Questions & Answers

What else might guys want to know about undetectable viral load?

How well does undetectable viral load work in stopping HIV transmission?

When doesn’t undetectable viral load work in preventing HIV transmission?

What can I do to make undetectable viral load work best as a sexual health strategy?

Is an undetectable viral load a cure for HIV?

So can poz guys and negative guys fuck without a condom?

How well does undetectable viral load work in stopping HIV transmission?

Undetectable viral load works extremely well in preventing the transmission of HIV. In the most recent studies — the PARTNER study and the HPTN 052 study —no HIV infections took place between sexual partners when one partner was undetectable and the other did not have HIV, even when condoms were not used. Some HIV-negative men in the study did acquire HIV from other sex partners outside of the main relationship with their undetectable partner. Relationship agreements and open communication helps keep you and your partners on the same page about the sex you want!

The latest research on undetectable viral load says “Undetectable= Untransmittable”. Read more about the initiative.

When doesn’t undetectable viral load work in preventing HIV transmission?

Depending on undetectable viral load as a strategy can be less effective if a guy isn’t able to maintain his viral load at undetectable levels. HIV is still unlikely to be transmitted even with low, but detectable viral loads. However, if a guy no longer has an undetectable viral load, it is much less dependable as a sexual health strategy.

This kind of change in viral load may be the result of difficulty taking medication consistently or other changes in his health. Also, it can be difficult for some guys to reach an undetectable viral load for reasons out of their control. After a poz guy starts treatment, he should have two undetectable viral load tests in a row to depend on this strategy to prevent passing on HIV to sexual partners.

We all have a lot going on, and aren’t always able to take care of ourselves and adhere to our medications. If you are experiencing challenges around taking your medications consistently, you have support options. Try setting alarms in your phone, using a calendar, or setting up text message alerts with our medication reminder tool.

Some people find pill organizer cases helpful. Post-it notes in conspicuous places in your apartment, recording your doses, carrying extra pills around with you, or flipping your pill bottle upside down every day once you’ve taken your meds can also be useful strategies. Talk to your doctor, pharmacist, or reach out to your local HIV/AIDS service organization for more help.

Whether you’re taking HIV meds because you’re HIV-positive, or because you are on PrEP, being consistent is really important for the effectiveness of the strategy. Most of the time, guys are able to maintain undetectable status once they reach it. If you’re viral load is going up and down each time its tested, talk with your doctor about why that might be happening and consider using additional strategies like condoms with your sexual partners.

What can I do to make undetectable viral load work best as a sexual health strategy?

For HIV-positive guys on treatment, the best bet to maintain an undetectable viral load is to stick to your treatment as prescribed and make regular visits to your doctor to monitor your viral load. When you’re undetectable you protect both your health and prevent new HIV infections.

Regardless of HIV status think about the kind of sex you want to have and openly discuss the use of sexual health strategies like undetectable viral load. Talk with each other! If you’re HIV negative using other strategies like PrEP can provide additional peace of mind.

Using condoms when one partner has an undetectable viral load may seem unnecessary, but has the advantage of protecting both guys from getting other STIs. Test frequently for STIs and if you have one, get it treated right away.

Finding Resources:

Life can pose challenges, especially for gay guys and other men who have sex with men. There are lots of factors that can make us feel alone, like HIV stigma, stress, anxiety, depression, racism, violence, relationship issues, substance use… the list goes on. Dealing with this kind of stuff doesn’t have to be something you do on your own — there’s help out there.

Counsellors, coaches, therapists, and other mental health practitioners can help you think through the problems going on in your life and offer you help to solve them. It can take some courage, but finding someone to talk to can help you get through difficult times and issues that don’t seem to go away.

So take care of yourself. Get support.

ConnexOntario operates three helplines that provide health services information for people experiencing problems with gambling, drugs or alcohol and mental illness. They can:
• provide contact information for services and supports in your community
• listen, offer support and provide strategies to help you meet your goals
• provide basic education about gambling, drug or alcohol and mental health problems

The Canadian Mental Health Association has 32 branches across Ontario providing community mental health services. Click here to find your local branch.

Community based AIDS Service Organizations provide a safe space for gay men to connect. They can also be very helpful at providing referrals to a variety of community support services. Everything from mental health and substance use to housing and income support. Visit our finding local services page to find your local organization

Is an undetectable viral load a cure for HIV?

No. But for a lot of guys, having an undetectable viral load is a big relief, since it helps people living with HIV to have good health, makes it easier to have sex and relationships, and also prevents the transmission of HIV. Testing for HIV, getting diagnosed early, connected to HIV care and maintaining an undetectable viral load provides the best possible health outcomes for HIV positive guys.

So can poz guys and negative guys fuck without a condom?

If a poz guy has an undetectable viral load, this is a highly effective strategy for preventing HIV just like condoms and PrEP. Studies show that people living with HIV who are on treatment and have an undetectable viral load do not transmit HIV to their HIV-negative sexual partners.

If you’re HIV-negative, using PrEP can add extra reassurance if you aren’t using condoms, especially with anonymous and casual sex partners, though neither strategy protects you from other STIs. It’s always important to openly discuss and negotiate sexual health strategies like condoms, PrEP and undetectable viral load.

Some guys wonder if they’ll get into legal trouble if they don’t share their HIV status. In Canada, some people have been criminally charged for not disclosing their HIV status to sexual partners, so knowing what the criminal law says about HIV non-disclosure may help you make better decisions and avoid legal problems.

If you are interested in what legal experts are saying about this issue, HALCO has a very thorough legal guide about HIV disclosure that may be helpful. CATIE also has some useful information about HIV disclosure.

If someone is giving you a really hard time or talking about the legal implications of disclosure or non-disclosure, you should get in touch with HALCO right away.