People living with HIV who are on antiretroviral treatment and maintain an undetectable viral load for at least six months do not sexually transmit HIV.

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When someone first acquires HIV, the virus replicates quickly in their body. During this stage, their viral load is high, and it is very easy for the virus to be transmitted to sexual partners, especially through unprotected anal sex. Many new HIV infections in New Zealand happen when someone is living with HIV and doesn’t know it. As time goes on, their viral load drops and the use of HIV treatment medication can usually bring their viral load down to undetectable levels.

New research shows that starting treatment as soon as possible can make it easier for people living with HIV to get an undetectable viral load sooner and live longer and healthier lives.

Being undetectable does not mean cured - as of yet, there is still no cure for HIV. But it does mean that a person living with HIV will have more health benefits, including not being able to transmit HIV through condomless sex.

For some people, it could take a while to to get their viral load to an undetectable level, and some people might not ever be able to get there despite adhering to medications. It’s important that people living with HIV don’t feel pressured or expected to have an undetectable viral load.

Having an undetectable viral load also does not provide protection from any other STIs like syphilis, gonorrhoea, or LGV. 

New Zealand law requires people living with HIV to take “reasonable precautions” to avoid transmission if they do not disclose their HIV status. “Reasonable precautions” has been interpreted by the courts to mean using condoms for sexual intercourse. At present, there has not been case law that has tested whether the courts will interpret having an undetectable viral load as taking reasonable precautions.

Using condoms and lube for anal and vaginal sex is an effective barrier to sexual transmission for both HIV and most other STIs.

The NZAF network

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