An undetectable HIV viral load is also called untransmittable (U=U), and that means as long as you keep taking your HIV medicine as prescribed, you wont spread HIV to your partner(s) through sex.
When you have HIV, your viral load is the amount of virus in your blood and body fluids. It’s usually highest when you find out that you have HIV. But medicine called antiretroviral therapy (ART) slows or stops the virus from growing.
After you take your HIV treatment as prescribed, your viral load should come down to a very low level. That can keep you healthy for years.
When Your Viral Load Is Undetectable
Eventually, you want to have an undetectable viral load — one so low that a lab test can’t find it. When you have an undetectable viral load, you can’t spread the virus to your sexual partner(s).
Even when you reach that point, you must remember that the virus is still in your body. To keep it at bay, take your medicine just as your doctor prescribes. If you skip doses or stop treatment, your viral load can go up quickly. The chance that you can transmit the virus to your partners also goes way up.
Tell your doctor if you have trouble sticking to your treatment.
Talk to your partners, too, about prevention of HIV (if they don't have it) as well as other STD issues. Discuss the different kinds of protection, like condoms, safer sex, or pre-exposure prophylaxis (PrEP). PrEP is a pill or injection that can lower the chance of infection in people who don’t have HIV by up to 99% through sex and at least 74% for people who inject drugs.
Things to Remember
An undetectable viral load isn't a free pass. There are still important details that you must keep in mind.
HIV medicine and pregnancy. If you want to get pregnant, you'll need medical supervision and you'll have to continue to take your HIV meds to maintain viral suppression. This can generally be done safely while you’re pregnant and during delivery to help your baby stay healthy. Your baby also needs treatment for a few weeks after birth. These measures help ensure you won’t pass the virus to your newborn.
HIV can spread through breast milk. There’s probably less chance of this if you have an undetectable viral load, but the risk is not zero. Talk to your doctor about what’s best for you and your baby.
Even if you’re on ART and your viral load is undetectable, you can get other STDs. This includes gonorrhea, chlamydia, syphilis, herpes simplex virus (HSV), and hepatitis B and C. PrEP doesn’t protect against other STDs, either.
To lower your chances:
- Use a new condom every time you have sex. Be sure you know the right way to use it, and leave it on the whole time.
- Limit the number of partners you have sex with.
- Don’t drink or use drugs before or during sex.
- Get tested. STDs don’t always cause symptoms. The only way to know for sure if you have an STD is to get tested. Talk to your doctor about the tests you want and need. Your partners should do the same thing.
- Have an honest discussion with your partners about the best ways to stay safe and healthy.
HIV can spread when you share needles to inject drugs. Your odds of infection may be less if you:
- Use clean equipment every time you inject
- Don't share needles
- Take HIV medicine
- Maintain an undetectable viral load
