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Stopping HIV Transmission Effectively

The CDC has issued new statements regarding the Undetectable=Untransmittable (U=U) campaign. As most of us know by now there is no question that adherence to anti-retroviral therapy or ART, protects the health and partners of those living with HIV. The goal of ART is to reduce the amount of HIV viral load in the body to less than 200 copies per ml of blood. This is called viral suppression. In most cases ART can reduce the viral load to a level that is undetectable by standard viral load tests. This is called an undetectable viral load.
 

Obtaining an undetectable viral load not only keeps the immune system working and prevents illness, but there is now overwhelming data that supports having an undetectable viral load prevents transmission of HIV to others. This is referred to as treatment as prevention. The U=U campaign was designed to reduce HIV related stigma, and to increase awareness surrounding treatment as prevention. While there is strong evidence about treatment as prevention for some of the means by which HIV can be transmitted, more research is needed to determine the risk of transmission for other circumstances. Please read below the CDCs new statements regarding U=U.
 

Sexual Transmission

People living with HIV who take HIV medicine as directed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative sexual partners.

 

Transmission From Pregnancy, Labor and Delivery

If a woman living with HIV can take HIV medicine as directed throughout pregnancy, labor, and delivery and provides HIV medicine to her baby for 4-6 weeks after delivery, the risk of transmitting HIV can be 1% or less.

 

Transmission From Sharing Needles or Other Injection Drug Use Equipment

We don't know whether getting and keeping an undetectable viral load prevents HIV transmission through sharing needles or other injection drug equipment. While we do not yet know if or how much being undetectable prevents some ways that HIV is transmitted, it is reasonable to assume that being on treatment and getting undetectable provides some risk reduction.

 

Transmission From Breastfeeding

We don't know if a woman living with HIV who has an undetectable viral load can transmit HIV to her baby through breastfeeding. While we do not yet know if or how much being undetectable prevents some ways that HIV is transmitted, it is reasonable to assume that being on treatment and getting undetectable provides some risk reduction.

 

John Arcaro
Prevention Director of Prevention Services Community Initiatives