In the past few years, you may have started to come across the word ‘undetectable’, and it is a very important word for those living with HIV.
When we speak of ‘undetectable’, we would be referring to the viral load, which is the quantity of the virus that is detected by standard blood tests. Most people who are living with HIV and who are adhering to the antiretroviral treatment over a period of at least six months will find that their viral load has become undetectable. When this is confirmed by a health professional, then there is zero risk of transmitting HIV sexually. That is why undetectable = untransmittable.
Three large studies undertaken between 2007 and 2016 have shown that there was no single case of HIV transmission from persons with an undetectable viral load. These important studies have confirmed that serodiscordant couples, or couples where one partner is HIV-Positive and one partner is HIV-negative can have a healthy relationship, including a full sexual relationship.
What is an Undetectable Viral Load?
The ‘viral load’ is the amount of HIV present in the blood. It cannot be known what the viral load is, unless it is measured by a healthcare professional who would be assessing how well the antiretroviral treatment is working. Keep in mind that the body takes time to adjust to new medicines, and that is why being on treatment does not automatically mean that the virus is undetectable. There is also a chance that the viral load may fluctuate, but that usually occurs when a new treatment regime is started, or if the person is not taking treatment as indicated.
An ‘undetectable’ diagnosis would be one where the HIV levels in the body are under 40 copies/ml. Obviously it cannot be known whether your levels are below or above this level without professional support. This is why it is recommended that your viral load is monitored every 2-4 months by a healthcare professional to ensure that you are, and remain undetectable.
I am Undetectable. What Now?
This is great news! This means that you are able to maintain treatment and remain undetectable. It also means that you do not have to worry about passing HIV on to your sexual partners. Importantly, it also means that your immune system is healthy and defending your body.
Now that you know that the viral load is undetectable, do not take your treatment for granted. It took hard work to become undetectable, so following your treatment is now more important than ever.
If you are not certain whether or not you are undetectable, speak to your healthcare professional about your viral load, and establish what success has been achieved using your medicine. If you have been following your treatment as advised for a period that is longer than 6 months and you are still not undetectable, speak up and ask for better medication. It is your right to receive the healthcare that you deserve.
Do I share the news?
Sharing your diagnosis can be a difficult conversation. However, if your viral load is undetectable, and your partner is HIV-Negative and you would like to reassure them, you may wish to have a discussion about ‘Undetectable=Untransmittable’. There are also preventative measures that can be taken, such as PrEP, which would still lead to a healthy sex life, but would also provide the peace of mind your partner may require.
If you have a steady partner who is HIV-Negative, and you are undetectable, this information may help develop a healthy relationship.
Last Updated: 1st September 2019
