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:
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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.