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Top US doctor on HIV undetectable sex: ‘From a practical standpoint, the risk is zero’

Top US doctor on HIV undetectable sex: ‘From a practical standpoint, the risk is zero’

Dr Anthony Fauci, Director of NIAID

One of the most respected HIV experts in the world has spoken bluntly about the facts behind the U=U campaign.

U=U means Undetectable = Untransmittable. Someone who is HIV positive, on medication and has had an undetectable viral load for at least six months, will effectively not pass the virus on to sexual partners.

Dr Anthony Fauci is the Director of National Institute of Allergy and Infectious Diseases (NIAID). It is regarded as the premier medical research institute in the US. The immunologist made his comments in an interview with sexual health advocate Josh Robbins on Friday.

Since the launch of the U=U campaign, over 500 organizations have voiced their support for its message, including the Terrence Higgins Trust, Avert, Center for Disease Control, National AIDS Trust and NIAID.

‘Don’t worry about it’

‘From a practical standpoint, the risk is zero, so don’t worry about it,’ says Fauci of someone with an undetectable viral load potentially passing the virus on to someone else.

Robbins pushes him for clarification. ‘We’ve got all these word semantics happening: virtually zero risk, essentially no risk, low risk, practically zero risk, negligible, probably zero, almost zero, from a practical standpoint, you’re saying it’s zero?’

‘Right,’ replies Fauci.‘And then the reason … I hope you got what I was saying, when you’re going to put it in the context of relative risk, how you live your life, from the practical standpoint is zero.

‘How you live your life, from a practical standpoint is zero, with how you conduct yourself at work, how you do this, how you go to work, how you travel, how you have sex. You’ve to look at the practicalities. From a practical standpoint. What’s the risk? From a practical standpoint, the risk is zero.

What Fauci means is people run the risk of involvement in an accident when commuting to work – but it’s a risk most of us live with on a daily basis.

‘It’s impossible to live in a world with a zero risk’

Robbins then puts to him a Tweet from Avert, which stated ‘When HIV is undetectable there is a zero risk of it being transmitted to others.’ He asks Fauci if it is factual.

‘You know, it gets back … See, I don’t want to be backed into things that I’m going to get out of context. I stand by what I said. From a practical standpoint … And I would say from a practical standpoint, that tweet is accurate.

‘Biologists and scientists are always reticent to say zero risk. In other words, nothing is 100% effective and nothing is 100% risk-free. But if you stop there, then you get confusion.

‘See, it’s impossible to live in a world with a zero risk, but from a practical standpoint with how you conduct yourself at work, how you do this, how you go to work, how you travel, how you have sex – what’s the risk? From a practical standpoint, the risk is zero, so don’t worry about it.’

Earlier this month Fauci, 77, gave an interview to Associated Press and discussed the latest advances in combating the HIV epidemic. He said he hoped to see an end to the endemic within his lifetime.

Why the opinion of Dr Fauci matters

‘Dr Fauci is the leading expert in the world on the HIV epidemic,’ Robbins told Gay Star News.

‘The reason I secured an interview with him was because of the word semantics that I was witnessing around how organizations and individuals describe the risk of transmissions from someone undetectable.

‘It is because of the work of the U=U campaign that the truth is coming out worldwide, but for some reason the stigma and fear of HIV continues to show in a few organizations that still choose to ignore the data and continue to inaccurately describe the risk.

‘Dr Fauci gave the most impressive crowning vindication that U=U is scientific fact and it was remarkable to hear a scientist explain from a practical standpoint that the risk is zero.

‘This will be one of those phrases we all remember in the epidemic moving forward. You can’t get more clear than “don’t worry about it” from the leading immunologist in the world.’

‘The U=U message is about science and finally telling the truth’

Robbins acknowledges that many people remain resistant to the U=U message, but says the science on the matter is clear.

‘Convoluting the freeing and accurate message of U=U with inaccurate assumptions that it has to do with condomless sex is completely telling of the toxic desire to keep a population of people living with HIV stigmatized by some individuals. It’s a shame, really.

‘The manner and way that educated people choose to become intimate with others is really none of our business. However, being honest about what science shows us, what the data says, and the opinions of real experts in the field is not only the ethical and right thing to do, but it is now being demanded by activists all over the world.

‘The U=U message is about science and finally telling the truth. Then, after that, people can decide the best combination of prevention strategies that works best for them.’

Robust evidence

Robbins’ comments were echoed by Dr Michael Brady, medical director at Terrence Higgins Trust.

‘It’s great to have this public and unequivocal endorsement from Dr Fauci that people living with HIV who are on effective treatment can’t pass it on. This message is supported by robust scientific evidence and already endorsed by hundreds of other experts and organisations.

‘Since the early days of the epidemic, we’ve made unprecedented progress in the fight against HIV; most of which is as a result of the development of effective HIV therapy. However, despite our confidence in this message, there are still too many people who don’t know it or don’t believe it.

‘That’s why the more experts and influential organisations that publicly endorse U=U, the better able we are to tackle the misinformation and stigma that still surround HIV and how it’s passed on.’

H/T: Imstilljosh

See also

HIV: When will it sink in that undetectable = untransmissible?