How Do We Know That U=u What Is The Evidence
The evidence for U=U comes from several groundbreaking research studies and clinical trials. A study called HPTN 052, a randomized control trial to find out if ART can stop transmission of HIV in sero-different couples, enrolled more than 1,700 sero-different heterosexual couples who were randomly assigned to have the HIV-positive partner either immediately start ART or delay the start of ART. Over time, results among study participants showed no linked transmissions when the index partner was suppressed.
Another study, the PARTNER Study, which was carried out at 13 sites in Europe, had specific enrollment eligibility criteria that included undetectable sero-different couples who had condom-less sex. In what were a reported 58,213 sexual encounters during this study, there were no transmissions linked to the HIV-positive partners. In the summer of 2017, at the International AIDS Conference in Paris, the results of the Opposites Attract study were reported. It studied 358 gay male sero-different couples and found no linked HIV transmissions in nearly 17,000 condom-less sexual acts.4
The findings from these three key studies show that not only does being on effective antiretroviral treatment improve the health of each person with HIV, it also keeps them from transmitting HIV to sexual partners.
If I Am Hiv Negative And My Hiv
In the age of U=U, prevention and safer sex now means an undetectable viral load, condoms, PrEP, or a combination of these, depending on your needs and feelings. If your partner is undetectable, they cannot transmit HIV through sex. However, your decisions about condoms should be based on your sexual behavior and your partner sexual behavior. Remember that U=U only protects against HIV transmission! Condoms are still the best way to prevent STIs and pregnancy. If you are HIV negative and have other partners, you should consider and condoms or emergency PEP . However, if you are in a monogamous relationship and your partner is undetectable, you could choose not to use any other forms of protection. It is very important to have an open and honest conversation with your sexual partner and your doctor about which prevention methods are right and most comfortable for you.
How Do I Explain This To A Sexual Partner
If you have sexual partners who are not living with HIV, explaining U=U to them is likely to be mutually beneficial. If you had previously relied on other means of preventing HIV transmission , you may jointly decide that these methods are no longer necessary because of U=U.
It may take some time for an HIV-negative partner to accept the U=U message and to rely on it as the sole method of preventing HIV. Some HIV-negative people may reject the message or deny its accuracy. It may be helpful to direct your partner to information resources that explain the accuracy and significance of U=U. NAM has also produced a page for people who dont have HIV to help them understand the impact of an undetectable viral load on HIV transmission.
Another option could be for your partner to hear about U=U from a healthcare worker or another reliable and trusted source.
Despite sharing this information, some people may still not accept that U=U. In this kind of situation, it is important to find a balance between providing your partners with information and taking care of yourself.
Many people find it difficult to talk about sex, even with the person who is closest to them. If this is the case, you might want to discuss your concerns with someone at your HIV clinic, sexual health clinic or a support organisation. This can help you clarify your thoughts and what youd like to say.
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Learn What It Means To Reach An Undetectable Hiv Status And How You Can Get There
Are you living an HIV-positive life, or think youre experiencing HIV symptoms? If you dont already know your HIV status, its time to get tested and find out. While you may be afraid to learn what the results are, know one thing: youre in control and your life doesnt stop if your test results are positive.
It also doesnt mean you will be facing death, can never have sex again or any other negative stereotype you may have heard of before. In fact, you can live a long, healthy and fulfilling life and still enjoy sex by taking treatment for HIV.
Most people living with HIV who start taking daily antiretroviral therapy as prescribed reach an undetectable viral load, or undetectable status, within one to six months after beginning treatment.
What does it mean to reach an undetectable HIV status?
Your HIV treatment plan is designed to strengthen your bodys immune system to fight infections and keep you as healthy as possible. When you take HIV medication as prescribed, you have the chance to reach an undetectable viral load. In other words, you have a lower risk of transmitting HIV to a partner.
Among others, one major benefit of an HIV treatment plan is that it can reduce the amount of HIV in the blood flow, a process called viral suppression. Viral suppression is when the body has less than 200 copies of HIV per milliliter of blood.
Ready to know your status or talk to a healthcare provider about treatment? Visit TakeControlHIV.com.
What Does Undetectable = Untransmittable Mean
“Undetectable” means that a test cannot detect the virus in the blood of a person living with HIV, although extremely small amounts of HIV are still present. Someone who takes HIV treatment and is “undetectable” for 6 or more continuous months does not transmit the virus through sex.
Undetectable also means the virus is being well controlled by HIV meds. If a person with undetectable HIV stops their medications, the virus will return to a detectable level, which then increases the risk of transmission.
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What Is Important For This Approach To Work
For HIV treatment to provide protection against HIV transmission, a persons viral load needs to become and remain undetectable after they start treatment.
When a person begins treatment, it usually takes three to six months for their viral load to become undetectable. Most people will eventually have an undetectable viral load if they are using HIV treatment that is effective against their strain of HIV and take it as prescribed by their doctor.
A persons viral load needs to remain undetectable for at least six months before they can use this approach as an effective HIV prevention strategy. They must continue to have high adherence to treatment to maintain an undetectable viral load over time. The only way for them to know if their viral load remains undetectable over the long term is to have regular viral load tests.
However, not everyones viral load becomes and remains undetectable on treatment. The most common reason why a persons viral load remains detectable is low adherence to their medications, but drug resistance can also occur. When treatment fails, a person wont know that their viral load is detectable until they get another viral load test. Depending on the reason the treatment failed, a person may require a change in treatment, or they may benefit from adherence counselling, to bring their viral load back down to undetectable levels. The best options for moving forward should be discussed with a doctor.
If My Viral Load Is Undetectable Can I Transmit Hiv To Other People
Im very happy to say that we know the answer to this. If you are undetectable, and have been on HIV medications for at least six months, and you continue that treatment, the risk of transmitting HIV is effectively zero.
This finding has been well-established over the last six to seven years . After studying thousands of couples, over many years, research has shown that if an HIV-positive person is on effective HIV medications for at least six months, is undetectable, and stays on their HIV medications, they will not transmit HIV to other people.
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Does Hiv Treatment Always Work
About one in six people on their first HIV treatment regimen either never have an undetectable viral load or their treatment stops working in the first year. During the second year on treatment, the chance of your therapy ceasing to work is about one in twenty and this declines further over the next decade to about a one-in-fifty chance of failure in any one year.
So, the longer youve been on a particular HIV therapy, the less likely it is to stop working. Almost everyone who goes on to a second or third regimen reduces their viral load to an undetectable level.
If someones treatment does not result in viral load becoming undetectable, this is usually because they are having problems taking their treatment as prescribed, i.e. they dont take all their pills at the right time, without missing doses. Occasionally missing a dose of medication is unlikely to cause your viral load to become detectable again, but frequently missing doses may lead to a detectable viral load and should be avoided.
If you are having problems sticking with your treatment, talk to your doctor and they may be able to find a drug combination that suits you better.
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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Can You Get Hiv From Somebody Who Has Undetectable Levels
The core message is this: You cannot get HIV through sexual contact from somebody living with HIV who has had an undetectable viral load for at least six months . This has revolutionized the way people with HIV live and is also great news for public health workers and anybody else who has an interest in HIV prevention. Achieving undetectable levels gives everybody who has HIV a goal of treatment and is a powerful step towards ending the HIV epidemic.The common methods of HIV transmission include via sexual contact, from mother to child during pregnancy and childbirth, or through sharing needles during intravenous drug use. According to the Centers for Disease Control and Prevention , the risk of somebody with undetectable HIV transmitting the virus through any of these methods is as follows :
While attaining an undetectable level of HIV is one prevention method, There are other ways to decrease the spread of HIV. Practicing safe sex can decrease the risk of transmission in serodiscordant couples . Additionally, people who dont have HIV can take medications like Truvada, generic Truvada or Descovy as pre-exposure prophylaxis , which can reduce the risk of acquiring HIV from sex by about 99% when taken correctly .
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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Getting Pregnant When A Male Partner Is Hiv
If a male partner is HIV-positive, a procedure called sperm washing can be used to conceive. During this procedure a machine separates sperm cells from the seminal fluid, which can carry the virus. The washed sperm is then used to fertilise the womans egg using a special catheter inserted into the uterus.
If the male partner is on effective treatment and has a stable undetectable viral load, there is no risk of HIV transmission.
In-vitro-fertilisation may also be an option.
Do I Still Need To Use Condoms If Im Undetectable
Some couples decide that they want to stop using condoms once they or their partner are undetectable. Its important to remember that although theres no HIV risk, being undetectable doesnt prevent you from getting or passing on other sexually transmitted infections or stop unwanted pregnancies, so you will have to use other measures to avoid these.
If you do stop using condoms, its important that both you and your partner are comfortable with the decision. It can help to talk it through with a healthcare worker first. Its recommended that you have a least two viral load tests confirming that youre undetectable before relying on this for HIV prevention. If your partner is HIV-negative they may consider using PrEP as an extra precaution.
In couples where both partners are living with HIV, its important that you are both undetectable before deciding not to use condoms. This is because if one partner has a different strain of HIV or has developed drug resistance this can be passed on if they have a detectable viral load.
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Dating An Hiv Positive Man
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What Does It Mean To Be Undetectable For Hiv
A person who is undetectable still has HIV and is still HIV positive but to be undetectable means that the viral load cannot be detected through HIV tests. That is, if somebody receiving HIV treatment got an HIV test, the result may come back negative because of how well the treatment works to reduce the viral load.
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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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