Youth Blog — “Undetectable”: What does it really mean?
People often get confused about what it means to have an undetectable viral load: “Does being undetectable mean you don’t have HIV?” “Can you still infect someone else if you are undetectable?” People even get confused about whether HIV-infected is the same as HIV-positive: “If you are undetectable, does that mean you’re HIV-negative?” If these are questions that you’re also wondering about, keep reading!
The purpose of antiretroviral therapy (ART) is to decrease the “viral load,” or the amount of HIV, in your blood. When ART lowers your viral load to an amount that tests can’t detect, your viral load is considered undetectable .
Undetectable test results mean the ART is working, but you are still infected with HIV (i.e., HIV-positive). There is still HIV in your body, just not in your blood at a level high enough for tests to detect. In order to maintain this undetectable level, you will need to stay on ART. Getting on HIV treatment is the first step to health, but it’s not the last step: Staying on treatment and staying in care is the best way to keep the HIV virus suppressed in your body, and to get an early leg up on any health conditions that might develop. Even when you are undetectable, HIV is hiding out in places medicine can’t reach, like your lymph nodes .
Now that you’ve achieved lab tests that are undetectable, and you are staying on ART, you need to have viral load tests every 3 months to make sure the ART is still working. Having undetectable test results means it is much harder to transmit the virus to someone else . You need to have these tests done often because the treatment might stop working if you don’t take the ART correctly or if your type of HIV becomes resistant to medicine. If this happens, your tests would no longer be undetectable, and it could be easier for you to transmit HIV to someone else. Even when you are undetectable, using condoms for anal sex is still the best way to protect your sex partners from infection.
Taking your meds as your doctor instructs you to will help you stay undetectable. This means not missing doses and taking these meds when the label on the bottle says. Visiting your doctor and having a viral load test and other necessary tests every 3 months will help you and your doctor determine if you are still undetectable.
If you are having sex with someone who is HIV-negative, consider talking to them about PrEP. PrEP, or Pre-Exposure Prophylaxis, is a tool to help keep someone HIV-negative. This involves taking HIV medicine once a day. Studies have shown that PrEP lowers the risk of HIV infection . Adding partner PrEP use (and condom use) to your undetectable viral load makes the risk of transmitting the virus very low.
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 U.S. Department of Health & Human Services. (2015, September 03). Viral load. Retrieved February 18, 2016, from https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/understand-your-test-results/viral-load/
 Clifford, A., & Remble, T. (2016, February 18). Youth Blog – Finding hidden HIV virus in the body – IMPACT Program. Retrieved February 18, 2016, from http://www.impactprogram.org/youth-blog/finding-hidden-hiv-virus/#sthash.pzawadtL.dpbs
 Cairns, G. (2014, March 04). No-one with an undetectable viral load, gay or heterosexual, transmits HIV in first two years of PARTNER study. NAM. Retrieved February 18, 2016, from http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748
 U.S. Department of Health & Human Services. (2016, January 29). Pre-Exposure Prophylaxis (PrEP). Retrieved February 18, 2016, from https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/