By the time you read this, you should be very aware of the campaigns #UequalsU and #Cantpassiton. Both of these worldwide efforts to increase the awareness and knowledge that those living with HIV and on proper medication, reaching the goal of undetectable, cannot pass on the HIV virus. But, what exactly is undetectable and what does it mean?
The easiest way to approach this topic is to start with your fears and discuss what undetectable DOES NOT MEAN:
- Someone is HIV negative
- Someone is cured of HIV
- Someone will remain undetectable even if they stop medication
- Someone can accidentally or intentionally infect someone with HIV
- Condoms are the only way to combat HIV infection
HIV, when left undiagnosed and/or untreated, can lead to AIDS. Modern medication has made it so that someone living with HIV can take a ONCE DAILY dose of medication, with few (or any) side-effects to manage the effects on the body. This includes the person’s ability to infect others.
- HIV. HIV is the virus that causes AIDS. HIV hijacks cells in your immune system and uses them to replicate (make more copies of itself), destroying those cells in the process.
- Viral load. Viral load refers to how many copies of HIV are present in a milliliter sample of blood. Viral load testing is a way to estimate how much HIV is in the blood. It is used to monitor immune function and see how well HIV treatment is working.
- Antiretroviral therapy (ART). ART involves taking medications to keep the virus from replicating in an HIV-positive person’s cells. These drugs thereby decrease viral load.
- Undetectable viral load. When copies of HIV cannot be detected by standard viral load tests, an HIV-positive person is said to have an “undetectable viral load.” For most tests used clinically today, this means fewer than 50 copies of HIV per milliliter of blood (<50 copies/mL). Reaching an undetectable viral load is a key goal of ART.
What this means for your sex life:
Treatment as Prevention (TasP) is the method of treating someone living with HIV with ART medications so that the virus is sufficiently suppressed in their body. This keeps him healthy and able to live a normal life span and sex life. But, it also means that he is uninfectious and unable to infect his partners with HIV, even if they have chosen to not use condoms. The PARTNER study is one of the latest studies of gay male couples, who had condemless sex, with one partner living with HIV and the other, HIV negative, also without the usage of PrEP. None of the HIV negative partners contracted HIV from his ART treated, undetectable partner!
The great news is that we no longer have to fear sex and intimacy with those who are living with HIV. And those infected don’t have to be concerned that they could even accidentally infect their sexual partners, with or without condom usage. This science not only helps reassure those in mixed status relationships but should also reduce the stigma around being sexually active with a guy living with HIV. This is the news we have waited a generation for! This is to be celebrated, not fought.
“Barebacking verses Condomless sex:
At GMJ, we are very sex positive and believe words that shame our natural desires are counterproductive and lead to more harm than good. So called “barebacking” is one of those words. This term was created with the full intent to shame those who choose to not use condoms and spread fear and HIV stigma along the way. Within the last few years, the CDC has begun using the term “condomless sex to reduce these levels and promote honest conversations about condom usage. But, words without context mean nothing.
The choice to use any sort of HIV/STD protection is entirely up to the parties involved and no one else. The options for protection have increased over the last five (5) years in successful ways. We have condoms, PrEP and PEP as well as TasP but the most important level of protection is communication and honesty. We must do better in discussing our STD status from a point without shame or blame, and make room for honest conversations about sexual habits and methods of prevention.
Barebacking is a high risk activity based on little or no knowledge of the other persons sexual history or STD status. No conversation has been had about protection or the possible outcomes of infection. Drugs such as METH and alcohol have been shown to increase the amount of bareback sex as well as anonymous hook-ups from the Internet. Some gay dating apps have included an option for Undetectable in their profile settings but it is very important to know what this word means when reading it.
On the other hand, Condomless sex is exactly what it sounds like; sex without a condom. This could involve one who is living with HIV but is undetectable, on PrEP, or has access to PEP. The human penis was not born with a condom and numerous studies have shown that men, both gay and straight, don’t like using them and often times won’t put one on his dick. Condomless sex that includes conversation and honesty is an option that many are taking, including those in mixed status relationships. These are options that many have waited a very long time for, but it is not the right choice for everyone. Only you can make this decision for yourself, and you should allow others the same independence.
Contrary to popular opinion, condomless sex has not lead to an increase in STDs, just as the usage of PrEP has not been linked to greater numbers of STD infections. If you use condoms in your sex life is not a moral decision and should not be one of public debate. This leads only to shame and stigma, as well as less guys wanting to be honest about their HIV status or receive regular STD testing.
The Internet has made information transference possible within seconds, but it does not always explain this information well. This can increase the level of stigma surrounding HIV. We are neither promoting or shaming anyone’s sexual practices but we hope that this information, about what #uequalsu means to you and your real life will decrease the amount of fear you might have and the level of stigma those living with HIV experience.