Undetectable equals Untransmittable (U=U)
When someone takes their medication as prescribed, they can reduce their viral load to such a low level that 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 problems is massively reduced.
Someone who is undetectable cannot transmit HIV to others through sexual contact.
Let’s repeat that… There is ZERO risk of someone with an undetectable viral load passing HIV onto anyone through sex.
HIV is still present, but the amount of virus is so low it is undetectable by a blood test and is, therefore, untransmittable, meaning that it is unable to be passed on to others through sexual contact.
Spreading the word about U=U not only helps people understand the science behind the treatment of HIV, but it also debunks fear that seronegative people may have and reduces the stigma for people living with HIV, particularly when seeking intimate relationships.
The evidence behind 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. We can’t completely get rid of HIV, but treatment can greatly lower the amount of virus (also called viral load).
Since 2005, there have been three major studies published, all of which gave resounding support to the statement “that if someone takes ART daily, as prescribed, and achieves and maintains an undetectable viral load there is effectively no risk of sexually transmitting the virus to a HIV-negative partner.”
These studies featured heterosexual and same-sex couples from all over the world, and collectively over 93,000 reported condomless sexual encounters. Of all those encounters, not one HIV-positive person passed the virus on to their HIV-negative partner through sexual contact.
What is an undetectable viral load?
The viral load is how many copies of the virus are present per millilitre of blood.
For the virus to be undetectable, there must be less than 200 copies per mL. This can be achieved by keeping to an ART treatment plan which includes regular blood tests to monitor the viral load.
U=U and the law
Taking ART and having an undetectable viral load is considered a preventive measure.
Western Australian law states that so long as you are taking preventative measures to stop transmission if you are HIV-positive (i.e. being undetectable), then you don’t have to disclose your status.
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 screening and condom use regardless of your status.
U=U, PrEP and PEP
Looking for that extra, extra peace of mind?
If you have sex with a person with an undetectable viral load, you have ZERO risk of getting HIV.
You do not need to access post-exposure prophylaxis (PEP). In fact, if you try to access PEP you will be told that you don’t meet the eligibility requirements for PEP.
You also do not to use PrEP as there is no risk. How great is that?!
Why is U=U so important?
There is still so much misinformation and misplaced anxiety around HIV in the community, which leads to the stigmatising of people living with HIV.
By talking about U=U and the advancement of ART we can reduce stigma and break down barriers for people living with HIV, who would otherwise lead long, healthy and fulfilling lives.
So, what can you do personally to end stigma for people living with HIV?
1. Normalise HIV as part of conversation (whether asking about HIV status before sex, talking about it as a health professional) and encourage regular HIV testing for all people!
2. When people talk about HIV, plug U=U. What do they know about it? Do they believe in the facts?
3. Reframe HIV as a chronic condition rather than a life-threatening illness, where people can lead lives equivalent to their HIV negative counterparts.
To learn more about U=U or find out more about our services, get in touch.