Why Might People Living With Hiv Get Tested For Hiv
Because we connect with every single person who tests positive at one of our locations, we always ask why people get tested for HIV if theyve already been diagnosed in the past.
It happens for many reasons: People may test with a partner they havent yet disclosed to, they may have mental health concerns that come into play, or they need a letter of diagnosis to access services . Sometimes its because they are confused about the kind of information an HIV test will provide.
Now that weknow undetectable equals untransmittable , some people may have the misconception thatif youre undetectable, you will no longer test positive for HIV. They may think that if they test HIV-negative on an HIV test, theyll be able to show this to their sex partners as a way to prove that theyre undetectable and untransmittable. Or, they may think it will be easier to tell partners theyre HIV-negative rather than undetectable and uninfectious.
If you are living with HIV and have an undetectable viral load, you will still test positive for HIV. But, if you are living with HIV, have been taking HIV medications every day as directed, have a durably suppressed viral load and have been undetectable for at least six months, you will not transmit HIV to sex partners. You are not infectious. Thats the meaning of U=U.
Heres why you will still test positive for HIV even if you are undetectable.
Be Aware Of Potential Symptoms
Its important for anyone whos sexually active to know how to spot potential STI symptoms.
See a healthcare professional if you notice any of these:
- unusual discharge from the anus, penis, or vagina
- sores, bumps, or blisters on or around your genitals or anus
- rash on or around your genitals or anus
- genital itching
- unusual vaginal bleeding, like bleeding after sex or between periods
- changes in urination, like frequency, urgency, burning, or pain
Are certain activities higher risk?
Penis-in-anus sex has the highest risk for HIV transmission and contraction. The risk is higher for the receptive partner because the rectums lining is thin and can tear. This gives infected bodily fluids direct entry into the bloodstream. Though not as risky, penis-in-vagina sex is also considered a higher risk activity.
Its possible, but unlikely.
There are two main types of HIV:
- HIV-1. This is the type. It accounts for around 99 percent of all infections in the United States.
- HIV-2. This type is uncommon, less transmissible, and mostly concentrated in West Africa.
This involves the person with HIV taking ART through pregnancy and delivery, as well as giving the baby HIV medication for 4 to 6 weeks after birth.
How To Be Safe When Coming Into Contact With Infected Blood
A condom will act as a barrier against any contact with blood during sex.
As well as sex, sharing equipment for injecting drugs is a way blood can get into someones body. This can be avoided by using fresh needles and not sharing needles, syringes and other equipment.
If a woman has HIV, her menstrual blood also carries a risk of transmission if she has a detectable viral load.
If youre HIV negative and taking pre-exposure prophylaxis youll be protected against getting HIV if you come into contact with infectious blood.
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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%.
What We Know About Kissing
Theres no chance of getting HIV from closed-mouth or social kissing, and you cant get HIV through saliva. In some very rare cases, people have gotten HIV from deep, open-mouth French kissing because they and their partners had blood in their mouths from bleeding gums or sores . But the chance of getting HIV from deep, open-mouth kissing is much lower than from most other sexual activities.
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Stay On Top Of Oral Hygiene
Having open sores, ulcers, or cuts in your mouth can let HIV into your bloodstream. Practice good oral hygiene and avoid vigorous brushing that can cause your gums to bleed.
If Ds on the menu, give your mouth a once-over before heading out, er, or down.
Skip oral or use a barrier if you have open sores or cuts.
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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Get And Keep An Undetectable Viral Load
- If you take HIV medicine and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- We dont know whether getting and keeping an undetectable viral load prevents HIV transmission through sharing needles, syringes, or other drug injection equipment . It very likely reduces the risk, 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.
Tips To Avoid Hiv Transmission
To prevent the spread of HIV, follow these guidelines:
- Use condoms during sexual intercourse
- Never share needles and syringes
- Avoid multiple sexual partners
- Use lubricant during sexual intercourse to reduce friction and dryness which can cause vaginal tears and broken condoms.
- Speak to your doctor about PrEP , if you believe you are at high risk of exposure. PrEP is a daily medication used to help prevent HIV.
- Speak to your doctor about taking post-exposure prophylaxis if you think you’ve just been exposed to the virus. PEP is a type of antiretroviral medication that help prevent HIV if started within 72 hours after you might have been exposed to the virus.
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Is The Risk Zero
In real-world terms, yes, the risk is zero. Its not helpful to focus on the theoretical risks because it is never possible to prove zero risk in science. Through statistical analysis, the estimated risk will keep getting closer and closer to zero. Researchers agree we can confidently say that a person with HIV on ART with an undetectable viral load cannot transmit HIV to their sexual partners. When someone is virally suppressed, they are not infectious and the risk of transmitting HIV is scientifically equivalent to zero.
What About Sexually Transmitted Infections
It is important to remember that while HIV treatment will protect your partners from your HIV, it does not protect them or you from other sexually transmitted infections . For this reason, regular sexual health check-ups are recommended. Using condoms will help prevent STIs.
Another concern is whether having a STI could lead to an increase in viral load. This does happen to people with HIV who are not taking treatment: for instance, syphilis can double your viral load. HIV-negative partners are also more likely to get HIV if they have an STI.
But it is not the case for people taking HIV treatment who have an undetectable viral load. In the PARTNER and Opposites Attract studies, there was not a single HIV transmission even though many people had STIs.
If you maintain good adherence to HIV treatment, catching an STI will not raise your viral load from undetectable to detectable. Effective treatment prevents sexual transmission of HIV even if there are other STIs present.
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Theoretic Vs Documented Risk
Whenever discussing HIV risk, it is important to differentiate between a theoretic and documented risk. A documented risk is based on the actual number of cases to which HIV can be directly attributed to an act of oral sex. And, when looking through that lens, the risk of infection by oral sex is actually extremely low. Not zero, perhaps, but edging close to it.
In fact, according to a study from the University of California San Francisco’s Centers for AIDS Prevention Studies, the probability of HIV infection through unprotected oral sex was statistically zero, although the researchers went so far as to add that “we can not rule out the possibility that the probability of infection is indeed greater than zero.”
For an individual perspective, there are numerous factors and situations that can increase personal risk, sometimes considerably. By understanding and identifying these factors, you can make better, more informed choices about the sexual health of you and your partner.
Are There Any Side Effects To Being On Hiv Medicines
HIV medicines can cause side effects for some people. Most are manageable. Fortunately, there are numerous HIV medicines available today that people can take without serious side effects. If you do experience any side effects it is important to discuss these with your healthcare provider.
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What Are Viral Load Blips
Even if a person is durably undetectable and taking antiretroviral therapy daily as prescribed, they may experience small, transient increases in viral load called blips followed by a decrease back to undetectable levels. Having a blip is relatively common and does not indicate that antiretroviral therapy has failed to control the virus. Scientists are working to better understand what causes blips.
Dont Breastfeed Your Baby
- Do not breastfeed your baby, even if you have an undetectable viral load. Having an undetectable viral load reduces the risk of transmitting HIV to the baby through breastfeeding but doesnt eliminate the risk.
- The current recommendation in the United States is that mothers with HIV should not breastfeed their babies.
You should also have a pelvic examination and get tested for other sexually transmitted diseases during your pregnancy.
If I have an undetectable viral load, do my partner and I need to use anything else to prevent sexual transmission of HIV?
Getting and keeping an undetectable viral load prevents HIV transmission during sex. But there are situations when either partner may want to use additional prevention options.
- Using condoms can help prevent some other STDs.
- Using condoms or having your partner take PrEP can provide added peace of mind.
- Also consider using additional prevention options if you
- Are unsure, for any reason, that you have an undetectable viral load
- Have a high viral load
- Have trouble taking HIV medicine regularly
- Missed some doses since your last viral load test or
- Have stopped taking HIV medicine or may do so in the future.
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What Does This Mean For Reproductive Health Such As Conception Pregnancy And Breastfeeding/chestfeeding
Knowing that an undetectable viral load prevents HIV transmission through sex may be especially useful for people wishing to conceive a baby without using assisted reproduction methods. An undetectable viral load also dramatically reduces the risk of transmission during pregnancy, birth, or breastfeeding. For more information on HIV and reproductive health, such as pregnancy and breastfeeding/chestfeeding, please refer to the sources below.
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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No Risk Of Hiv Transmission Really
So is it true that if a HIV positive partner is on treatment and has a UVL sustained , then there is no risk of HIV transmission?
Yes!
In 2016, the PARTNER study from Europe found that the chance of HIV transmission where one partner had a UVL is negligible. In fact, there were zero partner-transmissions recorded in the study despite approximately 22,000 acts of condomless sex by gay couples. Additionally, PARTNER2 the extension study of PARTNER that aimed to gather data pertaining to mixed-HIV-status gay male couples found that after an additional 54,000 acts of condomless sex there were zero transmissions.
This is also supported by a large international study, led by the Kirby Institute here in Australia, the Opposites Attract study, which focused solely on gay and other men who have sex men from Australia, Brazil and Thailand, confirmed that HIV positive men who are on treatment and have an undetectable viral load do not transmit the virus to their partners.
So, between these two studies there has was a combined total of over 89,000 acts of condomless sex occurred between gay couples with zero transmissions!
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.
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Can You Get Hiv From Someone Who Is Undetectable
According to the CDC, if you take your HIV medication regularly and reach the point where your viral load is undetectable, you have effectively no risk of transmitting the virus to an HIV-negative partner through sex.
Having an undetectable viral load also helps prevent transmission to others through sharing needles, syringes, or other injection equipment though it doesnt eliminate it entirely.
If youre dating someone who has an undetectable viral load, youre not going to test positive for HIV just by having sex. That said, regular testing for HIV, especially if you have multiple sexual partners, is important.
Both the National Institute of Allergy and Infectious Disease and the CDC promote HIV treatment as prevention. Undetectable = Untransmittable or U=U is the guiding principle.
How Can Alcohol Put You At Risk For Getting Or Transmitting Hiv
Drinking alcohol, particularly binge drinking, affects your brain, making it hard to think clearly. When youre drunk, you may be more likely to make poor decisions that put you at risk for getting or transmitting HIV, such as having sex without a condom.
You also may be more likely to have a harder time using a condom the right way every time you have sex, have more sexual partners, or use other drugs. Those behaviors can increase your risk of exposure to HIV and other sexually transmitted diseases. Or, if you have HIV, they can also increase your risk of transmitting HIV to others.
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What If I Forget To Take My Meds One Day
Missing your meds once or occasionally will not change U=U.
This is because viral load will still be undetectable.
Good adherence is important, but you would probably need to miss HIV meds for 2-3 days before viral load becomes detectable.
If you do miss ART for several days, it is important to check your viral load is still undetectable before relying again on U=U. This is importance for avoiding drug resistance as well.
Good adherence is essential for U=U.
U=U depends on not regularly missing your HIV meds.
What We Know About Less Common Ways That You Can Get Hiv From Syringe Use
The risk for getting or transmitting HIV is very high if an HIV-negative person , other injection equipment with someone who has HIV. Its also possible to get HIV from tattooing or body piercing if the equipment has someone elses blood in it or if the ink is shared. The risk of getting HIV from tattooing or body piercing is higher when the person doing the procedure doesnt have a license. That person may be more likely to use unsafe practices like sharing syringes or ink. There are no known cases in the United States of anyone getting HIV this way.
More Information On average, an HIV-negative person has a 1 in 420 chance of getting HIV from a needlestick if the needle or syringe contains HIV-infected blood.
More InformationThere may be extremely tiny amounts of blood in syringes or works that you may not be able to see, but could still carry HIV. Be aware that HIV can survive in a used syringe for up to 42 days depending on temperature and other factors.
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