Do Viral Blips Increase The Chance Of Transmission
Small transient increases in viral load known as blips sometimes occur on effective ART when people are taking their medication as prescribed by a healthcare provider. After a blip, viral load typically returns to undetectable levels without any change in treatment. Viral blips have not been shown to increase the transmission of HIV. Unless the viral blips start to increase in frequency, they do not mean treatment isnt working and are normally not of concern to healthcare providers. For more information about viral load testing and frequency, please see question 11.
What Does It Mean To Be Durably Undetectable
Taking antiretroviral therapy daily as prescribed to suppress HIV levels leads to an undetectable status. A person is considered to have a durably undetectable viral load if their viral load remains undetectable for at least six months after their first undetectable test result. It is essential to continue to take every pill every day as directed to maintain an undetectable viral load.
Reducing Hiv Transmission Risk During Pregnancy
For HIV-positive women, ways to reduce the risk of transmission include:
- Taking antiretroviral medications before conception to reduce your viral load . The lower the viral load, the lower the risk of transmission to your unborn baby.
- Start antiretroviral HIV treatment as soon as you are diagnosed with HIV .
Being on treatment and having a low, or undetectable, viral load improves your immune system and health throughout pregnancy.
HIV-positive pregnancy today, with specialised care, is the same as HIV-negative pregnancy. Pregnancy does not make HIV progress any faster.
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What If There Is Detectable Hiv In Semen Vaginal Or Rectal Fluids But Not In The Blood
Scientists have found that HIV treatment that leads to an undetectable viral load in the blood also normally leads to an undetectable viral load in semen, vaginal, and rectal fluids.Occasionally enough HIV genetic material is found in semen, vaginal and rectal fluids to register as a detectable viral load in tests. But this is usually both very low and transient, and may not indicate the presence of entire, replicating virus. Such viral load results have not been found to increase transmission risk. Further, studies show that HIV RNA and DNA are most common soon after starting HIV treatment and are hardly seen after a year or more of an undetectable viral load in the blood.
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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More Sensitive Viral Load Testing
In NSW we now have more sensitive viral load testing, which means laboratories across the state can detect small amounts of the virus as low as 20 copies/mL. For HIV positive guys this means that they may see some change from their previous viral load readings from below 20 copies/mL a new, potentially higher number. This should not be a cause for concern as any viral load of 200 copies/mL or less is still considered undetectable. A person with this level of viral suppression cannot transmit HIV to their partners, however if you still feel concerned, we recommend speaking with your doctor.
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.
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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.
Sex Toys Fingering Fisting And Hiv
Sex toys, such as dildos, come into direct contact with rectal/vaginal fluids and mucous membranes. This means sharing an uncleaned dildo or other toy can pass on HIV. Using sex toys on your own has no risk.
There is no direct risk of HIV from fingering or fisting , but be aware of being rough. Damage to anal/vaginal tissues, especially if there is any bleeding, will increase risk of HIV transmission if you then have anal, vaginal or oral sex later.
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Why Is Viral Load Significant
For the past 20 years, evidence has been building up to show that the likelihood of passing on HIV is linked to the amount of the virus in the blood.
The landmark PARTNER 1 study looked at over 58,000 instances of sex without a condom, where one partner was HIV positive and one was HIV negative. There were zero cases of HIV transmission in couples where the HIV positive partner was on effective treatment .
The statistical certainty of the PARTNER 1 study was slightly lower for receptive anal sex with ejaculation than it was for vaginal sex though. The PARTNER 2 study , which looked only at instances of condomless anal sex, showed zero transmissions for both same-sex male couples and heterosexual couples.
With the results of both those studies, scientists have concluded that the chance of any HIV-positive person with an undetectable viral load transmitting the virus to a sexual partner is scientifically equivalent to zero.
Combined studies PARTNER 1 and PARTNER 2, with 2017s Opposites Attract study, together make up about 126,000 occasions of condomless sex between serodiscordant partners, with no transmissions.
This gives us the robust evidence to say, with confidence, that people on effective HIV treatment cant pass on the virus.
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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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Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine daily as prescribed can make the viral load very lowso low that a test cant detect it .
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.
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.
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What We Know About Oral Sex
The chance an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low. However, its hard to know the exact risk because a lot of people who have oral sex also have anal or vaginal sex. The risk is even lower if the HIV-negative partner is taking medicine to prevent HIV . If the partner with HIV is taking HIV medicine as prescribed and keeps an undetectable viral load , they have effectively no risk of transmitting HIV through sex, including oral sex.
But you can get other sexually transmitted diseases from oral sex. And, if you get feces in your mouth during anilingus, you can get hepatitis A and B, parasites like Giardia, and other bacteria like Shigella, Salmonella, Campylobacter, and E. coli.
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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What Does U=u Mean For Me If I Dont Have Hiv
You dont need to be afraid of getting HIV when your sexual partner is undetectable. As stated in the NAM aidsmap resource Undetectable viral load and transmission information for HIV-negative people, If you have a partner with HIV who is on treatment and has an undetectable viral load, they will not pass HIV on to you even if you dont use condoms. However, if you have other sexual partners, you could still contract HIV outside the relationship, possibly from someone who does not know that they have HIV. In these instances, prevention methods such as condoms or PrEP may still be important. It is important to remember that while an undetectable viral load will prevent transmission of HIV, it does not protect you or them from other sexually transmitted infections or unwanted pregnancy. Condoms are highly effective at preventing STIs. Condoms and other birth control options may be considered to prevent pregnancy as well.
How Hiv Spreads
HIV transmission can be prevented! There are ways to avoid, or at least reduce, contact with body fluids that transmit HIV. This fact sheet explains how.
Many people still do not understand how HIV is passed, or transmitted, from one person to another. Knowing the basics helps you avoid acquiring HIV. If you are living with HIV, these basics help you avoid transmitting HIV to someone else.
HIV is transmitted, or spread, through contact with the following body fluids:
- Blood including menstrual blood and any blood in saliva , urine , and feces
- Semen and other male sexual fluids
- Vaginal fluids
- Breast milk
When a person living with HIV is taking HIV drugs and their viral load has stayed at undetectable levels , that person cannot sexually transmit HIV to a partner. This is called treatment as prevention, and is often represented in the HIV community by the simple phrase undetectable equals untransmittable, or “U=U.” For more information on this development, see our fact sheet Undetectable Equals Untransmittable: Building Hope and Ending HIV Stigma.
HIV is also spread through contact with the body fluids below. However, usually only health care workers come into contact with these fluids. These fluids are:
- Cerebrospinal fluid around the brain and spinal cord
- Synovial fluid around the joints
- Amniotic fluid around a developing fetus
HIV is not spread through contact with these body fluids:
- Sweat
- Feces
- Urine
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What You Can Do
Not having sex is a 100% effective way to make sure you dont get or transmit HIV through sex. If youre sexually active, you can lower your risk by choosing sexual activities that carry a lower risk for HIV than anal sex. You can also do other things to reduce your risk, including taking medicine to prevent or treat HIV and using condomsthe right way, every time. Condoms and medicine to prevent or treat HIV are highly effective at preventing HIV if used correctly. But the medicines are much less effective if you dont take them daily as prescribed, and condoms can sometimes break or come off during anal sex. Using a water-based or silicone lubricant can help prevent condoms from breaking or slipping.
Talking openly and frequently with your partner about sex can help you make decisions that decrease your risk of getting or transmitting HIV. Learn more about how to get the conversation started.
Conversation Starters
Certain things about your sex and injection partners can put you at increased risk for getting or transmitting HIV. Explore Estimate the HIV Risk to learn more.
Explore other resources from CDC:
How Variable Is An Undetectable Viral Load Can This Change Over Time
HIV specialists have decades of experience managing antiretroviral therapy and are confident that you can remain uninfectious as long as you:
- take your medication every day as prescribed, and
- have your viral load checked regularly.
The presence of other sexually transmitted infections can potentially affect viral load, but in the PARTNER study there were no HIV transmissions even when other STIs were present. Those results held through the PARTNER 2 trial as well.
It is however important to remember that HIV treatment can only be successful if you have access to it and are taking it as prescribed.
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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.