What is Undetectable HIV? Explaining U=U
Generally, HIV can be passed from someone living with HIV to a sexual partner who does not have HIV. But when someone living with HIV takes their medication every day (or as directed) and keeps the virus at an undetectable level, they cannot pass HIV to a partner through sex. This isn’t just a theory—years of scientific research prove it. It’s called Undetectable = Untransmittable (U=U), and it has revolutionized HIV treatment, prevention, and care.
In this video, characters ready to take their relationship to the next level discuss how having sex with HIV might work, in particular when one has a viral load that is undetectable. We break down how HIV treatment works, why U=U is a game-changer, and how it helps fight stigma. People living with HIV can have full, healthy relationships just like anyone else. U=U isn’t just about science—it’s about understanding, kindness, and the power of medicine to change lives. [AMZ-175]
Youth
HIV is considered a sexually transmitted infection (STI) because it can be transmitted through vaginal or anal sex (and even oral sex, although the chances are much lower). There is no cure for HIV, but it can be treated. In fact, people living with HIV today can take medication that is so effective that the HIV in their blood becomes undetectable – they still have HIV, and an HIV test looking for HIV antibodies will still be positive, but the virus is undetectable in their blood. When someone’s HIV is undetectable, they will no longer transmit HIV to a sexual partner, even if they don’t use condoms. Medical professionals call this U=U, which stands for “undetectable equals untransmittable.” Scientists have done a lot of research to prove this. It’s like a superpower that helps people with HIV stay healthy and protects others at the same time!
Taking HIV medication to become undetectable only affects the transmission of HIV; It does not stop the transmission of other STIs or prevent pregnancy. That’s why you should still use condoms to prevent STIs and/or other forms of birth control to prevent pregnancy.
U=U only applies to sexual intercourse. Even if the amount of HIV in a person’s blood is so low that a test cannot detect it, the HIV could still be transmitted by sharing needles or other intravenous equipment.
Not everyone has easy access to the medicine that treats HIV, but if people living with HIV ask a medical professional, they can answer questions on how to access treatment. By taking medicine exactly as instructed and getting regular checkups, people living with HIV will remain undetectable and feel healthy. If they don’t follow the medication instructions, they could start transmitting HIV again. It could also impact their health and make it easier for them to get sick, so it’s really important to stick to the instructions
You’ve probably heard the terms HIV and AIDS used together, which may have led you to believe they are the same thing, but in reality they are different. HIV stands for “human immunodeficiency virus,” and AIDS stands for “acquired immunodeficiency syndrome.” HIV is the virus that causes AIDS. When someone has HIV and does not get treated, the virus begins to attack their immune system, which can make them more likely to get sick from other germs. It can take many years without treatment for someone with HIV to develop AIDS, and some people who are HIV positive never develop AIDS.
FAQs
You cannot tell if someone has HIV just by looking at them. The only way to know for sure if a person has HIV is for that person to get tested for HIV and tell you the results of their HIV test.
You can take an HIV test at home for free by ordering a test through together.takemehome.org! You can also search the internet for free HIV testing in your area, or ask a trusted medical professional about testing options in your community. They may be able to do it right there, recommend a nearby clinic, or refer you to an at-home testing kit. There are a few different kinds of tests for HIV, but most often, a small amount of blood from a vein in the arm will be drawn for testing.
The medicine used to treat HIV is called ART which stands for “antiretroviral therapy.” ART is a combination of medicines that someone living with HIV takes daily, monthly, or every other month. ART can reduce someone’s viral load to an undetectable level so they stop transmitting HIV sexually.
Most likely, no. There are a few different kinds of tests that doctors will run for HIV. The vast majority of tests look for antibodies that the body produces to fight HIV. The body produces those antibodies when you have an HIV infection, and they never go away. A different test looks at how much of the HIV virus is in the blood. If these results come back very low, the person may be undetectable. So even if HIV is undetectable in someone’s blood, the antibodies will always be there and the test will be positive.
Incredibly accurate. Modern day HIV tests can detect HIV in 99% of people tested within 45 days of exposure. If someone tests negative, they should assume they do not have HIV. If someone tests positive, they should assume they have HIV and seek treatment. For someone living with HIV to test negative would be extremely rare, and it would most likely be because they took the test too soon after exposure (so the body has not yet reacted to the virus by creating antibodies) or the test was administered wrong, which would be extremely rare in a medical setting.
No! HIV is not like the common cold or the flu. You cannot get it from sharing food or drinks with someone who is infected. It also cannot be spread by shaking hands, kissing or hugging. HIV is spread through exposure to an infected person’s blood, semen, vaginal fluids or breast milk. It is most commonly transmitted through sexual contact or sharing needles with someone who is infected.
Like with other STDs, the only 100-percent effective way to avoid getting HIV through sexual behaviors is to abstain from vaginal-penile sex, oral sex and anal sex. Your next best bet is to practice safer sex, such as using condoms and/or a dental dam every time you have vaginal, anal or oral sex. You should also get tested regularly for STDs and HIV and ask your partners to do the same.
When people are first infected with HIV, they often have no symptoms or very mild symptoms, which is why they must get tested to know for sure if they have HIV. Later, the virus can weaken the immune system, allowing specific infections and diseases to occur. At this point, the person is diagnosed with AIDS. People with an AIDS diagnosis still have HIV in their bodies, and if they have unprotected sex or share needles, they can transmit the virus to someone else.
Not all people with HIV develop AIDS. It’s impossible to say how someone’s body will respond to the infection, and there are different strains (kinds) of HIV. Over time most people with HIV get a weakened immune system that makes them more susceptible to infections and diseases that people with healthy immune systems typically don’t get.
Parents
As with all AMAZE content, parents and families are encouraged to watch the video and read additional resources before showing it to your child and engaging in a discussion. It’s extremely important to know that HIV prevention, treatment, and care has changed dramatically over the last few decades, and we all may have preconceived notions about HIV that are no longer accurate.
This video is meant to both educate about safer sex practices when someone is living with HIV, as well as shift harmful stereotypes and stigma associated with someone living with HIV. That is why in one section of the video, the character says “HIV is more comparable to diabetes than cancer.” That is not to suggest the two are equivalent. It is simply stating that by taking medication and getting regular checkups, someone living with HIV today can live a full, healthy life and have relationships just like everyone else.
It can be daunting for a young person to navigate the medical system in order to get testing, medicine, and regular check ups. It’s important for the trusted adults in their lives to help them navigate treatment. By taking medicine exactly how instructed and getting regular checkups, young people living with HIV will remain undetectable and feel healthy. If they don’t follow the medication instructions, they could start transmitting HIV again. It could also impact their health and make it easier for them to get sick, so it’s important for young people to know their treatment plan and to have a trusted adult to come to when they have questions.
The initials HIV and the acronym AIDS are often used together, leading people to believe they are the same thing when in reality they are different. HIV is the virus that can cause AIDS, and AIDS is the illness that can occur later when the immune system is no longer able to fight off infections like it is supposed to. HIV is a sexually transmitted disease (STD) that can be transmitted from one person living with HIV to another who does not have HIV through certain sexual behaviors. Despite many myths that exist, the truth is that not all bodily fluids transmit HIV. The bodily fluids that can transmit HIV are semen, vaginal fluid, blood and breast milk.
Even though most people don’t like to talk about HIV, it is important for caring adults to talk with young people about HIV transmission and prevention before they begin engaging in sexual behaviors with a partner. Research shows that young people whose parents talked to them about condoms before they began having sex are more likely to use condoms at first intercourse and thereafter. While it is good to normalize HIV and STIs, it is also important to be clear with young people about how HIV and STIs can affect them and why it is important to practice safer sex
Conversation Starters
If you start essential conversations about topics like HIV with your children, then they will know they can come to you with questions. The easiest way to start these conversations is to talk about issues as they arise in everyday life while you are doing things like watching TV together. Symptoms, testing and understanding what it means to live with HIV may not naturally come up in conversation, but it is important to talk about them.
Here are some ways to start these conversations:
For example, if a sex scene comes up on TV, there is an opportunity to talk about whether the partners talked about safer sex or used a latex barrier, like a condom or dental dam. While you may be nervous about having these conversations, a simple, “Wow, do you think they’re worried about STDs or HIV?” is one way to start the conversation.
If you are shopping together in the market or drugstore, walk up the aisle where the condoms are hanging and ask your child if they know what condoms are and how they are used. Purchase a pack to take home and open so your child can see what they look like and how they are used.
Educators
As with all AMAZE content, educators are encouraged to watch the video and read additional resources before showing it to your students and engaging in a discussion. It’s extremely important to know that HIV prevention, treatment, and care has changed dramatically over the last few decades, and we all may have preconceived notions about HIV that are no longer accurate.
This video is meant to both educate about safer sex practices when someone is living with HIV, as well as shift harmful stereotypes and stigma associated with someone living with HIV. That is why in one section of the video, the character says “HIV is more comparable to diabetes than cancer.” That is not to suggest the two are equivalent. It is simply stating that by taking medication and getting regular checkups, someone living with HIV today can live a full, healthy life and have relationships just like everyone else.
There is no cure for HIV, but it can be treated. In fact, people living with HIV today can take medication that is so effective that the HIV in their blood becomes undetectable – they still have HIV, and an HIV test looking for HIV antibodies will still be positive, but the virus is undetectable in their blood. When someone’s HIV is undetectable, they will no longer transmit HIV to a sexual partner, even if they don’t use condoms. Medical professionals call this U=U, which stands for “undetectable equals untransmittable.” Scientists have done a lot of research to prove this.
A young person living with HIV may have an undetectable viral load and still test positive for HIV. There are three commonly used tests to evaluate HIV status. The primary test detects the person’s HIV antibodies. This will tell doctors if a patient does or does not have HIV. Looking at someone’s viral load is a different test, sometimes referred to as a Nucleic Acid Test, and signifies how much HIV is in the person’s blood. When there is very little HIV in the blood, the person has an undetectable viral load. An antigen test may also be performed. While an undetectable viral load isn’t a cure, it’s an incredibly effective way to stay healthy, and someone with an undetectable viral load cannot transmit HIV to someone else sexually (Undetectable=Untransmittable).
Young people should also know about a medicine called PrEP, which stands for pre-exposure prophylaxis. PrEP is a daily pill that can be prescribed to help reduce the risk of contracting HIV and in studies has been shown to be highly effective when used properly. This medication is often prescribed for individuals who are considered to be at higher risk for contracting HIV.
The initials HIV and the acronym AIDS are often used together leading people to believe they are the same thing when in reality they are different. HIV is the virus that can cause AIDS, and AIDS is the illness that can occur later when the immune system is no longer able to fight off infections like it is supposed to. It’s important for educators to try to use HIV as much as possible, and to correct students who say “AIDS” when they mean “HIV.”
Despite many myths that exist, students should know that not all bodily fluids transmit HIV. The bodily fluids that can transmit HIV are semen, vaginal fluid, blood and breast milk. Emphasize to students that HIV does NOT transmit from saliva, kissing, or touching.
When someone first gets infected with HIV they usually do not show any symptoms. This is why getting tested regularly is important. If someone is tested and they have HIV, there are many medications that can help treat the symptoms of HIV. These medications, in addition to regular check ups, can help someone with HIV to have undetectable viral loads of HIV in their blood. When someone is undetectable, they cannot transmit HIV through sexual intercourse. It’s important young people understand that HIV treatments are incredibly effective and allow people living with HIV to live a healthy, symptom-free life.
Before young people begin engaging in sexual behaviors, they should know how they can reduce the risk of contracting HIV by decreasing their number of sexual partners, getting tested before sexual activity and properly and consistently using latex barriers, like condoms, female (internal) condoms and dental dams.
It’s also very helpful for young people to know how to get tested once they begin having sex. HIV and other STD testing and treatment is offered through your family doctor or at most family planning clinics and community health centers. Home testing kits are now available in most major pharmacies as well. HIV testing often involves either a simple blood test or a mouth swab.
National Sex Education Standards
Define STDs, including HIV, and clarify common myths about transmission
Discuss current biomedical approaches to prevent STDs (e.g., hepatitis B vaccine, HPV vaccine) and HIV (e.g., PrEP, PEP)
Explain medical breakthroughs in HIV prevention and treatment and why HIV can now be considered a chronic condition
International Technical Guidance on Sexuality Education
Discussion Questions
- What do you think is the most important information communicated in this video?
- What new information did you learn about HIV/AIDS from the video?
- Did any of this information surprise you?
- What would you tell a friend who is worried about being infected with HIV?