so low that a lab test canât find it. When you have an undetectable viral load, you canât spread the virus to your sexual partner.
Even when you reach that point, you must remember that the virus is still in your body. To keep it at bay, take your medicine every day, just as your doctor prescribes. If you skip doses or stop treatment, your viral load can go up quickly. The chance that you can transmit the virus to your partners also goes way up.
Tell your doctor if you have trouble sticking to your treatment. Talk to your partners, too. Discuss other kinds of protection, like condoms, safer sex, or pre-exposure prophylaxis . This daily pill can lower the chance of infection in people who donât have HIV by up to 99%.
How Can You Prevent Getting Or Transmitting Hiv Through Sex
There are several ways to prevent getting or transmitting HIV through anal or vaginal sex.
If you are HIV-negative, you can use HIV prevention medicine known as pre-exposure prophylaxis or post-exposure prophylaxis to protect yourself. You can also use other HIV prevention methods, below.
If you have HIV, the most important thing you can do to prevent transmission and stay healthy is to take your HIV medicine , every day, exactly as prescribed. People living with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners. Read more about Treatment as Prevention. There also are other options to choose from, below.
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Taking Hiv Medication To Stay Healthy And Prevent Transmission
If you have HIV, it is important to start treatment with HIV medication as soon as possible after your diagnosis.
If taken every day, exactly as prescribed, HIV medication can reduce the amount of HIV in your blood to a very low level. This is called viral suppression. It is called viral suppression because HIV medication prevents the virus from growing in your body and keeps the virus very low or suppressed. Viral suppression helps keep you healthy and prevents illness.
If your viral load is so low that it doesnt show up in a standard lab test, this is called having an undetectable viral load. People living with HIV can get and keep an undetectable viral load by taking HIV medication every day, exactly as prescribed. Almost everyone who takes HIV medication daily as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment.
There are important health benefits to getting the viral load as low as possible. People living with HIV who know their status, take HIV medication daily as prescribed, and get and keep an undetectable viral load can live long, healthy lives.
There is also a major prevention benefit. People living with HIV who take HIV medication daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.
How Do I Talk To My Partner About Their Risk Of Acquiring Hiv
People living with HIV can involve their partners in their treatment plans. Research shows that adhering to treatment often can improve with support from loving relationships and from the community.
Pre-exposure prophylaxis , in which an HIV-negative person takes antiretroviral medication to prevent infection, can be part of the conversation. Learn more about PrEP.
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How Long Do I Need To Be On Art And Be Undetectable In Order Not To Transmit Hiv
First, being on ART and being undetectable are two different things. When you start on ART, it takes a while for the medication to do its job. Generally, if the ART is working, it should reduce the amount of virus in your blood to an undetectable level within a few months. Once you are undetectable , you then need to stay undetectable for at least six months before your HIV is considered untransmittable. In other words, you need at least two confirmatory tests that your viral load is less than 200 copies/mL at the beginning and the end of a six-month period before you can use your undetectable status as a method of HIV prevention.
Thats Good News For All
Undetectable viral load is game-changing news for both poz and neg guys. If youre HIV poz, undetectable comes with amazing health benefits as well as the assurance that you are keeping the guys you play with safe.
And if youre neg, having sex with a poz guy whos undetectable can give you the confidence that you wont get HIV. UVL puts safety first for everyone.
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How Does Hiv Treatment And An Undetectable Viral Load Work To Prevent Hiv Transmission
HIV treatment, also called antiretroviral therapy , works by controlling the replication of HIV in the body that is, it reduces HIVs ability to make copies of itself. When HIV replication is controlled, the amount of virus in the blood and other bodily fluids decreases. Research tells us that as the amount of virus in the body decreases, so does the risk of HIV transmission. When successful treatment lowers the viral load to undetectable levels, this can reduce or even eliminate the risk of HIV transmission.
HIV treatment usually consists of a combination of three antiretroviral drugs taken daily. Newer HIV treatments are safer, simpler and more effective than when treatment was first introduced. The power of treatment today is so profound that many people who start effective treatment soon after becoming HIV positive will have a near-normal lifespan.
For most people the virus becomes so well controlled that within three to six months of starting treatment the amount of virus in their blood becomes undetectable by routinely used tests. Most viral load tests used in Canada cannot detect HIV in the blood if there are fewer than 40 to 50 copies/ml of the virus but some newer tests can detect as few as 20 copies/ml. The virus is still present in very low amounts in the body when the viral load is undetectable.
Bites That Break The Skin
A bite that opens the skin and causes bleeding can lead to the transmission of HIV. However, according to the
goes up with increasing viral load.
Viral load is highest both during the early phase of HIV and without treatment with antiretroviral medications. Taking antiretroviral medications every day can reduce a persons viral load to very low levels that cant be detected through testing.
In this way, antiretroviral medications arent only a treatment, but an important tool for prevention. When HIV cant be detected in the blood, a person living with HIV cant sexually transmit the virus to a partner without HIV.
This principle is called Undetectable = Untransmittable and has been supported by
up to 6 months of taking antiretroviral medications each day to achieve an undetectable viral load.
A persons viral load is said to be durably undetectable when all test results are undetectable for at least 6 months after the first undetectable result.
Theres no need to be afraid of having casual contact with someone who is living with HIV. The virus doesnt live on the skin and cant live very long outside of the body.
Additionally, bodily fluids like saliva, tears, and sweat dont transmit HIV either.
Therefore, casual contact, such as holding hands, hugging, or sitting next to someone who has HIV, wont transmit the virus. Closed-mouth kissing isnt a threat either.
These include:
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How Can Service Providers Improve The Uptake And Correct Use Of Hiv Treatment And An Undetectable Viral Load To Prevent The Sexual Transmission Of Hiv
Educational and counselling activities for people whether they have HIV or are at risk for HIV should include information on the HIV prevention benefits of treatment and an undetectable viral load, along with information on the other highly effective ways to help prevent HIV. These include PrEP, PEP, condoms for sex and new equipment for using drugs. Encourage clients to choose the combination of strategies that will work most effectively for them as there are multiple approaches to HIV and STI prevention that can be combined in different ways. Discuss how the use of HIV treatment to maintain an undetectable viral load fits into a comprehensive plan for sexual health including regular STI testing and safer sex practices.
Education and counselling on the use of this HIV prevention strategy should include a discussion about the large body of evidence showing that people on HIV treatment who maintain an undetectable viral load do not transmit HIV through sex. Education should also include the factors necessary for maximizing the effectiveness of this strategy. Emphasize the following:
You can also lead or support efforts to improve awareness of the use of HIV treatment to maintain an undetectable viral load as a prevention approach among a range of service providers in your area including doctors, nurses, pharmacists and non-clinical staff at community-based organizations.
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About Undetectable And Hiv
Chances are youve probably heard of the term undetectable, undetectable viral load or UVL when chatting to friends or potential sexual partners, on apps or social media, or in blogs, magazines and medical journals.
But, what does it mean?
Having an undetectable viral load not only improves a HIV positive guys overall health, but it also means he wont transmit HIV to his partners. When a HIV positive guy is on treatment, within six months he can, in most cases, achieve an UVL.
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People Living With Hiv Who Are On Antiretroviral Treatment And Maintain An Undetectable Viral Load For At Least Six Months Do Not Sexually Transmit Hiv
For more up to date news and information on Undetectable Viral Load, please visit Ending HIV.
When someone first acquires HIV, the virus replicates quickly in their body. During this stage, their viral load is high, and it is very easy for the virus to be transmitted to sexual partners, especially through unprotected anal sex. Many new HIV infections in New Zealand happen when someone is living with HIV and doesnt know it. As time goes on, their viral load drops and the use of HIV treatment medication can usually bring their viral load down to undetectable levels.
New research shows that starting treatment as soon as possible can make it easier for people living with HIV to get an undetectable viral load sooner and live longer and healthier lives.
Being undetectable does not mean cured – as of yet, there is still no cure for HIV. But it does mean that a person living with HIV will have more health benefits, including not being able to transmit HIV through condomless sex.
For some people, it could take a while to to get their viral load to an undetectable level, and some people might not ever be able to get there despite adhering to medications. Its important that people living with HIV dont feel pressured or expected to have an undetectable viral load.
Having an undetectable viral load also does not provide protection from any other STIs like syphilis, gonorrhoea, or LGV.
After I Begin Hiv Treatment How Long Does It Take For The Risk Of Sexually Transmitting Hiv To Become Effectively Zero
There is effectively no risk of sexual transmission of HIV when the partner living with HIV has achieved an undetectable viral load and then maintained it for at least six months. Most people living with HIV who start taking antiretroviral therapy daily as prescribed achieve an undetectable viral load within one to six months after beginning treatment.
A persons viral load is considered durably undetectable when all viral load test results are undetectable for at least six months after their first undetectable test result. This means that most people will need to be on treatment for 7 to 12 months to have a durably undetectable viral load. It is essential to take every pill every day to maintain durably undetectable status.
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What Is Involved In The Consistent And Correct Use Of Hiv Treatment To Maintain An Undetectable Viral Load For Hiv Prevention
The consistent and correct use of HIV treatment to maintain an undetectable viral load includes:
- high adherence to medications, to achieve and maintain an undetectable viral load
- regular medical appointments to monitor viral load and receive adherence support, if needed
Regular testing and treatment for sexually transmitted infections is also important because HIV treatment does not protect against STIs.
A person on HIV treatment needs to work with their doctor to determine an appropriate schedule for medical checkups and viral load monitoring.
How Will I Know If I Am Undetectable
You cant tell if you have an undetectable viral load simply by how healthy you look and feel. The only way to know that your viral load is undetectable is by regular viral load monitoring.
Viral load monitoring involves a simple blood test to measure how many particles of HIV there are in a small sample of your blood . From this you and your healthcare worker can understand how well your ART is working.
A low viral load means that your ART is working well and controlling your HIV. If you have an undetectable viral load, it means that the amount of HIV in your body is so low that you can’t pass it on to other people through sex.
The point at which a viral load is classified as being undetectable may vary across different countries depending on the tests available. But so long as your viral load is under 200 copies per millilitre, youre considered virally suppressed and unable to pass HIV on.
The frequency with which you are offered viral load testing may vary depending on where you are and the services available to you. The World Health Organization recommends that when first starting ART, you should have your viral load measured after the first 6 months of treatment and again at 12 months. After becoming undetectable you should still receive viral load testing at least every 12 months. Depending on the resources available and your particular health status, your health worker may recommend that your viral load is monitored more often than this.
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Viral Load And Pregnancy
Taking antiretroviral medications during pregnancy and delivery can greatly reduce the risk of passing HIV on to a child. Having an undetectable viral load is the goal during pregnancy.
Women can take HIV medications safely during pregnancy, but they should talk to a healthcare provider about specific regimens.
If an HIV-positive woman is already taking antiretroviral medications, pregnancy may affect how the body processes her medication. Certain changes in treatment might be needed.
If I Have A Viral Load Blip Could I Pass On Hiv
People with an undetectable viral load sometimes experience what are called blips in their viral load. Their viral load increases from undetectable to a low but detectable level before becoming undetectable again on the next test.
For example, your viral load may temporarily rise to 60 copies/ml or 150 copies/ml. This should not be a cause for concern.
Remember that in the PARTNER and Opposites Attract studies, undetectable was defined as below 200 copies/ml. These studies showed that transmission does not occur below this level.
However, a blip could indicate a problem if it happens around the same time as missed or late doses of your medication, or if your viral load stays above detectable on two consecutive tests.
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If My Viral Load Is Undetectable Can I Transmit Hiv To Other People
Im very happy to say that we know the answer to this. If you are undetectable, and have been on HIV medications for at least six months, and you continue that treatment, the risk of transmitting HIV is effectively zero.
This finding has been well-established over the last six to seven years . After studying thousands of couples, over many years, research has shown that if an HIV-positive person is on effective HIV medications for at least six months, is undetectable, and stays on their HIV medications, they will not transmit HIV to other people.
Medications To Achieve Undetectable Levels
For people who are newly diagnosed, there are five different types of medication that can treat HIV, some of which are used in combination with others. Once a person finds the right regimen, it typically takes three to six months to suppress the virus to an undetectable level, according to the U.S. Department of Health and Human Services.
Some experts say that HIV medications can work even faster. Monica Gandhi, MD, MPH, an infectious-diseases physician at the University of California at San Francisco, says that San Francisco General Hospital’s RAPID program gets patients started on antiretrovirals the same day they’re diagnosed and that some people achieve undetectable status in two months or less.
Unfortunately, some barriers prevent people with HIV from achieving a suppressed virus. Some infected people dont know they have HIV, others aren’t given a prescription, and still others don’t take the medications or only take them sporadically.
The technology is there, Dr. Gandhi says, but it’s a question of access and compliance.
“But for a individual who goes to see a doctor, Gandhi adds, they have a 100 percent chance of finding a regimen that, if taken every day, will suppress their viral load.
Thats good news, both for people with HIV and for their partners. But to maintain an undetectable status, the HIV-positive partner must stick to his or her ART regimen, and only the partner with HIV can make that commitment.
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