This is a phrase we see and hear often. But some of us (me included) aren't 100% sure of the meaning. I know it means that the person has a low viral load and is healthier(as far as HIV goes) than someone who is positive. I'm unclear, though, on what that means to me. Someone who is negative. Can I still contract the disease from an undetectable guy? What are the odds of that happening? How often. Does someone become positive after being undetectable? Why? Let's get thus discussion going.
Someone with an undetectable viral load is "positive" - they carry antibodies for HIV, and although HIV is undetectable in their blood, where their HIV drugs circulate and are most effective, the virus remains hidden in other tissues. Yes, you can still get HIV from contact with an undetectable partner, although the risk is less than 1/20th the risk otherwise, low enough that it's difficult to study. See this recent study, of mixed-status couples. These were people under intensive testing and care, of course. The greatest risk is probably that undetectable people can quite quickly become detectable again, with any irregularity or failure in their drug regime or change in their virus, and neither they nor their partners will know this until they're again evaluated. For the highest-risk sort of contact, particularly with anyone other than a live-in partner whose health and status you are always aware of, it would be best to observe the usual precautions. I was in a mixed-status relationship for years, and yea, the usual precautions are a bit of a chore, but do become a routine. Outside a relationship, it's something to negotiate, but if you are not comfortable asserting yourself or your partner presses you to risk your health, even a little, move on. You deserve better.
This is no longer considered true. 10 years of studies with thousands and thousands of serodiscordant couples (one poz, one neg, the poz man undetectable) has resulted in zero transmission. Condoms fail 2-8 percent of the time. The scientific consensus is endorsed by almost everyone including the CDC. The greatest risk still remains from men or women who don't test and assume their status is negative, by a massive margin. Everyone must choose for themselves what they think is risky and what is not, but the strategy most have used which is turning down Poz folx who disclose has had awful repercussions, both in terms of stigma but also the ongoing crisis, because a person is only as negative as their last test before sex again.
The last study I read about mixed couples, one with HIV and one Neg, there were zero new conversions between these thousands of couples. That being said, even if there was an absolute zero risk one must add to the mix other STDs. It always pays to practice "safer sex."
Great question. Undetectable simply means that the viral load is very low and therefore that person is less efficient at passing on the virus while they remain on meds and continue to be "undetectable". It is true that if the person continues to put themselves at risk by having unprotected with multiple partners or engaging in drug injecting activities, they are more likely to revert to detectable which makes it easier to pass on the virus. While condoms or other barriers are not 100% effective 100% of the time, they are among the best alternative we have, except for celibacy which may not be appropriate for everyone.
It means for example that there is no virus in my semen. None. So without virus how are you at risk?
Your choices are your choices but you were just given numbers that show condom use is far riskier than sex with an undetectable partner without. The studies now cover 10k subjects. Not one case of transmission..
Stigma and fear continue to make it hard to see that things have changed. The reality is that for me, I have been unable to transmit since 1998. I waited decades for the science to be in and the data is clear: I, nor anyone like me can transmit.
No. None of this is true. This is old information and falsehood. In the early years, the data threashold for viral load was 40ppm. We could not measure finer numbers. This does not mean undetectable is not zero. It means we did not know for certain The current diagnostic does down to 0ppm. It's over a decade old. The information you just passed on is derived from the early protocol. Turns out those at 40ppm were actually 0ppm. So this is 100% false information stigmatizing poz folx AGAIN. Moreover the 40ppm is not enough to cause infection. The virus needs to be present in much higher amounts or the immune system eradicates it.
Please inform yourself before making such crucial statements yet that are false.
It means for example that there is no virus in my semen. None. So without virus how are you at risk?Your choices are your choices but you were just given numbers that show condom use is far riskier than sex with an undetectable partner without. The studies now cover 10k subjects. Not one case of transmission..Stigma and fear continue to make it hard to see that things have changed. The reality is that for me, I have been unable to transmit since 1998. I waited decades for the science to be in and the data is clear: I, nor anyone like me can transmit.
Well said. I'm HIV undetectable an I cannot transmit, however I do use caution as there are other STI's out there
Further, a protocol compliant patient who has sex with thousands of men cannot get 'new' HIV or extra HIV or become infectious. If the person is less than three months poz, a new strain can supplant the original that is drug resistant there are two cases of this. After that, any new virus is immediately inhibited by the meds and attacked by the immune system. Injection drugs don't give you HIV either when you have it already. Non compliance can cause viral load to spike. Party lifestyle is not necessarily supportive of compliance but its important to say drug addicts are good at taking drugs. If a person is undetectable they cannot transmit. HIV is being spread by people who don't know their status. Not poz folks on meds.