What does undetectable = untransmittable mean for HIV management?

U = U. These three basic characters mean everything to the future of people living with HIV.

“U = U” translates into “undetectable equals untransmittable.” See, scientists have proved that if you have an undetectable amount of HIV in your blood, you can’t transmit the virus to anybody else when you have sex.


U = U: Why it’s a huge deal

Scientists and health experts have found that taking meds as prescribed every day will kill off almost every trace of the virus in your blood.

When HIV gets into your bloodstream, it starts making copies of itself. HIV tests count the copies of the virus in a milliliter (ml) of blood. (One milliliter isn’t much: about one-fifth of a teaspoon.)

If you’re living with HIV, you can have up to a million copies of the virus per milliliter of blood.

Taking HIV meds as directed every day can reduce the copies of HIV per ml to 200 or less — the “undetectable” level.

This is so important because at the undetectable level, you can’t pass the virus to somebody else when you have sex.

The human body has no trouble fighting off a couple hundred copies of HIV with the help of some antiretroviral (ART) medications. But a million copies of the virus in each milliliter of blood means trillions of copies in your body. That’s too much for your immune system to battle on its own.


How scientists discovered U = U

Researchers around the world looked at thousands of cases where people living with HIV had sex with other people. Some used condoms, some didn’t. They did it every which way, but it didn’t matter.

As long as they took their meds and got their HIV to the undetectable level for six months or more, they never infected anybody.

Not once out of thousands of cases.

That’s why the experts at the U.S. Centers for Disease Control and Prevention (CDC) say this:

“People who take ART daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to their sex partner.”

One note of caution: We don’t know if U = U applies to injecting drugs. Don’t assume you’re in the clear to share needles when your HIV level is undetectable (sharing needles is normally never a good idea).


Does U = U mean it’s OK to go bareback?

If your viral load stays undetectable, you can’t infect a sex partner. So, in theory, you might think you could skip condoms. The trouble is, going without a condom exposes you to any other sexually transmitted infections (STIs).

Also, sex without a condom could mean an unplanned pregnancy.

Thus, it’s always a good idea to keep your condoms handy.


What about PrEP?

PrEP, or “Pre-exposure prophylaxis,” is a treatment for people not living with HIV who might be at risk for infection.

If you’re living with HIV and you’re in a relationship with a new partner who is not, you can talk to them about PrEP so they don’t have to worry about getting infected.


Where to find out more on U = U

Here’s a website with all the details on U = U.

Check it out to find out how you can join forces with the world’s top scientists and health experts.

If we all chip in and get the word out on U = U, we can fight another word starting in U: Unfairness.

HIV stigma creates unfair outcomes for people who are living with HIV. Everything we do to combat HIV stigma brings more fairness into the world.

And better health. That’s as boss as it gets.

Need some more motivation? Check out these hashtags: #ScienceNotStigma, #UequalsU.

You’re the boss of your body. If you have a question or concern please contact us for information about STI testing and treatment or other health services.

HIV walk-in testing hours:
Mon – Thurs 1 pm – 7 pm
HIV Services (216) 707-3448

STI walk-in medical testing:
Wed  11 am – 3:30 pm
Thurs 9 am – 11:30 am

PrEP or STI medical testing by appointment:
(216) 721-4010

Testing Location:
Circle Health Services
12201 Euclid Avenue
Cleveland, Ohio 44106


Please visit www.circlehealthservices.org for more information or e-mail info@circlehealthservices.org.

What happens if I don’t seek treatment for HIV?

You know the answer. You’ve heard it gazillion times: “HIV is incurable. If you don’t get treated, you’ll die too young.”

Of course, that sounds like a scare tactic. You may have lost friends and family before their time. Car crashes, accidents, gunfire — there are all sorts of ways to go that don’t include old age or natural causes.

But to deal with HIV, you can’t think about death. It’s too scary and depressing.

Instead, you have to think about life: Making yours last as long as you can.

When you get into treatment, you stand an excellent chance of living as long as anybody else does. If you don’t get treated, you’ll only get sicker and sicker. And not getting treated may even cause problems for others: spreading the virus.

When you’re the boss of your body, you understand you won’t live forever. But there’s no sense in causing a bunch of problems you know how to prevent.


What HIV does if you don’t stop it

HIV destroys a certain kind of cell that your immune system needs to fight off diseases. Scientists call them CD4 cells, or t-cells. CD4 cells don’t fight the infection themselves. Instead, they alert the immune system, which sends soldiers called antibodies to attack invaders.

Here’s the messed-up thing about HIV: Instead of attacking the antibodies, HIV attacks the alarm system. Without CD4 cells to sound the alarm, your immune system doesn’t even know it’s under attack.

HIV works in stages. At first, it causes a nasty viral infection. Some people living with HIV = remember it as the worst case of the flu they’ve ever had. But that infection goes away, and they feel healthy again.


The long slow march to AIDS

It turns out your body has more than enough CD4 cells to fight off the first stage of an HIV infection. The trouble comes with all the stages after that.

Over the course of many years, HIV keeps attacking your CD4 cells. Eventually, HIV kills so many CD4 cells that the immune system doesn’t work right anymore. That’s when you develop AIDS.

With AIDS, you start getting rare cancers. A minor lung infection can turn into pneumonia that fills your lungs with fluid and drowns you.

AIDS is what freaks people out about HIV. It’s a nasty way to go that you wouldn’t wish on your worst enemy.

With HIV treatment, your risk of AIDS goes way, way down. And your odds of living a long, healthy life go way, way up. (And there’s this bonus: Even if you have AIDS, today’s meds can get you healthy again and add years to your life.)


Passing HIV to other people

Nobody can force you to take HIV treatments. Eventually, you’ll get so sick that you feel like crap 24 hours a day and get so weak you can barely walk. But hey: It’s your body, and your choice.

It’s one thing to let yourself go that way. It’s something else to infect other people.

Everybody gets that. You don’t do something you wouldn’t want done to you.

But life gets complicated. You could say, “I’ll make sure I use a condom every time I have sex.” But what if things get hot and heavy and you don’t have a condom available? Or you could be buzzed from too much beer and wine — and forget to use one.

Next thing you know, your partner has HIV too.

Or, let’s say you inject drugs. Can you be sure you’ll never share needles again? One slip could infect the people you may also use the drugs with.

It’s not that you would infect somebody on purpose. It’s just that accidents happen when the urge for sex or drugs takes over your brain.

If you get into HIV treatment and stay with it for at least six months, it’s essentially impossible to infect somebody else. Scientists have proved it in multiple studies.


Protecting what you have

The Be Boss outlook is that your life is precious. Other people value it as well. They need you around to help them make it through life.

So, you’re not just in this for yourself. You’re in it for everybody.

When you get into HIV treatment, you’re giving yourself a future. That includes staying in school, getting a better job, settling down with a life partner, starting a family, and all the other stuff people do.

Everything you do for yourself to fight HIV helps everybody you know, and everybody they know.

When you’re the boss, you see why you need to get into care soon — and to stay there for the rest of your life. You deserve it. And so does everybody else.

You’re the Boss of your body. If you have a question or concern please contact us for information about STI testing and treatment or other health services.

HIV walk-in testing hours:
Mon – Thurs 1 pm – 7 pm
HIV Services (216) 707-3448

STI walk-in medical testing:
Wed  11 am – 3:30 pm
Thurs 9 am – 11:30 am

PrEP or STI medical testing by appointment:
(216) 721-4010

Testing Location:
Circle Health Services
12201 Euclid Avenue
Cleveland, Ohio 44106

Please visit www.circlehealthservices.org for more information or e-mail info@circlehealthservices.org.


What does HIV treatment look like?

HIV treatment looks pretty simple at first:

  • Your doctor writes you a prescription.
  • A pharmacist gives you some pills.
  • You take the pills every day, following your doctor’s directions exactly.
  • The pills fight HIV, defending your immune system.
  • You stay healthy.

Nothing to it, right?

Well, there is more. It turns out it’s not so easy to follow all these directions every day for the rest of your life.

Scientists say the problem is adherence. “Adhere” means “to stick” (you know, like glue). It’s tougher than you might think to stick to your HIV treatments.

If you want to protect yourself from HIV, you’ll need to commit yourself to the idea of fighting HIV every day. And then you have to stand by your commitment. It’s like making a promise — to yourself and everybody who cares about you.


PEP as prevention

Be Boss PEP as prevention

PEP is almost like the morning-after pill — except it fights HIV.

PEP is short for “post-exposure prophylaxis.” It’s a fancy name for a prescription that can block HIV after you’ve been exposed to the virus.

Sounds great, right? But if PEP can prevent an HIV infection, why doesn’t everybody take it every day?

Because you have to start taking PEP within three days of exposure to the virus. It doesn’t work after HIV has been in your blood more than 72 hours.


Using PrEP as prevention against HIV

Be Boss - prep

PrEP — short for pre-exposure prophylaxis — is a daily medication for people who are not living with HIV but who are at a high risk of getting it.

If you take PrEP every day, you can drastically reduce your chances of getting HIV. It’s a good choice if you’re:
• In a relationship with somebody who is living with HIV
• Having sex without a condom regularly
• Using injected drugs and sharing needles and works

PrEP is all about reducing your risk of getting HIV. Let’s dig deeper into how that happens:


How to use a condom and find the right one for you

BeBoss - Safe Sex Can Be Fun

Using a condom every time you have sex is a cornerstone of the Be Boss outlook.

Wait, what? Every time?

Yeah. Here’s why:

Bosses are leaders and managers. They have responsibilities — to themselves first but to everybody else, too. That includes sex partners.

Sex is supposed to feel good. Condoms have a reputation for messing with that: People say they feel strange and reduce the sensations that make sex so much fun in the first place.

But it doesn’t have to be that way. Choosing the condom that works best for you and using it right can juice up your sex life.

A condom also takes a lot of the worry out of sex because it can prevent unwanted pregnancies and sexually transmitted infections (STIs).

Worry is the last thing you want when you’re getting down with that special somebody.

Here’s how to get rid of the worries and have the most fun with a condom:


Why everyone should get tested for HIV

You can be a superhero just by taking an HIV test.

BeBoss Everyone Should Get Tested

Getting tested means you’re taking the first step toward keeping yourself healthy, protecting people you care about, and putting the brakes on a global epidemic.

That’s heroic stuff. It’s easy to do nothing and let somebody else worry about HIV. The Be Boss way is to grab HIV by the horns and deal with it.


Is it possible to have HIV/AIDS without knowing it?

In short, the answer is “yes.” You could have HIV in your blood for years and not have a clue. Your best friend could have it and you’d never know.

BeBoss HIV Without Knowing

You could feel sick for a week, think it’s the flu, and not realize you have AIDS.

Seems crazy — everybody has heard about HIV and AIDS, right? But most people don’t know much more about the diseases, and there’s plenty of wrong ideas people have about them.

That’s why so many people pass HIV to others when they have sex or share needles. It’s not like they’re evil. They just don’t know.


What does it mean to have HIV?

It may sound strange, but check this out: There’s nothing to fear from HIV.

BeBoss HIV is nothing to fear

HIV is an example of a viral infection. You get colds and the flu from other viral infections, and nobody freaks out over them.

Don’t get us wrong: HIV is a dangerous infection if it’s not treated. It’s the virus that causes AIDS (acquired immune deficiency syndrome), which is a much more serious progression of the illness.

But today, we have medications to treat and control HIV, just like we do with diabetes and other common diseases. Sure, you probably can’t help being afraid of HIV at first. You may not know much about HIV, and everybody fears the unknown.

But once you know the facts on HIV, your fears start to drain away.


What is an STI?


STI means sexually transmitted infection. Did you know HIV is a sexually transmitted infection?

You get an STI from having sex with somebody carrying a germ — usually a virus or bacteria — that causes the infection.

The good news is that you can protect yourself from these infections, and if you get an infection, you can get treatment.

We’ll break down some of the most common STIs (including their symptoms and treatments), how you can protect yourself, and how you can get tested for free.