Advances in antiretroviral therapy (ART) have led to major developments in HIV treatment since the 1980s. The virus is no longer a death sentence, and with effective antiretroviral medication, people can live a full and healthy life. Furthermore, an HIV positive person can become so-called 'HIV undetectable' when the level of the virus in that person’s blood is too low to be detected through testing.
If you didn't already know, a so-called 'viral load' test shows how much HIV there is a person's blood. When your viral load is below 200 copies/ml, you are classed as ‘undetectable’. This means the amount of HIV in your blood sample was too little to be measured by the tests.
However, an undetectable viral load does not mean the person with HIV is cured or can stop taking their HIV meds. The virus is still present in their body, but there is very little HIV in their bloodstream and/or body fluids at the time of testing. Significantly, an undetectable viral load shows that someone's HIV treatment is working well by suppressing the replication of the virus. This is why adherence to medication and regular HIV testing are so important for people living with HIV.
Studies have shown that people with HIV at undetectable levels cannot pass on the virus, even with condom-less or bareback sex – as long as the person remains on their HIV treatment and is taking their antiretroviral medication as prescribed. This is how the expression u=u – undetectable equals untransmittable – came into being.
This scientific evidence that led to u=u was gathered from several studies. These studies looked at thousands of couples undergoing HIV treatment – both heterosexual and gay couples, in which one partner was HIV-positive and the other was not (in a so-called serodiscordant relationship). Among those study participants who had undetectable HIV, not a single one passed the virus to their sexual partner. The evidence is now overwhelming – you cannot pass HIV on if you are undetectable and taking your meds as prescribed – undetectable equals untransmittable.
There has always been too much shaming surrounding HIV. Too often gay men will judge one another based upon their HIV status, bandying about terms such as “unclean”. Some of those that do this who may have tested negative five years previously, but have not taken a test since, and may still loudly proclaim that they’re ‘negative’.
Furthermore, the same kind of people may refuse to have sex with gay men who are HIV positive or poz – even with a condom, or any type of HIV preventing protection – from fear of possible HIV transmission. Education is key in changing attitudes towards HIV – and this includes vital information on what being HIV and undetectable really means, and crucially, how to achieve it.
One sadly too common form of prejudice is the view that men with an HIV undetectable status are potentially luring HIV negative men into risky sexual antics. Such an attitude conveniently forgets that both partners have a shared and equal responsibility for their sexual health.
“Studies have shown that people with HIV at undetectable levels cannot pass on the virus, even with no condom use. This is how the expression u=u – undetectable equals untransmittable – came into being.”
Even if you're undetectable and therefore can't pass the virus on, disclosing your positive HIV status before sex with a new partner can be traumatic, with fear of judgement and rejection. And, at the same time, how often do people ask about your HIV status – or general sexual health status – before fucking? Rarely. Communication and being brave is key.
Indeed, the shame and blame game has never been far where HIV is concerned. Thankfully, things are slowly changing with better education around u=u – undetectable equals untransmittable. Indeed, better education and communication between partners is the only way to improve things.
Rather than casting aspersions on the personality and sex life of a person who is HIV undetectable, let’s look at the facts:
Surely such a person should be applauded, not shamed?
Wear your HIV undetectable status proudly shutterstock/Krakenimages
Coming out as HIV+ is difficult. However, too many gay men are vague about their status or rely on results given years ago. Regular HIV testing is still not widespread enough. And it's only through regular HIV testing that we can combat the epidemic, by getting people on meds which lead to an HIV undetectable status and therefore being unable to pass the virus on because of u=u – undetectable equals untransmittable. Those in our community who shout about being HIV undetectable should be celebrated.
We urgently need to have further discussions about what being HIV-positive and undetectable means. Slut-shaming and dismissive, wounding terms such as ‘unclean’ must be eradicated when we talk about sex within the LGBTQ+ community. Uninformed generalisations when it comes to HIV status are more than unproductive – they are dangerous.
Similarly, stereotypes which cast HIV-positive undetectable gay men as reckless and irresponsible over sexual health must be stamped out. The opposite is indeed the case: HIV undetectable people are leading the way in fighting the epidemic through openness and honesty. Furthermore, through doing so, they are challenging the destructive narrative of guilt which has surrounded HIV for far too long. •
Main image: shutterstock/Blue Titan
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Images: model released from Shutterstock
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