Undetectable = Untransmittable: Public Health and HIV Viral Load Suppression

Posted by Maria Codina on September 21, 2018 at 4:27 pm

Twenty years of evidence demonstrates that HIV treatment is highly effective in reducing the transmission of HIV. People living with HIV on antiretroviral therapy who have an undetectable level of HIV in their blood have a negligible risk of
transmitting HIV sexually.

Three large studies of sexual HIV transmission among thousands of couples, one partner of which was living with HIV and the other was not, were undertaken between 2007 and 2016.

In those studies, there was not a single case of sexual transmission of HIV from a virally suppressed person living with HIV to their HIV-negative partner (1–3). Hence, in addition to enabling people living with HIV to stay healthy and have a lifespan similar to people not living
with HIV, antiretroviral medicines now provide an opportunity for people living with HIV who have an undetectable viral load to have sex without a condom with effectively no risk of passing HIV on to their partner. Globally, 47% [35–58%] of people living HIV are virally suppressed (4).

The primary purpose of antiretroviral therapy is to keep people living with HIV in good health. For most people living with HIV, antiretroviral medicines can reduce the amount of HIV in the blood to levels that are undetectable by standard laboratory tests. With the right choice of antiretroviral medicines, viral levels will decline over several months to undetectable levels and allow the
immune system to begin to recover.

Access to antiretroviral therapy is transformative for people living with HIV. It enables people to regain their quality of life, return to work and enjoy a future with hope. For many people living with HIV, the news that they can no longer transmit HIV sexually is life-changing. In
addition to being able to choose to have sex without a condom, many people living with HIV who are virally suppressed feel liberated from the stigma associated with living with the virus. The awareness that they can no longer transmit HIV sexually can provide people living with
HIV with a strong sense of being agents of prevention in their approach to new or existing relationships.

Read the ‘Undetectable = Untransmittable: Public Health and HIV Viral Load Suppression’.