Undetectable = Untransmittable

Undetectable = Untransmittable

Undetectable: HIV+ and unable to transmit the virus sexually.

What is a viral load? What does it mean if it’s undetectable?

An HIV+ individual will regularly have blood work done by their physician. One of the tests done is a viral load test, which quantifies the amount of HIV virus in the person’s blood. When someone adheres to their HIV medication regimen, the amount of circulating virus becomes so low that it is undetectable by these tests. A term often used to describe this undetectable status is “virally suppressed”- when an individual has less than 200 viral copies/mL of blood. Someone who has maintained an undetectable status for at least 6 months cannot pass the virus on to sexual partners, thus undetectable=untransmittable.

Science behind U=U

Many studies have shown that when someone maintains an undetectable viral load for at least six months, there is zero risk of sexually transmitting the virus. These studies disprove the common assumption that there is always some risk of HIV transmission when one partner is HIV+.

The PARTNER study followed 1166 serodiscordant (one partner is HIV+ and one partner is HIV-) couples, including both gay and straight couples. The study did not include data from couples who used PEP, PrEP, or those who used condoms as prevention for transmitting HIV. The only form of HIV prevention was adherence to anti-retroviral therapy. Over 58,000 condomless sex acts were reported through the course of the four-year study. The study concluded that there were no phylogenetically linked cases of HIV transmission from the HIV+ partner to the HIV- partner.

The Opposites Attract study followed serodiscordant gay couples in Australia, Thailand, and Brazil, recording nearly 17,000 condomless sex acts. Again, there were zero cases of HIV transmission from the positive partner to the HIV negative partner.

The PARTNER 2 study continued the research from the first PARTNER study, following 783 gay serodiscordant couples over the course of 8 years and recorded over 77,000 condomless sex acts. Again, when the HIV+ partner maintained an undetectable viral load, there were zero cases of HIV transmission between the two partners.

Research has continually showed that when an HIV+ individual maintains undetectable status for at least six months, there is zero risk of HIV transmission to any sexual partner. The medical community and the CDC have stated that using HIV treatment as prevention is a highly effective form of HIV prevention. The use of HIV treatment effectively reduces the risk of HIV transmission to zero.

Why do we care about U=U?

U=U is a game changer. This provides hope and empowerment to those living with HIV. Individuals living with HIV are often negatively impacted by stigmas and false ideas about what living with HIV is like. These studies have shown that it is safer to have sex with someone who is HIV+ and undetectable, than to have sex with someone of an unknown HIV status.