Viral Load At Different Stages
During the first few weeks after someone gets HIV, viral load is usually very high typically several million viral copies per millilitre of blood . There is a considerable risk of passing on HIV at this point. In fact, many people acquire HIV from someone who has only recently acquired it themselves .
After this period of early infection, viral load usually drops. A typical viral load in someone not taking treatment may be 50,000 copies/ml. There is still a considerable risk of passing HIV on.
After starting HIV treatment, viral load usually falls rapidly. Within three to six months, most peoples viral load has become undetectable.
Most clinics in the UK report a viral load as undetectable if it is below 20-50 copies/ml. However, if your viral load remains below 200 copies/ml , there is no risk of passing HIV to your sexual partners. There is no need to worry if your viral load goes slightly above the detection limit of 20-50 copies/ml.
When viral load is detectable, this indicates that HIV is replicating in the body. If the person is taking HIV treatment but their viral load is detectable, the treatment is not working properly. There may still be a risk of HIV transmission to sexual partners.
What We Know About Vaginal Sex
When a woman has vaginal sex with a partner who has HIV, HIV can enter her body through the mucous membranes that line the vagina and cervix. Most women who get HIV get it from vaginal sex. Even if a womans male partner withdraws or pulls out before ejaculating, she can still get infected because pre-seminal fluid can carry HIV.
On average, an HIV-negative woman has about a 1 in 1,250 chance of getting HIV every time she has vaginal sex with a man who has HIV.
On average, a woman with HIV has about a 1 in 2,500 chance of transmitting HIV every time she has vaginal sex with an HIV-negative man.
For an HIV-negative woman, anal sex is about 17 times more risky than vaginal sex for getting HIV from a partner with HIV.
For a woman with HIV, anal sex is about 3 times more risky than vaginal sex for transmitting HIV to an HIV-negative partner.
If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , their partner has effectively no risk of getting HIV through sex. See how receptive vaginal sex compares to other sexual activities here.
On average, an HIV-negative man has about a 1 in 2,500 chance of getting HIV every time he has vaginal sex with a woman who has HIV.
On average, a man with HIV has about a 1 in 1,250 chance of transmitting HIV every time he has vaginal sex with an HIV-negative woman.
If Im Undetectable Is There A Chance My Viral Load Will Become Detectable Again
Being undetectable does not mean that you are cured of HIV. There are three instances when your HIV viral load might come back and be detectable again.
The most common instances are so-called viral blips. Blips are when your HIV levels become slightly detectable, but at a very low level, and then goes back to being undetectable again. People may experience viral blips when they take their HIV medications every day. Viral blips are usually due to issues in the lab, such as some slight error in the test or in the test conditions in the lab. Occasionally they are due to a slight but true increase in the viral load due to a stress such as an illness or a vaccine. Viral blips, in which the viral load goes right back down to undetectable soon, are considered harmless. There is no appreciable chance that a person with a viral blip will transmit HIV to another person.
People also become detectable when they stop taking their HIV medications or take them only partially. It may take between a week to several weeks after stopping HIV treatment for HIV to become detectable again, but people will see the levels of virus in their body go up to detectable levels.
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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 “body 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.
Hiv/aids: Why Don’t Some People Get Sick
It’s a medical mystery that has baffled scientists for nearly two decades. How do some HIV-infected people, about one in 300, keep the virus at such a low level that they don’t get sick with full blown AIDS, even if they don’t take medicine?
Now, researchers at Massachusetts General Hospital and Harvard University think they have a clue.
It’s in the genes, they say, specifically five amino acids in a protein called HLA-B.
“We found that, of the three billion nucleotides in the human genome, just a handful make the difference between those who can stay healthy in spite of HIV infection and those who, without treatment, will develop AIDS,” said study co-author Dr. Bruce Walker, MD, director of the Ragon Institute, in a statement.
Never heard of HLA-B?
Well, the protein plays a vital role in the immune system by grabbing onto pieces of a virus and bringing them into the cell membrane where they get tagged for destruction by “killer” T cells. Researchers believe the shape and structure of five critical amino acids on HLA-B help determine whether the immune system can outfox HIV viruses or not.
At this point it’s high science, but understanding how some people naturally fight HIV, researchers say, is critical to curing it for everyone else.
“We have a long way to go before translating this into a treatment for infected patients and a vaccine to prevent infection,” Walker said, “but we are an important step closer.”
The study was published in Science.
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Reducing The Risk Of Hiv Transmission
The most effective way to prevent HIV transmission during sex is to use a condom. Get a condom ready before any sexual contact occurs, since HIV can be transmitted through pre-ejaculate, vaginal fluid, and from the anus.
Lubricants can also help reduce the risk of HIV transmission by helping to prevent anal or vaginal tears. The right lubricants also help prevent condoms from breaking. Only water-based lubricants should be used with condoms, because oil-based lube can weaken latex and sometimes cause condoms to break.
The use of a dental dam, a small plastic or latex sheet that prevents direct contact between the mouth and the vagina or anus during oral sex, is also effective at reducing the risk of HIV transmission.
For people who may have a higher risk for contracting HIV, preventive medication is an option. Pre-exposure prophylaxis medication is a daily antiretroviral treatment.
Everyone at increased risk of HIV should begin a PrEP regimen, according to a recent recommendation from the US Preventive Services Task Force. This includes anyone who is sexually active with more than one partner, or is in an ongoing relationship with someone whose HIV status is either positive or unknown.
Although PrEP does provide a high level of protection against HIV, its still best to use condoms as well. PrEP provides no protection against STIs other than HIV.
Understanding A Negative Result
What does a negative test result mean?
A negative result doesnt necessarily mean that you dont have HIV. This is due to the window period.
If you test again after the window period, have no possible HIV exposure during the window period, and the result comes back negative, you do not have HIV.
If you have certain risk factors, you should continue getting tested at least once a year. Learn more about who is at risk for HIV and why they should be tested more often.
If I have a negative result, does that mean my partner is HIV-negative also?
No. Your HIV test result reveals only your HIV status.
HIV is not necessarily transmitted every time you have sex or share needles, syringes, or other drug injection equipment. And the risk of getting HIV varies depending on the type of exposure or behavior. It is important to remember that taking an HIV test is not a way to find out if your partner has HIV.
Its important to be open with your partners and ask them to tell you their HIV status. But keep in mind that your partners may not know or may be wrong about their status, and some may not tell you if they have HIV even if they are aware of their status. Consider getting tested together so you can both know your HIV status and take steps to keep yourselves healthy.
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Hiv And Stds Are Spread In The Same Ways
You can get HIV or an STD by having sex without a condom with a person who is already infected. HIV and some STDs can be passed from a mother to her baby while she is pregnant, during birth or through breast feeding. HIV and some STDs can also be spread by sharing drug “works” with someone who has HIV or an STD.
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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Blood Transfusions And Organ Donation
The risk of contracting HIV from a blood transfusion, other blood products, or organ donation is now extremely rare in the United States. All donated blood or blood products in the United States are tested for several types of bloodborne pathogens, including HIV.
Blood donations that test positive for HIV are safely discarded and dont enter the blood supply. The risk of HIV transmission during a blood transfusion is conservatively estimated to be
, there are no known instances of HIV being transmitted by receiving a tattoo or piercing. However, its technically possible for transmission to occur if equipment or ink is reused or shared.
If You Dont Know You Or Your Partners Hiv Status
If you are negative and dont know your partners status, it is always better to assume they are HIV positive.
If you dont know your own HIV status, also assume you are HIV positive. This is so you dont put anyone at risk.
Rather than assuming your partners are negative, this will stop you taking risks that you are not happy with.
This will help you feel in control during sex. It should stop you feeling anxious or worried afterwards.
Your HIV status is only as accurate as your last test result. This needs to include any risks you took in the window period before the test. It also needs to include any risks you have taken since.
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What Does This Mean For Me
‘Undetectable equals Untransmittable’ has been a life-changing finding for many people living with HIV. It means that if you are on effective treatment with an undetectable viral load, you do not have to worry about passing on HIV through sex, even if you do not use a condom.
This has helped many people living with HIV have more fulfilling sex lives and less anxiety around sex.
Knowing that ‘Undetectable equals Untransmittable’ is especially useful for people wishing to have a child. Couples in which one person has undetectable HIV and the other is HIV negative can have unprotected sex in order to conceive.
However, the law on HIV may not have caught up with the science. In some countries, condomless sex without disclosing your HIV status is a criminal offence, regardless of the likelihood of HIV transmission. For information on specific countries, visit our page on criminalisation laws around the world.
“For as long as your viral load stays undetectable, your chance of passing on HIV to a sexual partner is zero.”
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.
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How Can My Hiv+ Partner Help
In addition to keeping themselves healthy, your HIV positive partnerâs treatment plan can also help you stay HIV negative. This is called treatment as prevention, and it works because the less of the virus someone has in their system, the harder it is for them to transmit it to someone else. In fact, an extremely exciting recent study found no instances of transmission between partners when the HIV positive partnerâs viral load count was less than 200 copies per ml of blood .
So if your partner takes their medication and gets their viral load count down, they are also helping your health! Everybody wins.
Hiv And Std Criminalization Laws
As of 2021, 35 states have laws that criminalize HIV exposure.The laws for the 50 states, the District of Columbia, and Puerto Rico were assessed and categorized into four categories.
General criminal statutes, such as reckless endangerment and attempted murder, can be used to criminalize behaviors that can potentially expose another to HIV and or an STD. Many states have laws that fall into more than one of the categories listed above. For this analysis, only HIV-specific laws are captured for states with both HIV-specific laws and STD/communicable/infectious disease laws. Only HIV or STD/communicable/infectious disease laws are captured for states with both HIV or STD/communicable/infectious disease laws and sentence enhancement statutes.
Criminalize or Control Behaviors Through HIV-Specific Statutes and Regulations
Criminalize or Control Behaviors Through STD/Communicable/Infectious Diseases Specific Statutes
Sentence Enhancement Statutes
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Undetectable: Your Burning Questions Answered Get An Hiv Doctors Answers To Your Burning Questions About Undetectable Viral Loadand What It Means For Your Health And Your Sex Life
In 2013, BETA published an article about viral suppression and having an undetectable viral load. A lot has changed since the original article was published.
To keep us up-to-date, Barry Zingman, MD, the medical director of the AIDS Center at Montefiore Medical Center and professor of medicine at Albert Einstein College of Medicine joins us to answer our questions about what it means to be undetectable, the risk of HIV transmission, and more.
How Do You Get Hiv From Sex
HIV is transmitted through semen , vaginal fluid, blood, and anal mucus. During sex without a condom the bodily fluids from one person can pass into the body of their sexual partner. This can happen through the mucous membranes of the penis, vagina and rectum, or sores in the mouth and throat.
You can only get HIV from someone who is living with HIV and has a detectable viral load.
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