What Does Undetectable Viral Load Mean
Antiretroviral therapy is medication that helps to keep the viral load in the body under control. For many people, HIV treatment can substantially lower viral load levels, sometimes to undetectable levels.
A viral load is considered undetectable if a test cant quantify the HIV particles in 1 milliliter of the blood. If a viral load is considered undetectable, it means the medication is working.
According to the Centers for Disease Control and Prevention , a person with an undetectable viral load has effectively no risk of sexually transmitting HIV. In 2016, the Prevention Access Campaign launched the U=U, or Undetectable = Untransmittable, campaign.
A word of caution: undetectable doesnt mean the virus particles arent there, or that a person no longer has HIV. It simply means that the viral load is so low that the test is unable to measure it.
HIV-positive people should consider continuing on antiretroviral medications to remain healthy and keep their viral loads undetectable.
These increased viral loads may occur between tests, and there may be no symptoms.
Viral load levels in blood or genital fluids or secretions are often similar.
Stage : The Asymptomatic Stage
Once a person has been through the acute primary infection stage and seroconversion process, they can often start to feel better. In fact, HIV may not cause any other symptoms for up to 10 or even 15 years .
However, the virus will still be active, infecting new cells and making copies of itself. HIV can still be passed on during this stage. If left untreated, over time, HIV infection will cause severe damage to the immune system.
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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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.
Monogamy And Open Relationships
You and your partner should talk to each other and agree whether your relationship will be monogamous or open .
There are risks in not discussing it and assuming that your partner agrees with you. Some people who think theyre in a monogamous relationship find out that their partner has had sex with others.
Both monogamous and open relationships can bring benefits and challenges. For example, some couples in monogamous relationships say they enjoy feeling both physically and emotionally committed to only one person. However, they may feel frustrated if they have a higher or lower sex drive than their partner.
Some couples in open relationships say they enjoy the sense of freedom and variety it can bring, but it can also highlight any feelings of jealousy or insecurity within the relationship. Mutual trust and honest communication are vital in both monogamous and open relationships.
If you both agree to be monogamous its important to discuss what would happen if either of you broke this agreement. If either of you feel that you must hide the fact that youve had sex outside the relationship, that can seriously threaten your relationship.
One advantage of monogamy is that no STIs are likely to come into your relationship.
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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 Does U=u Address Stigma
Since the beginning of the HIV epidemic, PLWH have been seen by many as “infectious”, feeding widespread discrimination and the unfortunate internalization of shame and stigma . HIV-negative people feared starting relationships with people living with HIV, and sex with a person living with HIV was seen as a possible health risk to the HIV-negative partner. U=U presents an opportunity to silence those damaging narratives by breaking the link between sex and HIV transmission.
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Hiv Medication And Infectiousness
In the UK, national guidelines currently recommend that anyone with HIV who is ready to commit to treatment should start it regardless of their CD4 count .
This means more people will be on treatment sooner and will have an undetectable viral load, so although reinfection is a theoretical risk, its unlikely.
If you had drug-resistant HIV, your viral load would be more likely to be detectable. You would be aware of that, meaning you could use protection to avoid the risk of reinfection. An undetectable viral load indicates your HIV isn’t resistant to your medication.
If you have a detectable viral load or dont know whether the person youre having sex with is undetectable, using condoms will prevent reinfection.
How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent Hiv Transmission To A Baby During Pregnancy And Birth
Without treatment, there is a 15% to 30% chance that a baby born to a person living with HIV will get HIV during pregnancy or delivery. Taking HIV treatment is the most effective way to reduce transmission to the baby. In fact, research has shown that if a pregnant person starts HIV treatment before conception and maintains an undetectable viral load throughout pregnancy and delivery, they do not transmit HIV to their baby. A short course of HIV medications is also given to the infant to prevent HIV transmission.
For the last three decades, a growing body of evidence has shown that babies are much less likely to be born with HIV if the pregnant parent is on treatment. A study of the French Perinatal Cohort, conducted between 2000 and 2011, is the largest study to show the impact of treatment on preventing HIV transmission to a newborn. This study found that no HIV transmissions occurred among 2,651 infants born to cisgender women who were on treatment before they conceived and throughout their pregnancy, who had an undetectable viral load at delivery and who did not breastfeed.
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Causes Of Hiv Infection
HIV is found in the body fluids of an infected person. This includes semen, vaginal and anal fluids, blood and breast milk.
It’s a fragile virus and does not survive outside the body for long.
HIV cannot be transmitted through sweat, urine or saliva.
The most common way of getting HIV in the UK is through having anal or vaginal sex without a condom.
Other ways of getting HIV include:
- sharing needles, syringes or other injecting equipment
- transmission from mother to baby during pregnancy, birth or breastfeeding
The chance of getting HIV through oral sex is very low and will be dependent on many things, such as whether you receive or give oral sex and the oral hygiene of the person giving the oral sex.
How To Take Truvada
Truvada, whether taken for treatment or as PrEP, is FDA-approved in the United States to be taken once daily, with or without food. Food does not impact absorption of either medication, but some may find that taking Truvada with food is easier on the stomach.
In some other countries, Truvada is also approved to be taken as PrEP in an on-demand fashion, so people can take two tablets anywhere from two to 24 hours before sex, then another pill 24 hours after the first two, and another pill 48 hours after the first two. Despite more recent evidence suggesting the effectiveness of on-demand PrEP in the United States, it has yet to receive FDA approval for this dosing strategy.
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Hiv During Pregnancy And Childbirth
Women living with HIV who are on treatment and have a stable undetectable viral load are extremely unlikely to transmit HIV to their baby during pregnancy and childbirth. There is a 1 in 1000 chance of transmitting HIV to the baby during pregnancy and delivery, when a woman is on antiretroviral treatment and has a viral load below 50 copies/ml .
HIV-positive women who are on treatment and have stable undetectable viral load, have a 1-2% chance of transmitting HIV to their baby if they breastfeed for 12 months.
So, although it is unlikely that a woman will transmit HIV to her baby when breastfeeding it is currently advised not to breastfeed.
What Is Viral Suppression
Antiretroviral therapy keeps HIV from making copies of itself. When a person living with HIV begins an antiretroviral treatment regimen, their viral load drops. For almost everyone who starts taking their HIV medication daily as prescribed, viral load will drop to an undetectable level in six months or less. Continuing to take HIV medications as directed is imperative to stay undetectable.
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Can My Viral Load Continue To Change
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.
Testing Positive On Nucleic Acid Tests
In addition to antibody tests, we also have HIV tests that detect viral RNA not necessarily live virus, but parts of the virus genetic material. These are called nucleic acid tests, and they are able to detect very early HIV infections. These tests are not used as often for screening as antibody tests , because results take longer and the test is more expensive. Usually, RNA tests are used to confirm an HIV positive diagnosis after someone tests positive on an antibody test or to see if a person is responding well to treatment.
Some of these viral detection tests are able to detect virus at very low levels. Some research HIV RNA assays can measure HIV RNA levels down to the single copy levels.
We commonly say someone is undetectable if they have a viral load less than 20 copies/mL or 50 copies/mL. Research studies have defined undetectable as any viral load less than 200 copies/mL.
So even if a person has a viral load less than 50 copies/mL or 20 copies/mL, viral RNA will still be detected with one of these viral detection tests.
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Can You Get Hiv From Someone Who Is Undetectable
The CDC confirms that patients with undetectable HIV cannot transmit the virus to others via sexual activity. Keep in mind, however, that undetectable HIV is different from undetected or undiagnosed HIV. A person with a detectable HIV load who does not realize they are infected can certainly spread the virus to others through syringe sharing or sexual contact. Furthermore, undetectable HIV loads can increase and become high enough to risk infecting others, particularly when ART is poorly managed or stopped altogether. For this reason, it is essential that HIV-positive patients undergo routine monitoring to ensure their HIV load remains undetectable.
All of our convenient HSNT locations in Denton County and Collin County offer comprehensive HIV/AIDS care, treatment, and monitoring, including the following services:
- HIV medication and therapy management
- Case management
What Does It Mean To Have An Undetectable Hiv Load
For those who are still unsure, an HIV-positive person can achieve undetectable levels after undergoing antiretroviral therapy . A level of a persons HIV viral load is what causes them to be more or less likely to transmit the disease. An undetectable viral load reduces the likelihood of transmission by 96 percent.
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How Can Service Providers Improve The Uptake And Correct Use Of Hiv Treatment And An Undetectable Viral Load To Prevent The Sexual Transmission Of Hiv
Educational and counselling activities for people whether they have HIV or are at risk for HIV should include information on the HIV prevention benefits of treatment and an undetectable viral load, along with information on the other highly effective ways to help prevent HIV. These include PrEP, PEP, condoms for sex and new equipment for using drugs. Encourage clients to choose the combination of strategies that will work most effectively for them as there are multiple approaches to HIV and STI prevention that can be combined in different ways. Discuss how the use of HIV treatment to maintain an undetectable viral load fits into a comprehensive plan for sexual health including regular STI testing and safer sex practices.
Education and counselling on the use of this HIV prevention strategy should include a discussion about the large body of evidence showing that people on HIV treatment who maintain an undetectable viral load do not transmit HIV through sex. Education should also include the factors necessary for maximizing the effectiveness of this strategy. Emphasize the following:
You can also lead or support efforts to improve awareness of the use of HIV treatment to maintain an undetectable viral load as a prevention approach among a range of service providers in your area including doctors, nurses, pharmacists and non-clinical staff at community-based organizations.
I Am Hiv Negative My Partner Has Been Undetectable For Over 6 Months And Now We Want To Have A Baby Why Does Our Doctor Say I Should Take Prep
The research on HIV transmission risk in couples trying to conceive when the HIV-positive partner is durably virally suppressed is still limited. If you are HIV negative and are trying to get pregnant with an HIV-positive partner’s sperm, it is generally recommended that you be on PrEP, regardless of your partner’s viral load. This is, however, a clinical judgment and a decision you and your doctor should make considering what is best for you, your partner, and your future child.
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Can A Person With Hiv Still Be Positive For Hiv
HIV ANTIBODIES WHEN YOURE UNDETECTABLE. Antibodies are still present in individuals living with HIVeven people who have suppressed their viral load. That means people living with HIV will still test positive for HIV on an antibody HIV test even if their viral load is undetectable. The virus may be undetectable,
When Your Viral Load Is Undetectable
Eventually, you want to have an undetectable viral load — one so low that a lab test canât find it. When you have an undetectable viral load, you canât spread the virus to your sexual partner.
Even when you reach that point, you must remember that the virus is still in your body. To keep it at bay, take your medicine every day, just as your doctor prescribes. If you skip doses or stop treatment, your viral load can go up quickly. The chance that you can transmit the virus to your partners also goes way up.
Tell your doctor if you have trouble sticking to your treatment. Talk to your partners, too. Discuss other kinds of protection, like condoms, safer sex, or pre-exposure prophylaxis . This daily pill can lower the chance of infection in people who donât have HIV by up to 99%.
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