A Viral Load Test Will Let You Know If You Are Undetectable
If youre living with HIV and want to know if youre undetectable, the right test for you is Similar to nucleic acid tests to detect HIV infection, HIV viral load tests measure the number of copies of HIV in a milliliter of your blood. Its recommended that people living with HIV getHIV viral load tests generally every 3 to 6 months, in addition toother lab tests that measure your CD4 count and more.
The bottom line is that if youre living with HIV and have an undetectable viral load, you will still test positive for HIV if you get tested. But, this is expected, and doesnt mean that your treatment is not working or that you arent undetectable. As always, check with your HIV care provider if you have questions about what HIV test is right for you, or what types of tests will give you the answers you need to best care for your health.
San Francisco AIDS Foundation offers a variety of free, confidential sexual health services includingHIV and STI testing,linkage to HIV care,PrEP and more.
How Do You Get Or Transmit Hiv
You can only get HIV by coming into direct contact with certain body fluids from a person with HIV who has a detectable viral load. These fluids are:
- Blood
- Semen and pre-seminal fluid
- Rectal fluids
- Vaginal fluids
- Breast milk
For transmission to occur, the HIV in these fluids must get into the bloodstream of an HIV-negative person through a mucous membrane open cuts or sores or by direct injection.
People 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.
How Is Hiv Spread From Person To Person
HIV can only be spread through specific activities. In the United States, the most common ways are:
- Having vaginal or anal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV. Anal sex is riskier than vaginal sex.
- Sharing injection drug equipment , such as needles, with someone who has HIV.
Less common ways are:
- From mother to child during pregnancy, birth, or breastfeeding. However, the use of HIV medicines and other strategies have helped lower the risk of mother-to-child transmission of HIV to 1% or less in the United States.
- Getting stuck with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers. The risk is very low.
HIV is spread only in extremely rare cases by:
- Having oral sex. But in general, the chance that an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.
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How Can You Get Hiv
HIV is found in the following bodily fluids of someone living with the virus:
- blood
- vaginal fluids
- breastmilk.
For you to get HIV, these bodily fluids need to get into your blood through a mucous membrane , via shared injecting equipment, or through broken skin .
There is not enough HIV virus in other bodily fluids, like saliva, sweat or urine, to transmit it from one person to another.
Someone living with HIV who has an undetectable viral load, meaning effective treatment has lowered the amount of virus in their blood to levels where it cannot be detected by a normal blood test, cannot pass on HIV.
A person living with HIV with a detectable viral load can pass the virus to others whether they have symptoms or not.
HIV is most infectious in the first few weeks after infection. At this time many people are unaware of their status.
The main ways you can get HIV are:
Is It True That There Is A Medication That Can Actually Prevent Someone From Getting Hiv
Yes. PrEP involves working with a healthcare provider to make an individualized plan to take medication to prevent HIV. Clinical trials have shown that PrEP is 99% effective at reducing sexual transmission of HIV. As of January 2019, the U.S. Food and Drug Administration has approved two medications as PrEP for HIV: Truvada , and Descovy . Note: Descovy is not approved for use by cis-gender women.
Key Points About PrEP:
- PrEP medication is prescribed by a healthcare provider. People interested in PrEP can work with a healthcare provider to determine how PrEP can be tailored to their individual needs and circumstances.
- PrEP is only for people who are not living with HIV. HIV testing should be conducted before starting PrEP and repeated every three months to make sure the person is not living with HIV. Testing may be done by the healthcare provider or at a conveniently located community-based organization , healthcare facility or lab.
- Some people benefit from counseling and support for taking the medication regularly. If this is needed, the person can talk with the healthcare provider, a trusted CBO, a peer worker, or other provider.
- People at risk for HIV are also at risk for sexually transmitted infections . Counseling about using condoms to prevent STIs and periodic screening for STIs is important and may be provided by the healthcare provider, a trusted CBO, or other provider.
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Whats The Risk For Types Of Oral Sex
Oral sex ranks very low on the list of ways HIV can be transmitted. Its more likely to transmit HIV through anal or vaginal sex. Its also possible to transmit the virus by sharing needles or syringes used for injecting drugs or tattooing.
However, the risk of contracting HIV through oral sex is not zero. The truth is, you can in theory still contract HIV this way. Theres just been from years of research to show that it has happened.
Why is it hard to get data?
Its difficult to know the absolute risk of transmitting HIV during oral sex acts. Thats because many sex partners who engage in oral sex of any type also engage in vaginal or anal sex. It may be difficult to know where the transmission occurred.
Fellatio carries some risk, but its low.
- If youre giving a blowjob. Receptive oral sex with a male partner who has HIV is considered exceptionally low-risk. In fact, a 2002 study found that the risk for HIV transmission through receptive oral sex was statistically zero.
- If youre receiving a blowjob. Insertive oral sex is an unlikely method of transmission, too. Enzymes in the saliva neutralize many viral particles. This may be true even if the saliva contains blood.
There are no documented cases of HIV being transmitted between partners through cunnilingus .
Anilingus , or rimming, has some risk, but it is negligible. Its especially low for receptive partners. In fact, the lifetime risk of transmitting HIV during rimming is
Get Help For Alcohol Abuse And Hiv
Alcohol can negatively impact the progression of HIV, both on the body and through behavior. There are no established safe levels of alcohol use for HIV+ individuals and alcohol consumption should be as limited as possible. If youre someone thats living with HIV and struggles with alcohol consumption, contact a treatment provider today. They can help to answer your questions.
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Can Sharing Dishes Or Drinking Glasses Spread Hiv
Dr. Flash clears up how HIV is and is NOT spread.
You cannot get HIV through casual contact like sharing dishes or drinking glasses, toilet seats, or holding hands. HIV is also not spread through sweat, tears, saliva, or kissing.
The most common way HIV is spread is through unprotected sex with someone with HIV who is not aware of their status or not on antiretrovirals . Unprotected here refers to sex without condoms or the use of medications that reduce the risk of passing HIV from one person to another. HIV can also be transmitted by sharing needles.
#AskTheHIVDoc is a video series from Greater Than AIDS featuring top HIV doctors providing answers to commonly-asked questions about HIV prevention, testing and treatment.
This information is shared for educational purposes only and should not be used as a substitute for professional medical advice. The views expressed are those of the featured medical professional and reflect information available to that professional at time of filming. Always consult a health care provider for any personal health decision.
While we make every effort to keep the medical information on our website updated, we cannot guarantee that the information reflects the most up-to-date research. Also, please note the views expressed by individuals who appear in Greater Than AIDS videos and other content are their own and are not made on behalf of any groups/organizations/associations.
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.
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Giving And Receiving Oral Sex
Though semen and pre-cum are not the only routes for contracting HIV, they are two avenues. Ejaculating during oral sex increases the risk. If you or your partner feels ready to ejaculate, you can remove your mouth to avoid exposure.
Barrier methods like latex or polyurethane condoms and dental dams can be used during every oral sex act. Change condoms or dental dams if you move from the vagina or penis to the anus, or vice versa.
Also use lubricants to prevent friction and tearing. Any holes in the barrier methods can increase exposure risk.
Abstain from oral sex if you have any cuts, abrasions, or sores in your mouth. Any opening in the skin is an avenue for possible viral exposure.
Be careful not to cut or tear your partners skin with your teeth during oral sex. This opening can expose you to blood.
Ways Hiv Can Be Transmitted
How is HIV passed from one person to another?
Most people who get HIV get it through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment . But there are powerful tools that can help prevent HIV transmission.
Can I get HIV from anal sex?
You can get HIV if you have anal sex with someone who has HIV without using protection .
- Anal sex is the riskiest type of sex for getting or transmitting HIV.
- Being the receptive partner is riskier for getting HIV than being the insertive partner .
- The bottoms risk of getting HIV is very high because the rectums lining is thin and may allow HIV to enter the body during anal sex.
- The top is also at risk because HIV can enter the body through the opening at the tip of the penis , the foreskin if the penis isnt circumcised, or small cuts, scratches, or open sores anywhere on the penis.
Can I get HIV from vaginal sex?
You can get HIV if you have vaginal sex with someone who has HIV without using protection .
Can HIV be transmitted from a mother to her baby?
HIV can be transmitted from a mother to her baby during pregnancy, birth, or breastfeeding. However, it is less common because of advances in HIV prevention and treatment.
Can I get HIV from sharing needles, syringes, or other drug injection equipment?
You are at high risk for getting HIV if you with someone who has HIV. Never share needles or other equipment to inject drugs, hormones, steroids, or silicone.
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Sharing Toothbrushes + Mouthguards
Ever forget a toothbrush and borrow your partners? The American Dental Association advises against this practice.
Toothbrushes may cause microtrauma. Someone elses saliva can come in contact with tears in your mucous membrane and transmit infection, explains Dr. Benninger.
Sharing toothbrushes is especially risky if you have a weakened immune system.
Have a cold, sore throat or other virus? Keep your toothbrush from touching the family toothpaste and others toothbrushes.
There are also several types of mouthguards those that protect your teeth, mouth and jaw during sports, and help keep you from grinding your teeth at night.
You can get stock mouthguards from a sporting goods store, bite and boil mouthguards from a drugstore, or custom-made mouthguards from your dentist.
Whatever type you use, mouthguards, which are porous, should never be shared. A 2007 study, reported in General Dentistry, found that mouthguards harbor bacteria, yeasts and molds.
Someone elses mouthguard may fit very poorly and cause microtrauma, says Dr. Benninger. This can expose your mucous membranes to infection.
If you wear a mouthguard, be sure to:
- Brush your teeth before inserting it.
- Clean it whenever you brush your teeth.
- Store it in a case.
- Avoid chewing on it.
What We Know About Hormone And Steroid Injecting
Hormone and steroid injections can be done safely by a health care provider. But theres a chance that someone can get or transmit HIV if an HIV-negative person uses needles, syringes, or other injection equipment after someone with HIV has used them. This is because the needles, syringes, or other injection equipment may have blood in them, and blood can carry HIV. Likewise, youre at risk for getting or transmitting hepatitis B and C if you share syringes because these infections are also transmitted through blood.
More Information About 1 out of every 10 HIV diagnoses in the United States is among people who inject drugs. This includes gay and bisexual men who inject drugs. 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 Information There 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.
There are medicines to treat hepatitis B. If youve never had hepatitis B, theres a vaccine to prevent it. There are medicines to treat hepatitis C, but they arent right for everyone. Theres no vaccine to prevent hepatitis C. Talk to your health care provider to learn more about hepatitis B and C.
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Other Types Of Transmission
In the past, HIV was spread by transfusion with blood products, such as whole blood or the “factor” used by hemophiliacs. Many people acquired HIV this way. The blood supply is now much more strictly tested and controlled in most countries. The odds of acquiring HIV from receiving blood or blood factor in countries like the US, the UK, and Canada are extremely low. For example, statistics from the US show that a person is more likely to be killed by a lightning strike than they are to acquire HIV from a blood transfusion. However, not every country screens all blood donations for HIV.
It is also possible to get HIV from skin grafts or transplanted organs taken from people living with HIV. Again, the risk is considered very low, as these “bodily products” must be strictly tested in the same way as blood products. Semen donations collected by sperm banks for artificial insemination are also considered “bodily products” and rigorously tested in high-resource countries. Private semen samples that are not processed by sperm banks or similar organizations may not have been tested. It is important for anyone receiving a private donor’s sperm for artificial insemination to have the donor tested for HIV.
If you are getting breast milk from a milk bank, it is important to ask if the bank tests the milk for HIV. Also, if your baby is getting breast milk from a wet nurse, it is important to make sure that she tests negative for HIV before giving her milk to your baby.
Does Menstruation Raise The Risk Of Hiv Transmission To Sexual Partners In Other Ways
If a person living with HIV is not taking antiretroviral treatment, levels of HIV in their vaginal fluid are likely to be higher during menstruation. Several studies have shown that viral load in the female genital tract can vary during the menstrual cycle, including a 2004 study which found that viral load levels in cervico-vaginal fluid tended to peak at the time of menstruation and fall to the lowest level just prior to ovulation, usually midway through the cycle. This would raise the risk of HIV transmission if preventative methods werent being used.
However, due to the effectiveness of HIV treatment, the bodily fluids of someone living with HIV are likely to have no detectable virus . Levels of HIV in blood and cervico-vaginal fluid are usually correlated, although viral load in vaginal secretions may fall more slowly than in blood so may not be undetectable for a few months after viral load has become undetectable in blood.
Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working.
If unsure, condoms, dental dams and PrEP are all options that reduce the risk of HIV infection during sex with a person living with HIV who is menstruating.
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