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Science trumps HIV stigma: ‘When we are undetectable we can’t pass the virus on’

Science trumps HIV stigma: ‘When we are undetectable we can’t pass the virus on’

Matthew Hodson, Executive Director NAM aidsmap - undetectable

Gay and bisexual men on successful treatment for HIV cannot pass the virus on to their sexual partners.

That’s a bold statement but it’s not only true, it’s a statement that needs to be widely known and understood.

New data, unveiled at the International AIDS 2018 conference, backs up the findings of previous studies. When someone with HIV whose treatment has suppressed the virus, they do not pose any risk of transmission when they have sex.

Scientists are wary of saying something could never happen but the researcher observed, that ‘You would have to have condomless sex for at least 420 years to have one incident of HIV transmission.’

‘No cases have ever been found’

When we who live with HIV are undetectable (i.e. when HIV treatment works) we can’t pass the virus on. This applies for sex without condoms. This applies for anal sex. This applies even when there are other STIs present.

Researchers are now as confident that undetectable gay men pose no risk of HIV transmission as they have been for some time about heterosexuals. This understanding is frequently expressed as Undetectable equals Untransmittable, or U=U.

We know that HIV can’t be transmitted by kissing, by spitting or by sharing teacups because no cases have ever been found. We can now say the same thing about sex when the positive partner is undetectable.

Recent years have seen a rise in activism promoting the U=U message. As Bruce Richman, the founder of the Prevention Access Campaign which has mobilised this movement, said, ‘HIV stigma is a public health crisis. U=U is an effective response.’

‘People’s sex lives have been tainted by fear’

Since the AIDS crisis first hit us, many people’s sex lives have been tainted by fear. The sex we have, which should be an expression of intimacy, passion, lust, tenderness and joy, has all too often been accompanied by thoughts of ‘Is this safe enough?’, ‘Will I be OK?’ or ‘Will he be OK?’

The impact of HIV treatment on new infections among gay and bisexual men in the UK can be traced back as far as 2012, before any impact from PrEP was felt. U=U challenges the fear that HIV negative people still have of those of us living with the virus.

It offers freedom from the fear of passing the virus on in our most intimate moments.

The preventative impact of effective HIV treatment underlines the importance of expanding access to treatment and of improving treatment uptake and adherence for all people living with HIV worldwide.

The new study, PARTNER 2, is an extension of the PARTNER study, which in 2014 indicated that people with an undetectable viral load do not transmit HIV.

Men who have sex with men were included in the previous study, but PARTNER 2 was added on to the earlier study to ensure that this finding was at least as certain for gay men as it was for heterosexuals.

PARTNER, together with an earlier study, Opposites Attract, have between them not found a single case of HIV transmission in 126,000 acts of condomless anal sex between partners of differing HIV status.

‘Facts must conquer fear’

This is the moment when facts must conquer fear. The knowledge that when we are undetectable we can’t pass the virus on to our sexual partners has the power to encourage people to test and to remain adherent to their treatment.

Treatment as prevention, alongside PrEP, has made our sex not merely safer, but safe. It has granted us freedom from fear while having the sex that we enjoy.

This is the moment when science trumps stigma.

Matthew Hodson is Executive Director of NAM aidsmap and the recent winner of Social CEO of the year. Follow him on Twitter at @Matthew_Hodson. NAM aidsmap provides HIV news and treatment information to support people living with HIV, throughout the UK and internationally, to live longer and healthier lives. If you would like to make a donation to support NAM’s vital work, please visit:

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