Monday, May 23, 2022

Is It Possible To Transmit Hiv When Undetectable

Can My Viral Load Continue To Change

Lets Stop HIV Together Undetectable PSA

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.

How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent The Sexual Transmission Of Hiv

Research conducted in serodiscordant couples shows that consistent and correct use of HIV treatment to maintain an undetectable viral load is a highly effective strategy to prevent sexual HIV transmission for both heterosexual and same-sex male couples. Evidence from this research shows that when people are on successful treatment and engaged in care they do not transmit HIV through sex.

Results from a large two-phase observational study known as PARTNER/PARTNER2 showed that treatment and an undetectable viral load prevents sexual HIV transmission in both heterosexual and same-sex male couples in the absence of other forms of HIV prevention . The first phase of the study included heterosexual and same-sex male couples, and the second phase continued with only same-sex male couples. In this study there were many unprotected sex acts when the HIV-positive partners viral load was undetectable approximately 36,000 among heterosexual couples and 76,000 among same-sex male couples enrolled in the study. By the end of the study, there were no HIV transmissions between couples in the study when the HIV-positive partner was on treatment and had an undetectable viral load. However, 16 new HIV infections were transmitted from a sex partner outside of the relationship.

Is It Possible To Transmit Hiv Through Saliva

It is only possible to transmit HIV through saliva if there are co-factors such as bleeding gums, throat or urethral infections or a high viral load. Saliva does carry the HIV virus but in such low quantities that it is not possible to pass on the infection through kissing or spitting as long as there are no open sores or bleeding gums which result in the exchange of blood. Even cases involving the transference of HIV through saliva with co-factors are extremely rare. However, infection is possible through oral sex but to a much lower degree than anal or vaginal sex.

High concentrations of HIV are present in blood, vaginal fluid, semen, breast milk and any other body fluids which contain blood. Any exchange of these fluids between an infected and a non-infected person is highly risky. There are very low quantities of HIV in saliva so it is not possible to transmit HIV through saliva alone as, to become infected with the virus, there has to be a sufficient quantity of the virus transferred. There is no transmission risk from kissing unless both partners have severely bleeding gums or large open sores in their mouth. There is no risk from sharing glasses, spitting or sneezing as the virus cannot spread or maintain infectiousness in the open air.

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Ways Hiv Cannot Be Spread

HIV is not spread by:

  • Air or water
  • Mosquitoes, ticks or other insects
  • Saliva, tears, or sweat 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

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What Will Being Undetectable Mean For Me

Viral Suppression and Preventing HIV Transmission

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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How Hiv Treatment Makes U=u

With any virus, the likelihood of transmitting it depends on the amount of virus in your body. HIV drugs prevent the HIV virus from reproducing . When a combination of HIV drugs is working, the viral load usually goes down quickly after starting the drugs.

If HIV is not able to reproduce, it will not infect new cells in your body and your viral load remains low. With a low viral load, you are more likely to have a healthy immune system. The lower your viral load, the less likely you are to transmit HIV to others.

HIV drugs cannot cure HIV. Even when your viral load is undetectable, there are still ‘resting’ or latent HIV cells in areas of your body such as your gastrointestinal tract , brain, or bone marrow these are called ‘reservoirs.’ But having an undetectable viral load means there is barely a trace of virus to be found in body fluids that transmit HIV: your blood, vaginal fluids, or semen.

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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What We Know About Anal Sex

Anal sex is the riskiest type of sex for getting or transmitting HIV. Although receptive anal sex is much riskier for getting HIV than insertive anal sex, its possible for either partnerthe insertive or receptiveto get HIV.

An HIV-negative receptive partners risk of getting HIV is very high because the lining of the rectum is thin. HIV can enter the body through this lining during anal sex from body fluids that carry HIV, including semen or pre-seminal fluid .

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On average, an HIV-negative receptive partner has about a 1 in 70 chance of getting HIV every time they have receptive anal sex with a partner who has HIV.

Being the receptive partner for anal sex is about 13 times more risky for getting HIV from a partner with HIV than being the insertive partner.

For women, anal sex is about 17 times more risky for getting HIV from a man with HIV than vaginal sex.

If the partner with HIV takes HIV medicine as prescribed, and gets and keeps an undetectable viral load , you have effectively no risk of getting HIV through sex with that partner.

See how receptive anal sex compares to other sexual activities here.

An HIV-negative insertive partner 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. There is some evidence that circumcision decreases a mans risk of getting HIV during sex.

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Can You Get Hiv Through Oral Sex

HIV: Undetectable Equals Untransmittable

The risk of HIV from oral sex is very small unless you or your partner have large open sores on the genital area or bleeding gums/sores in your mouth.

There is only a slightly increased risk if a woman being given oral sex is HIV-positive and is menstruating. However, you can always use a dental dam to eliminate these risks.

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Hiv And Maternal Transmission

HIV can be passed from mother to child during pregnancy, delivery, or through breastfeeding. If left untreated throughout these stages, there is a 15-45% chance of an HIV positive mother transmitting the virus to their child . However there are treatment options to prevent this from happening.

If pregnancy occurs and there has been potential HIV exposure, ask a healthcare provider about getting tested for HIV as early as possible. Taking medications called antiretroviral therapy as prescribed can reduce the viral load so that the baby has a very low chance of contracting HIV .

A person with HIV should not breastfeed their child, as breast milk can transmit HIV. Even if a person is taking ART and their viral loads are undetectable, they should still not breastfeed.

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How Will I Know If I Am Undetectable

You cant tell if you have an undetectable viral load simply by how healthy you look and feel. The only way to know that your viral load is undetectable is by regular viral load monitoring.

Viral load monitoring involves a simple blood test to measure how many particles of HIV there are in a small sample of your blood . From this you and your healthcare worker can understand how well your ART is working.

A low viral load means that your ART is working well and controlling your HIV. If you have an undetectable viral load, it means that the amount of HIV in your body is so low that you can’t pass it on to other people through sex.

The point at which a viral load is classified as being undetectable may vary across different countries depending on the tests available. But so long as your viral load is under 200 copies per millilitre, youre considered virally suppressed and unable to pass HIV on.

The frequency with which you are offered viral load testing may vary depending on where you are and the services available to you. The World Health Organization recommends that when first starting ART, you should have your viral load measured after the first 6 months of treatment and again at 12 months. After becoming undetectable you should still receive viral load testing at least every 12 months. Depending on the resources available and your particular health status, your health worker may recommend that your viral load is monitored more often than this.

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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.

How Do We Know Treatment As Prevention Works

Undetectable = Untransmittable

Large research studies with newer HIV medications have shown that treatment is prevention. These studies monitored thousands of male-female and male-male couples in which one partner has HIV and the other does not over several years. No HIV transmissions were observed when the HIV-positive partner was virally suppressed. This means that if you keep your viral load undetectable, there is effectively no risk of transmitting HIV to someone you have vaginal, anal, or oral sex with. Read about the scientific evidence.

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How Is Hiv Spread Through Blood

You can become infected if you have contact with the blood of someone who has HIV. Blood-borne infection with HIV can occur through:

  • sharing injection equipment when using drugs
  • getting tattoos or body piercings with unsterilized needles
  • accidental needle sticks
  • splashing blood in your eyes

HIV is NOT spread by blood passed through insect bites.

If you inject drugs, the best thing to do is to use new or sterilized injection equipment every time. You can also take a daily medication called pre-exposure prophylaxis to lower your risk of HIV. Learn more about PrEP.

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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How Long Do I Need To Be On Art And Be Undetectable In Order Not To Transmit Hiv

First, being on ART and being undetectable are two different things. When you start on ART, it takes a while for the medication to do its job. Generally, if the ART is working, it should reduce the amount of virus in your blood to an undetectable level within a few months. Once you are undetectable , you then need to stay undetectable for at least six months before your HIV is considered untransmittable. In other words, you need at least two confirmatory tests that your viral load is less than 200 copies/mL at the beginning and the end of a six-month period before you can use your undetectable status as a method of HIV prevention.

If I Have A Viral Load Blip Could I Pass On Hiv

HIV: Journey to Undetectable

People with an undetectable viral load sometimes experience what are called blips in their viral load. Their viral load increases from undetectable to a low but detectable level before becoming undetectable again on the next test.

For example, your viral load may temporarily rise to 60 copies/ml or 150 copies/ml. This should not be a cause for concern.

Remember that in the PARTNER and Opposites Attract studies, undetectable was defined as below 200 copies/ml. These studies showed that transmission does not occur below this level.

However, a blip could indicate a problem if it happens around the same time as missed or late doses of your medication, or if your viral load stays above detectable on two consecutive tests.

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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.

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