Looking to get educated on what Undetectable Viral Load is and how is can work for you? Start here.
WHAT IS U=U?
U=U means Undetectable = Untransmittable
[ Undetectable = HIV levels are so low cannot be detected by regular testing, Untransmittable= Cannot pass it on ]
Using a combination of HIV treatment medications most HIV-positive people are able to reduce the amount of HIV in their body to undetectable levels. This does not mean that they are free from HIV – but it means the amount of HIV in their blood is so small that they cannot transmit the virus, even if condoms or PrEP aren’t used.
This level of HIV viral suppression is called Undetectable Viral Load (UVL). You might see this on people’s social profiles as
WHAT IS VIRAL LOAD?
A viral load simply means the amount of virus present in the body. For HIV-positive people this means the amount of HIV present in their blood. Someone who has a high viral load is more likely to pass on HIV to their sexual partners, those sharing injecting equipment, or children their carry or breastfeed. Someones viral load can be checked by doing a blood test.
IS IT THE SAME AS CD4 OR T CELL COUNT?
No. HIV in the body targets immune cells called CD4 T-cells which usually act as the bodies defence against infections. If HIV is left untreated it can attack and destroy CD4 cells. If the virus is left untreated long enough, the virus can kill off enough of the CD4 cells to progress the infection to be defined as AIDS. When a person starts treatment the body will replenish its stock of CD4 cells, and stop the spread of HIV within their blood – keeping the body healthy.
WHAT IS UNDETECTABLE?
When a person living with HIV uses anti-retroviral medication as treatment (ART), they are able to reduce the amount of HIV in their body. Someone who has reached and kept an undetectable viral load for 6 months or more cannot transmit the virus to their sexual partners.
This does not mean they are now HIV-negative – but they are not able to transmit the virus to others.
DOES Being Undetectable WORK?
UVL is a prevention method used by HIV-positive people to prevent onward transmission of HIV. In the toolbox of HIV prevention being undetectable is the most effective tool there is. More effective than PrEP or condoms!
We know this because it’s based on overwhelming scientific evidence. Many major studies have followed positive undetectable people and their HIV-negative partners and nobody got HIV from their undetectable partner.
If you want to learn more about the science behind U=U - head to the Prevention Access Campaign website (the founders of the U=U campaign!) to look at the results from the HPTN 052, PARTNER, PARTNER 2 and Opposites Attract studies, and the Swiss Statement.
IS IT SAFE?
Of course! In fact, treatment forms an important part of keeping HIV-positive people healthy. HIV-positive people use anti-retroviral therapy (ART) to keep themselves healthy and their HIV virally suppressed – putting the power of protecting their partners in their own hands.
When HIV-positive people have good links to healthcare (like a good HIV trained doctor, treatment options etc) they can expect to live long and healthy lives around the same length as their HIV-negative friends and family.
WHAT ABOUT SIDE EFFECTS?
The main effect that HIV treatment has, is reducing the amount of HIV in the body – keeping the person healthy and eventually undetectable which is a wonderful and exciting thing. As far as other side effects go, the “different folks, different strokes” rule applies.
HIV-positive people use many different combinations of medications to treat HIV, based on what particular type of HIV they have, and how their body responds to treatment. The goal is to find the right regime for the right person that is powerful enough to suppress the HIV while causing minimal side effects - and that can be checked by running some tests with their doctor.
Mild side effects like nausea, dizziness, headaches, and insomnia are common, and mean the medicine has started to work – however don’t let side effects take over your treatment. Discuss your side effects with your doctor so that they can properly tailor a plan that’s right for you and your body.
WHAT ABOUT STIS?
If you decide to reduce or stop using condoms when you start treatment you need to be aware of your viral load, and other STIs. But, even if you’re using condoms 100% of the time guess what… you need to be aware of STIs.
Condoms don’t protect against ALL STIs. Herpes, crabs, and other bugs can spread from person to person even if you’re using condoms – and using the consistently.
The STIs condoms can protect against don’t always do that either. If you enjoy oral sex you’ll probably never have used a condom or other barrier method when getting orally fixated.
Recent evidence also shows that gonorrhoea can be spread by smacking tonsils, so no matter what your chosen method of protection is – you’re bound to get an STI along the road at some stage.
Around 13% of people with HIV in Australia are also living with hepatitis C, so screening for hep C for HIV-positive people is super important. find out more about HIV and hep C from Hepatitis Australia.
Generally, in the gay population, HIV-positive men test for STIs more frequently than HIV-negative guys.
People on an HIV care and treatment plan might test every 3, 6, or 12 months depending on a number of factors: type of medication, viral load at last test, and advice from their clinician.
It’s important to note that if you are HIV positive, other STIs may increase your viral load, especially in genital tissues. If you’re a sexually active person, and your treatment plan is to test every 6 months or more – it might be worth a ‘pit stop’ STI screen in between your regular treatment plan.
IS being Undetectable RIGHT FOR ME?
Undetectable is for HIV-positive people, so if you’re poz, ART is a great way to keep healthy and protect the people you fuck.
ART isn’t just about prevention, it’s about keeping yourself healthy. We advocate for testing for HIV regularly, and starting treatment early – however when you decide to start treatment should be made in consultation with your doctors and when the time is right for you.
You can find some great information about treatment on the Ending HIV website
I’M TRANS. IS Undetectable Right for ME?
HIV treatment works for trans people too, of course.
There is limited research available on the full scope of interactions between HIV treatment medications and hormone therapy. There are however many many many trans people living with HIV who are on treatment living happy and healthy lives.
Our friends over at PASH.tm have developed a wonderful resource for gay, bi and queer trans men called GRUNT which is well worth a look into – and you can follow up on HIV treatment for trans men specifically there.
WHAT IF I’M FIRST NATIONS?
Pricing for HIV treatment varies for the general population by state and territory. First Nations people (Aboriginal and Torres Strait Island people) can access reduced cost medication regardless of where they lived under the Closing the Gap healthcare program. Essentially this means that many PBS listed medications (such as HIV treatments) can be accessed for $6.80 – or free if you have a health care card. Your prescriber will need to put a note on your script so that the dispensing chemist will know to give you the correct pricing, so talk with your doctor.
If you’re a prescriber – get up to speed on Closing The Gap