Things To Know About Hiv Suppression
A vial of blood
A vial of blood
Development of antiretroviral drugs to treat HIV has turned what was once an almost always fatal infection into a manageable chronic condition. Daily antiretroviral therapy can reduce the amount of HIV in the blood to levels that are undetectable with standard tests. Staying on treatment is crucial to keep the virus suppressed. NIAID-supported research has demonstrated that achieving and maintaining a durably undetectable viral load not only preserves the health of the person living with HIV, but also prevents sexual transmission of the virus to an HIV-negative partner.
What If I Miss One Dose Will My Viral Load Become Detectable Again
If you are undetectable, and have been taking your medications every day recently, your viral load will very likely stay undetectable even if you miss one dose. The HIV medications are so good these days that it can take a week or even sometimes up to several weeks or more for peoples viral loads to become detectable after medications are stopped.
Can Prep Help With U=u
PrEP is a medication that uses a combination of drugs to keep HIV from reproducing and growing within the body. PrEP needs to be used before a person who does not have HIV comes into contact with the virus. For instance, if a person is dating a partner who is living with HIV, they would need to take PrEP before having sexual contact with their partner.
The same medication that is used for PrEP is also used for PEP a treatment that is used after a person is exposed to HIV but is not HIV positive. PEP can help to control the viral load and lowers the chances of HIV contraction by keeping the persons viral load undetectable.
Now, if a person is HIV positive and their viral load is detectable, they do not qualify for PrEP or PEP. There are HIV treatment drugs such as antiretroviral therapy, which can help to decrease their viral load but this does not cure them of HIV.
So, the answer here is yes PrEP can keep a person undetectable by ensuring they do not contract HIV in the first place even if they are exposed. PEP can also be used to keep a person undetectable after they are exposed.
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Benefits Of Having An Undetectable Viral Load
There are important health benefits to having a suppressed or undetectable viral load. People with HIV who know their status, take HIV medicine as prescribed, and get and keep an undetectable viral load can live long and healthy lives.
There is also a major prevention benefit. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load will not transmit HIV to their HIV-negative partners through sex. This is sometimes called treatment as prevention or undetectable = untransmittable .
In addition to preventing sexual transmission of HIV, studies have shown that there are other prevention benefits of taking HIV medicine to get and keep an undetectable viral load:
What Does Untransmittable Mean
HIV can be transmitted through contact with bodily fluids from a person living with HIV to another. However, if a persons viral load is undetectable, it cannot be transmitted to another person. Therefore, undetectable = untransmittable.
One of the most common ways that HIV is transmitted is through sexual intercourse and contact with seminal, pre-seminal, vaginal, or rectal fluids. HIV can also be transmitted through blood via shared needles or blood transfusions. Finally, babies may contract HIV during birth or shortly thereafter, as HIV can be transmitted through vaginal birth or breastmilk.
There are several measures people can take to prevent HIV transmission.
The first is to practice safe sex by always using a condom and getting tested regularly for STDs and STIs. Another way to safeguard yourself from HIV transmission is by taking PrEP, a medication regimen that protects a person before they are exposed to HIV.
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Do I Still Need To Use Condoms If Im Undetectable
HIV medicines only prevents HIV transmissionthey dont prevent other sexually transmitted infections , either from you to others, or others to you. Condoms are still very useful, especially if youre having sex with multiple partners or in situations when you dont know if your partner could have a detectable HIV viral load or might have an STI. I do recommend that people strongly consider using condomsbut its often for the other STIs or due to an unknown HIV status of their partners.
Get And Keep An Undetectable Viral Load
- If you take HIV medicine and get and keep an undetectable viral load, you will not transmit HIV to your sex partner.
- Having an undetectable viral load likely reduces the risk of HIV transmission through sharing needles, syringes, or other drug injection equipment , but we dont know by how much.
- Getting and keep an undetectable viral load is the best thing you can do to stay healthy and protect others.
- Learn more about HIV treatment.
What if I cannot get an undetectable viral load?
Some people face challenges that make it hard to stick to a treatment plan. A few people cannot get an undetectable viral load even though they take HIV medicine as prescribed. If your viral load is not undetectableor does not stay undetectableyou can still protect your partners by using other prevention options.
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What Is Effective Treatment
We are using the term effective treatment to mean that someone is on treatment, taking it as prescribed and has an undetectable viral load. In the UK this is usually classed as a viral load below 20 copies/ml.
The Partners PrEP study found that there remains a transmission risk within the first six months of treatment as the HIV positive partners viral load takes time to come down.
Therefore effective treatment means someone has been taking it as prescribed for at least six months and has an undetectable viral load.
Over 90% of people diagnosed with HIV in the UK are on effective treatment and undetectable, and therefore are not infectious .
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How Is Hiv Not Spread
HIV is not spread by:
- Mosquitoes, ticks, or other insects
- Saliva, tears, sweat, feces, or urine that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
- Other sexual activities that dont involve the exchange of body fluids .
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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.
What Is Viral Suppression
Antiretroviral therapy keeps HIV from making copies of itself. When a person living with HIV begins an antiretroviral treatment regimen, their viral load drops. For almost everyone who starts taking their HIV medication daily as prescribed, viral load will drop to an undetectable level in six months or less. Continuing to take HIV medications as directed is imperative to stay undetectable.
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Testing Positive On Nucleic Acid Tests
In addition to antibody tests, we also have HIV tests that detect viral RNA not necessarily live virus, but parts of the virus genetic material. These are called nucleic acid tests, and they are able to detect very early HIV infections. These tests are not used as often for screening as antibody tests , because results take longer and the test is more expensive. Usually, RNA tests are used to confirm an HIV positive diagnosis after someone tests positive on an antibody test or to see if a person is responding well to treatment.
Some of these viral detection tests are able to detect virus at very low levels. Some research HIV RNA assays can measure HIV RNA levels down to the single copy levels.
We commonly say someone is undetectable if they have a viral load less than 20 copies/mL or 50 copies/mL. Research studies have defined undetectable as any viral load less than 200 copies/mL.
So even if a person has a viral load less than 50 copies/mL or 20 copies/mL, viral RNA will still be detected with one of these viral detection tests.
What Does Undetectable Viral Load Mean
Antiretroviral therapy is medication that helps to keep the viral load in the body under control. For many people, HIV treatment can substantially lower viral load levels, sometimes to undetectable levels.
A viral load is considered undetectable if a test cant quantify the HIV particles in 1 milliliter of the blood. If a viral load is considered undetectable, it means the medication is working.
According to the Centers for Disease Control and Prevention , a person with an undetectable viral load has effectively no risk of sexually transmitting HIV. In 2016, the Prevention Access Campaign launched the U=U, or Undetectable = Untransmittable, campaign.
A word of caution: undetectable doesnt mean the virus particles arent there, or that a person no longer has HIV. It simply means that the viral load is so low that the test is unable to measure it.
HIV-positive people should consider continuing on antiretroviral medications to remain healthy and keep their viral loads undetectable.
Studiesshow that there may be temporary viral load spikes, sometimes called blips. These spikes can happen even in people whove had undetectable viral load levels for an extended period.
These increased viral loads may occur between tests, and there may be no symptoms.
Viral load levels in blood or genital fluids or secretions are often similar.
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What Will Being Undetectable Mean For Me
Having an undetectable viral load means that your ART is effectively controlling your HIV. This will protect your immune system and help you to stay in good health.
Being undetectable also means that you dont have to worry about passing HIV onto your sexual partners. For many people this is just as important to them, giving them relief from the anxiety of passing HIV on. Some people find that knowing theyre undetectable makes it easier to with others, as it can be reassuring for others to know that your health is protected and you cant pass it on too.
Testing Positive On Hiv Antibody Tests
Since the early days of the HIV epidemic, we have used antibody tests to test for HIV. Antibody tests are the most affordable and accessible HIV tests. They are the most common types of HIV tests at testing sites around the world because they provide rapid, on-the-spot results.
Antibody tests do not detect HIV. Instead, they detect antibodies that the immune system produces in response to HIV infection.
Want to know more about different types of HIV tests, how they work and how early they detect HIV? Check out thiseasy-to-read guide from Avert orread this Q& A by the CDC.
WHAT ARE ANTIBODIES?
Our immune systems develop antibodies in response to all kinds of pathogens. Anytime you get sick or get any kind of infection, your body builds up a defense system and creates antibodies to try and fight that specific infection off. If these antibodies are successful, some infections will go away but the antibodies never do. They will remain in your body, helping to protect you from getting the same infection in the future.
In this way, antibodies allow our bodies to remember a specific infectious agentlike a particular strain of the fluand then respond to it more quickly if exposed to it again in the future. Once we develop antibodies to a virus we may have those antibodies for life or for many years.
HIV ANTIBODIES
HIV ANTIBODIES WHEN YOURE UNDETECTABLE
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How Often Should Viral Load Testing Be Done
According to the United States Health and Human Services clinical HIV guidelines, patients on a stable, suppressive ARV regimen, viral load should be repeated every 3 to 4 months or as clinically indicated to confirm continuous viral suppression. Clinicians may extend the interval to 6 months for adherent patients whose viral load has been suppressed for more than 2 years and whose clinical and immunologic status is stable. In high-resource countries, providers are increasingly conducting viral load testing on an annual basis.
The World Health Organization guidelines, most often followed in low and middle income countries, however, note on page 148, Routine viral load monitoring for early detection of treatment failure: obtain and review result by 6 months after ART initiation, 12 months after ART initiation and yearly thereafter.
What Will Happen If I Skip My Arv For 2 Days
Missing doses of HIV medicines can reduce their usefulness and increase the possibility of developing drug resistance, which makes certain HIV drugs lose their effectiveness. If you realize you have missed a dose, go ahead and take the medication as soon as you can, then take the next dose at your usual scheduled time.
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When To Speak With A Doctor
HIV medicines may sometimes cause side effects. These are mostly manageable, but some may be serious. The side effects vary among mediations. However, a person should not start a new treatment or skip, stop, or cut down their current medications unless a doctor advises doing so.
When starting on ART, it is advisable to ask a doctor about the usual side effects and what to do if they occur.
A person already on ART should speak with a doctor if they experience any of the following:
- nausea and vomiting
- pain, numbness, or tingling in the hands and feet
- arms and legs feeling week
What Is Treatment As Prevention
Treatment as Prevention refers to taking HIV medicine to prevent the sexual transmission of HIV. It is one of the most highly effective options for preventing HIV transmission.
People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral loada very low level of HIV in the bloodcan live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex. This is sometimes called undetectable = untransmittable .
TasP works when a person with HIV takes HIV medicine exactly as prescribed and has regular follow-up care, including routine viral load tests to ensure their viral load stays undetectable.
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Does Hiv Treatment Always Work
About one in six people on their first HIV treatment regimen either never have an undetectable viral load or their treatment stops working in the first year. During the second year on treatment, the chance of your therapy ceasing to work is about one in twenty and this declines further over the next decade to about a one-in-fifty chance of failure in any one year.
So, the longer youve been on a particular HIV therapy, the less likely it is to stop working. Almost everyone who goes on to a second or third regimen reduces their viral load to an undetectable level.
If someones treatment does not result in viral load becoming undetectable, this is usually because they are having problems taking their treatment as prescribed, i.e. they dont take all their pills at the right time, without missing doses. Occasionally missing a dose of medication is unlikely to cause your viral load to become detectable again, but frequently missing doses may lead to a detectable viral load and should be avoided.
If you are having problems sticking with your treatment, talk to your doctor and they may be able to find a drug combination that suits you better.
Can My Viral Load Continue To Change
Yes, your viral load can continue to change. This would usually be a result of factors to do with your adherence , or other health issues. Regular viral load monitoring will help you stay on top of these changes, so you can manage your health accordingly.
Your viral load usually drops quickly after first starting treatment, however it may be a while before it reaches a point where its undetectable. Most people who adhere properly to their treatment become undetectable after about six months, but its important that you have a viral load test to confirm this.
While changes to viral load can occur, they should be relatively uncommon for people who adhere properly to their medication and are otherwise in good health. Your viral load monitoring appointments are there to help you to identify and respond to any changes in your viral load.
These appointments also give you time to discuss any difficulties you are having with your medication. Often big life changes, like starting a new relationship or moving to a new place, can make adherence more difficult. Your healthcare worker can help you with any new challenges and work with you to stay healthy and keep your viral load low.
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Never Share Needles Syringes Or Other Drug Injection Equipment
- Use new, clean syringes and injection equipment every time you inject.
- Many communities have syringe services programs where you can get new needles and syringes and safely dispose of used ones. SSPs can also link you to substance use disorder treatment, testing, and care and treatment for infectious diseases.
- Some pharmacies sell needles without a prescription.
How can I protect my baby?