What does undetectable mean?
You may have noticed that “undetectable” has become an increasingly used word and there is a good reason why it is an increasingly popular term among people living with HIV.
As the name suggests, an undetectable viral load occurs in people living with HIV when the virus exists in such small amounts that it cannot be detected by standard blood tests.
Many people living with HIV can reach an undetectable viral load in as little as six months with adherence to antiretroviral treatment. Evidence has shown that as long as you continue to have your viral load checked by your doctor to confirm that you are undetectable, there is zero risk of transmitting HIV to others and your health will not be affected by HIV. Undetectable = Untransmissible.
Why is it important to check your viral load?
“Viral load” refers to the amount of virus in your blood. It is measured by a simple blood test; it also shows how well antiretroviral treatment is working to protect your immune system from other potential illnesses.
An ‘undetectable’ diagnosis means that the level of HIV in your body is so low (below 40 copies/ml) that it is not infectious to other people. You may also hear health workers talk about “viral suppression” (where the HIV level is below 200 copies/mL) – if you have been told that you are undetectable or virally suppressed, then the risk of you transmitting HIV to others is zero.
It usually takes time for the body to adjust to new drugs and the same is true for HIV treatment. Taking treatment does not automatically mean you are undetectable and it is very common for viral loads to fluctuate, especially after starting a new type of treatment.
You may look and feel perfectly healthy, but this is not an indicator of your viral load. The only way to know if you’re undetectable is by monitoring it regularly.
It is recommended that you take treatment for at least six months and then monitor your viral load every 2-4 months to know that you are still undetectable.
It is important to remember that even if you have an undetectable viral load, HIV is still present in your body. This means that if you stop treatment, your viral load may increase – this will affect your long-term health and make HIV transmissible again.
Can everyone living with HIV achieve an undetectable viral load?
Not everyone living with HIV can reach an undetectable viral load, and this is due to factors that cannot be controlled.
For some, it can be difficult to find an appropriate treatment regimen. Also, in some places, viral load tests may not always be available.
If this is also the case for you, it is essential that you continue to take your medication exactly as prescribed and see your doctor regularly. Although you may not be ‘undetectable’, you can still stay healthy.
If you are unsure of your viral load, there are other ways to reduce the risk of HIV transmission to your sexual partners. They may want to take pre-exposure prophylaxis (PrEP) to stay negative. Using condoms will prevent both HIV and other sexually transmitted infections.
If you can’t regularly monitor your viral load, it’s important not to assume you’re undetectable.
I’m ” undetectable “, what does that mean to me?
Of course, if you keep yourself undetectable by taking the treatment regimen and having proper monitoring, the good news is that you don’t have to worry about transmitting HIV to your sexual partners!
Being undetectable also means that your body is in good health and that your immune system is working well to fend off everyday germs. Sticking to your treatment regimen and ongoing monitoring are essential to staying undetectable, but they’re also a good way to make sure you stay healthy.
Sharing your diagnosis can be a difficult conversation, but it’s helpful to explain what “undetectable” means to your sexual partners, as it will help you stay more comfortable.
This discussion may impact your decision to stop using condoms as your main form of protection during sex.
However, it’s a good idea to talk to your doctor about this before changing your protection routine. You should also remember that although being undetectable stops HIV transmission, it does not stop the transmission of other sexually transmitted infections (STIs).
What does “undetectable” mean if you are sero-negative?
If you are HIV-negative and your current sexual partner is living with HIV and has an undetectable viral load, then there is no risk of sexual transmission of HIV.
You and your partner can decide to stop using condoms, but you don’t have to feel pressured to change your existing protection routine if it’s one that makes you feel comfortable. You may actually find it more reassuring to be in control of your own sexual health and well-being.
Even if your partner is undetectable, condoms are still the only form of protection against other STIs. You can also consider PrEP as an additional precaution against HIV.
Whatever decision you make about protection, it’s important to get tested regularly for HIV to check that your status remains negative.