Undetectable = Untransmittable

Undetectable = Untransmittable

By Keith Reynolds | Sep 29 2017

Jury’s In: those of us who have an undetectable viral load cannot pass HIV to our partners. This news adds another option to what we can do to prevent passing HIV – gone are the days where condoms are our only option. The Prevention Access Campaign launched the campaign, “undetectable=untransmittable” or “UequalsU” in 2016 to bring the most up-to-date research about viral load and HIV to those of us who aren’t reading the latest medical journals with our morning coffee.  Here are the major messages from the campaign:

  1. Viral load refers to the amount of HIV in our body. For those of us living with HIV and getting medical care, a measure of viral load is one of the things that our doctors typically check when we do bloodwork.   
  2. One of the things HIV medications do is lower the viral load in our bodies. Less virus in our bodies means good news for our health, and less HIV to potentially pass on to a sex partner. When we get regular HIV care and follow our doctor’s instructions for our medications on an ongoing basis, many of us will be able to have a viral load that is undetectable.
  3. An undetectable viral load means that there is such a small amount of HIV in our body, that the tests used by labs are not able to find the HIV in our blood. The HIV is still there, but in very small amounts. It is only by taking HIV medications regularly that we can lower our viral load to the point it is undetectable. 

What this means is, if our viral load is consistently undetectable for 6 months, we continue to take our HIV medications, and we get tested and treated for STIs as needed, we can’t pass HIV to our sex partners. This information means those of us living with HIV can know that when we are having sex, we can’t pass HIV to our partners. We can also be confident in sharing this information with our partners.  While this news is exciting for those of us with an undetectable viral load, for many of us who are youth, getting and/or keeping an undetectable viral load is not always our reality. To put the UequalsU campaign into perspective, three youth shared their reactions to UequalsU:

UequalsU is all about understanding the new medical facts about our HIV statues. Those of us who are HIV+ may choose to take treatment, and this will be different for everyone. Part of treatment means at each appointment we’ll undergo the very icky moment of blood test. Don’t worry! Nurses and doctors are not collecting it to give it away to a vampire that is running low on blood; what they are actually doing is looking to see the amount of HIV in our blood, and how our overall health is as it relates to HIV. So, when they have the results, they can let us know how our health is doing, and what we can do together for our health. For me, I am always looking for the magic words, “Your viral load is undetectable.’’ Undetectable is the best thing to hear because it means I’m doing really well with my treatment. When my doctor said that I’m undetectable, it was like singing in the rain because I know that what I’m doing is going to keep me living long, and that if I were to start a relationship I would be able to confidently say I won’t pass HIV to my future partner or future children. -Samira

I believe the news of undetectability will reduce the stigma around HIV/AIDS. The information that we have now on undetectabilty and untransmissability will remove the stigma surrounding the sex we have which will, in turn, create a more pleasurable experience for all of us, as well as a safer one. U = U is going to be a major step in removing serophobia from our communities. Whether or not those of us living with HIV have an undetectable viral load, the UequalsU campaign helps our communities – which are often ignorant about HIV – confront the facts about HIV. Simply, the fact is whatever our viral loads, there is no place for stigma and exclusion of people living with HIV. -Dylan

When I think about the messaging behind U=U, change is the first thing that comes to mind.  We see that that the science has finally caught up to what our community has been purporting these last several years.  Being diagnosed with HIV in 2015 was a very transformative time for me.  I had just finished my undergraduate degree in Toronto, I was getting ready to move to Vancouver for graduate school, I started a new job, and I had just started seeing my current boyfriend.  My diagnosis was the last thing that was on my mind; I began to compartmentalize that part of my identity.  It was not until I had moved to Vancouver that I was ready to navigate what it meant to be a person living with HIV.  I found a community that welcomed me with love, compassion, and understanding.  It is very clear that this new messaging around being undetectable will bring about positive change within the poz community.  People will be able to engage in destigmatizing conversations and negotiate the kinds of sex they truly want; and for me, it means I can live a more honest and authentic life as a person living with HIV.  –Colt

For those of us living with HIV, whether or not we have an undetectable viral load, there are a number of options we can use to avoid passing HIV onto our partners. Condoms (external or internal) prevent HIV, STIs and pregnancy, our HIV-negative partners can use medications to prevent becoming HIV-positive, and we can choose kinds of sex that don’t or are less likely to pass HIV. Since HIV first impacted our communities, we have seen that those of us living with HIV do a lot to prevent passing the virus to our partners. And, whether we are talking about UequalsU or any other piece of health information, we believe that we get to make the decisions that are right for us.

Whether or not our viral load is undetectable, stigma has no place in sexual health messaging or services being provided to people living with HIV! For us, the UequalsU campaign is just one part of our efforts to Resist Stigma as a community!

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