People with HIV who are on successful treatment are not infectious.

This is huge. Think what this means to those living with HIV who are too scared to have sex in case they pass their virus on? Think what this means to those in relationships with people with HIV whose sexual pleasure has been hampered by fear? Think about all of the wasted energy that people have put into shunning gay men who have been brave enough to be open about their HIV status.

We’ve known for some time that being undetectable on treatment has a massive impact on reducing the risk of transmission. New data has just been released from the PARTNER study which adds to this. Between September 2010 and May 2014 the study monitored over 1,000 sero-discordant couples (i.e. where one had HIV and the other didn’t). To be included in the study the positive partner needed to have an undetectable viral load and the couple needed to, at least sometimes, not use condoms. After 58,000 acts of unprotected sex among the couples in the study, there were no cases of HIV transmission from one partner to another partner.

No infections were seen when participants got another STI. No infections were seen in cases of viral blips between tests. The only cases where the negative partner became positive were when they had sex outside of the relationship, presumably with someone who wasn’t undetectable, probably with someone who wasn’t diagnosed.

For those who aren’t sure what undetectable means, it’s when the level of HIV in your blood drops below the point at which it can be detected by a standard HIV viral load test. About 95% of people living with HIV in the UK who are on treatment are now undetectable[1].

This news comes shortly after the story that Grindr has been investigating whether to offer users ways to filter out people who didn’t share their HIV status. I don’t think I’ve ever met another openly positive gay guy who hasn’t had some story of sexual rejection based on their HIV status.

When we are undetectable, pretty much all the fear that HIV-negative guys have of those of us living with HIV is just wasted energy. An undetectable viral load is more effective at preventing HIV transmission than using a condom (although condoms are still key to preventing transmission of gonorrhoea, chlamydia and a whole host of other infections). So when someone says that they’re going to avoid John because he has HIV (and is on treatment), and then runs off with Jonah, whose status is unknown, they’re taking a far bigger sexual risk. 

We’ve a long way yet to go before everyone hears this message. What’s exciting though is that we are making progress. More and more people living with HIV are choosing to break out of the viral closet. More and more people are talking about not just HIV status but also about viral load and being undetectable when they negotiate sex. More and more we are dispelling the ignorance and fear around HIV and challenging stigma. 

So if you have never tested for HIV, even if your only sexual risk has been small, stop delaying and get tested now. If you find that you are living with HIV you will be able to access treatment which will extend your life and make you extremely unlikely to pass on the virus. If you are absolutely certain that you are not living with HIV, recognise that you will meet men who are, men who should be treated with the same respect and dignity that you would afford others, and that these men do not pose a danger to your health. And if you are living with HIV please consider the positive impact you could have by talking with your friends and partners about what it means to have HIV and be undetectable. 

Those of us who live with HIV are not to be feared. Everyone should know this.

(Ref: [1] HIV new diagnoses, treatment and care in the UK 2015 report: data to end 2014. October 2015. Public Health England, London)



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