How is HIV neutrality even possible? That’s a good question.
What does HIV Neutral mean?
HIV Neutral is a shortened way to say "HIV Status Neutral". HIV Status Neutral describes a world where HIV-positive people can't infect anyone and HIV-negative people can't get infected.
You might be wondering how is that possible? HIV neutrality is supported by two major HIV prevention and treatment methods: PrEP and viral load suppression.
- PrEP is a daily preventative medication that helps people void becoming infected with HIV.
- Viral load suppression, on the other hand, is the result of medications used to treat people who already have HIV. When the amount of virus copies in someone's body can't be measured and is considered undetectable. If a person is undetectable, HIV can still be hiding in their body, but the amount is so low that HIV cannot be passed to others through sex. This means that if your viral load is undetectable, you cannot transmit the virus to others.
If you’re interested in learning more about PrEP and viral load suppression, you can read our FAQ here.
Why is all of this important?
With these two prevention methods available, everyone is working together to prevent new HIV infections. The hope is that the HIV epidemic will end in our lifetime. And the people living with HIV will live long, healthy lives and face less stigma.
Where’s the proof?
We know some of this sounds too good to be true. But the evidence is there. Three recent studies — HPTN 052, PARTNER and Opposites Attract — followed male couples and heterosexual couples in which one partner was HIV-positive and the other HIV-negative. During these studies, not one HIV-positive person who was taking antiretroviral medicines and was virally suppressed passed HIV to their negative partner.
In the PARTNER and Opposites Attract studies, male couples had anal sex without condoms more than 34,000 times and heterosexual couples had vaginal or anal sex without condoms more than 36,000 times without a virally suppressed partner ever passing HIV to the negative partner. This is strong evidence that people do not sexually transmit HIV if they have an undetectable viral load.
Getting an “undetectable” viral load
If you have HIV, take antiretroviral medicines as prescribed by your health care provider. After you start your medicine, your provider will take blood samples to determine when the level of HIV virus in your blood has become undetectable. Once you have been undetectable for six months, you will not be able to sexually transmit HIV as long as you take your antiretroviral medicines and keep your viral load undetectable.
Programs in NYC can help patients start or stay in HIV care and take their medicines every day. These include the Undetectables, the Positive Life Workshop and, for those eligible for Ryan White services, the NYC Ryan White Care Coordination Programs.
Other important FAQs about HIV treatment, medication, and safe sex
- If I am HIV-negative, should I avoid having sex with people who have HIV?
Having sex with someone who knows they have HIV, but is on treatment and has an undetectable viral load, is much safer than having sex with someone who has HIV and does not know it, or someone who knows they have HIV but is not on treatment.
A person who was recently infected with HIV can have a very high viral load and can easily pass HIV to their partners.
A person with HIV who has kept their viral load undetectable for six months will not pass HIV to their sexual partners, even if they have sex without condoms.
- If my partner tells me they have an undetectable viral load, should we still use condoms?
Having an undetectable viral load only prevents HIV transmission. Condoms protect against HIV, other sexually transmitted infections (STIs) and unintended pregnancy.
If you are unsure about whether your partner is undetectable, take steps to protect yourself from HIV, such as using condoms or taking daily PrEP.
You should never feel pressured to have sex without condoms.
- If I am on HIV treatment, should my partner be on PrEP?
Couples share the responsibility of preventing HIV. HIV-positive people and their partners should discuss how they can have a healthy, fulfilling and worry-free sex life, including using condoms, HIV treatment, PrEP or emergency PEP (Post-Exposure Prophylaxis).
- What else can I do to prevent getting or passing HIV and other STIs?
Get an HIV test. A positive test is an opportunity to treat HIV, stay healthy and prevent HIV transmission. A negative test gives you the chance to discuss ways to stay negative, like using condoms, taking daily PrEP or taking emergency PEP.
Get tested regularly for other STIs. STIs may not show symptoms, but they can increase an HIV-positive person’s viral load, or make it easier for the virus to enter an HIV-negative person’s body.
All information derived from NYC.gov.