If you are undetectable, you can’t transmit HIV.
An undetectable viral load is where antiretroviral treatment (ART) has reduced your HIV to such small quantities that it can no longer be detected by standard blood tests. People living with HIV who have an undetectable viral load cannot pass HIV on through sex.
Being undetectable does not mean your HIV is cured. There is still HIV in your body, although it has been reduced to very small amounts. This means that if you stop taking treatment, your viral load will increase – affecting your health and making HIV transmittable again.
How will I know if I am undetectable?
You can’t tell if you have an undetectable viral load simply by how healthy you look and feel. The only way to know that your viral load is undetectable is by regular viral load monitoring.
Viral load monitoring involves a simple blood test to measure how many particles of HIV there are in a small sample of your blood (otherwise stated as how many HIV copies per mililitre of blood). From this you and your healthcare worker can understand how well your ART is working.
A low viral load means that your ART is working well and controlling your HIV. If you have an undetectable viral load, it means that the amount of HIV in your body is so low that you can’t pass it on to other people through sex.
The point at which a viral load is classified as being undetectable may vary across different countries depending on the tests available. But so long as your viral load is under 200 copies per millilitre, you’re considered virally suppressed and unable to pass HIV on.
The frequency with which you are offered viral load testing may vary depending on where you are and the services available to you. The World Health Organization recommends that when first starting ART, you should have your viral load measured after the first 6 months of treatment and again at 12 months. After becoming undetectable you should still receive viral load testing at least every 12 months. Depending on the resources available and your particular health status, your health worker may recommend that your viral load is monitored more often than this.
Some people may not have access to viral load tests, unfortunately this means that they cannot know if they’re undetectable. Your healthcare workers will still work with you to ensure that your HIV is managed and that you stay in good health. You will need to continue using condoms, PrEP or other forms of HIV protection to ensure that HIV is not passed on to your sexual partners.