Undetectable equals Untransmittable
What does Undetectable equals Untransmittable (U=U) mean?
When someone takes their HIV medication as prescribed, their viral load will be reduced to such a low level that it can’t be picked up on a test. This is called an Undetectable Viral Load. HIV is still in the body but its ability to cause health issues has been dramatically reduced.
Someone who is undetectable cannot transmit HIV to others through sexual contact. Put another way,
There is ZERO risk of someone with an undetectable viral load passing HIV onto their partner through sex.
Understanding and educating others about U=U not only allows people living with HIV live life, and have relationships like everyone else. It can also make testing for HIV less confronting for people whose knowledge of HIV might not be up to date. This benefits all of the community.
What is an undetectable viral load?
Undetectable viral load, sometimes written as U+, means that a person is living with HIV but the level of the virus is so low that it can’t detected in their blood. A viral load is how many copies of the virus are present per millilitre of blood. For the virus to be considered undetectable, there must be less than 200 copies per mL. This medication stops HIV from making copies of itself, allowing the immune system to remove the virus. And because so much HIV is removed from their body, a person with an undetectable viral load still has HIV but can’t pass it on.
So what’s the big deal about U=U?
We know there is still so much fear, misinformation and stigma about HIV in the community here in Queensland. However, what U=U means to many people living with HIV goes far beyond not being able to transmit HIV to their sexual partners, it means they can live a healthy, vibrant, long life, where HIV is no barrier.
Read how you can Help End HIV Stigma and be a HIV ally.
The Science of U=U
Treatment for HIV has come a long way in the last four decades. Antiretroviral medication is increasingly effective at managing the virus in the body, with options from pills to injectable versions. There is still no cure for HIV, but the latest treatments are incredibly effective, allowing most people living with HIV to maintain an undetectable viral load.
The 2008 Swiss Statement was the first to pronounce that HIV treatment stopped transmission; providing the positive person was adherent, had an undetectable viral load and no sexually transmitted infections (STIs). But there were still caveats of concern. Would having an STI affect viral load? Did the viral levels in blood always correlate to those in semen and vaginal fluids? What about viral blips?
In 2011, HPTN 052 reported on 1700 sero-different couples, half of whom were started on treatment, the other half not. Of the 28 seroconversions that happened, only one occurred among the treating group and that occurred very early on in the trial when viral load was likely still high. But it was a largely heterosexual group so we needed more evidence.
That’s when the PARTNER study reported its findings. This study had enrolled serodifferent couples where the HIV positive partner was on treatment and where couples were already not always using condoms (often for many years). And importantly, one-third of the almost 900 couples were gay men.
U=U and STIs
Having an undetectable viral load is great, but it doesn’t protect from catching or passing on other STIs. We recommend regular sexual health checks, and safer sex options regardless of someones status, or their use of PEP, PrEP, or ART. QPP operates a HIV/STI clinic called RAPID which is free from everyone, for more details go to their website.
U=U and PrEP & PEP
If you are HIV negative and have sex with a person with an undetectable viral load, you have ZERO risk of getting HIV. You don’t need to access post-exposure prophylaxis – PEP and you don’t need to have been taking PrEP. We’d still recommend safer sex options to reduce the risk of other STIs.
Help End HIV Stigma
Stigma is a challenge for all people with HIV, but there are things you can do to help, no matter your status.
How Is HIV Transmitted
HIV can be shared in some body fluids, like blood and semen, but not in fluids like saliva or sweat.
Treatment As Prevention
TasP refers to using HIV medication to eliminate the chance of transmitting HIV to others.
Our trained team is here to help you should you have any questions or need support. You can call for free from a Queensland land-line on 1800 636 241 or call (07) 3013 5555 (national). You can also email us or use the contact form or the chat function in the corner of our website.
