February 2018 Issue #14 February 2018 Issue #14, 4GUYS | Page 33

What is viral load and how does it impact risk?
Viral load refers to the amount of HIV a person has in their blood, cum and anal mucus
The lower the viral load, the less infectious the HIV-positive person will be
People who have been diagnosed with HIV are encouraged to have regular blood tests
Looking at viral load in the blood helps doctors monitor someone’s progress, e.g. to see if
the drugs are working for him
If HIV treatment is successful, someone’s viral load will become so low that it will be un-
detectable.
What is undetectable?
Modern anti-HIV drugs mean that most people with HIV on treatment have a very low or
undetectable viral load
Someone with an undetectable viral load is very unlikely to infect their sexual partners
Someone with an undetectable viral load still has HIV and if they stop taking treatment
their viral load will become detecta ble again (and the risk of transmission will increase)
The recent PARTNER study [8], found that in a period of two consecutive years, no-one
with an undetectable viral load, gay or heterosexual, who took part in the study transmit-
ted HIV to their partners.
Does being undetectable mean safer sex?
As more people now have an undetectable viral load, we are learning more about the im-
pact it has on infectiousness .So far the news is encouraging, however, you may want to
consider that it’s very difficult to know exactly what someone’s viral load is when you have
sex. Viral load tests usually take more than a week to process, so by the time you get
your result the information is already outdated. Viral load can go up if you pick up other
infections, including other STIs, so if you are in a discordant relationship (one of you has
HIV and the other has not) there may be less risk if you are confident that neither of you
will pick up an STI.
Also, the viral load level in someone’s blood isn’t the same as it is in his cum or anal mu-
cus [5]. In some men, viral load in their blood is usually higher than in their cum, but in
others it is higher in their cum. The prostate gland can harbour HIV, so the level of virus in
a man’s cum may be increased if he has recently been fucked. HIV treatments have been
shown to be less effective at reducing the levels of virus in anal mucus, so someone with
undetectable viral load in his blood may possibly still have high levels of virus in his anal
mucus.