"Undetectable": Your Burning Questions Answered

Published: December 12, 2013

Last month, we asked for your burning questions about “undetectable” viral load. Thanks to everyone who posted a question! We enlisted Dr. Joanna Eveland of Mission Neighborhood Health Center to answer your questions about what “undetectable” means for your health and for your sex partners.

Can I still transmit HIV if my viral load is undetectable?
“Undetectable” and “HIV-negative” are not the same thing. Having undetectable viral load does dramatically decrease the odds of transmitting the virus, but it doesn’t eliminate it.
What does the science say? Watch this video to see how lower viral load translates to lower risk of passing on HIV.
Viral load is the amount of virus that is measured in the blood at one point in time. The test result you see at your doctor’s appointment today tells you what your viral load was a few weeks ago, when you got your blood drawn. If you continued taking your antiretroviral medicines daily, your viral load is probably still undetectable, but not necessarily.
Taking even a brief break from your meds can increase your viral load, as can having another illness like the flu or a sexually transmitted infection (STI). It’s also good to note that viral load in the blood is not necessarily the same as viral load in semen.
If I’m undetectable, do I still need to use condoms? 
The decision to use condoms or not is ultimately between you and your partner. It’s important to discuss together what the health concerns might be for the two of you, and to be comfortable with your decision.
Things to think about and discuss with your partner(s) may include whether or not you have other sex partners, how frequently you get tested for other STIs, how adherent you are to your HIV meds, and how important (or not) using condoms is to you. Weighing the health concerns alongside the physical and emotional components will help you strike the right balance with your partner about “risks” and pleasure. While being undetectable is a great thing for your health, it doesn’t protect you against other STIs or offer an HIV-negative partner 100% protection against contracting HIV.
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