What is Viral Load HIV viral load is

What is Viral Load? HIV viral load is the amount of virus in a sample or milliliter of blood. If Persons living with HIV (PLHIV) stick to their treatment consistently, they can reduce their viral load to a level that is too low to be detected by a viral load test.

What is Viral Suppression? Once the HIV patient’s/your viral load is less than 1000 copies per milliliter/sample of blood. This means that the virus is under control and it is not multiplying. Achieving viral suppression reduces your chance of passing on the virus.

What is Viral Suppression? To reach viral suppression you/HIV patient’s need(s) to adhere to your/their medication and take it as prescribed When you/they reach viral suppression, you’re/they’re able to stay healthy and live longer, so please STAY ON MEDS!!!

What is Viral Suppression? It is possible for someone taking their medication consistently for 3 -6 months to reach viral suppression. So, it is important to GET ON YOUR MEDS, TAKE THEM & LIVE LONGER.

What is your GOAL after reaching viral suppression?

VIRAL LOAD UNDETECTABLE

What is an Undetectable Viral Load?

What is an Undetectable Viral Load? Once the patient’s/your viral load has fallen below 20 copies per milliliter of blood, it is said to be undetectable.

How it works? Become undetectable. This can take up to 6 months after starting HIV medication. Your health care provider will perform blood tests and let you know when you’re undetectable.

How it works? Stay undetectable. Get a second undetectable test result at least 6 months after the first. Continue to take your HIV medications daily and visit your health care provider regularly. They will monitor your blood tests to make sure you’re still undetectable.

How do I know if I’m undetectable? The only way to know is to have a viral load test (at least once per year) 2 undetectable results in a row over a 12 -month period to confirm the virus is undetectable.

What is an Undetectable Viral Load? It is possible for someone taking their medication consistently for 6 -12 months to reach viral suppression. It is important to STAY ON YOUR MEDS & LIVE A LONG, HEALTHY LIFE!!!!

GOAL after an Undetectable Viral Load?

What is U=U? It means that someone with an undetectable HIV viral load and on ART (Anti Retroviral Treatment/Treatment), is unlikely to transmit HIV sexually. UNDETECTABLE = UNTRANSMITTABLE

U=YOU=U The Ministry of Health & Wellness promotes U=U=U. YOU - before looking at being untransmittable what are the benefits to YOU as a PLHIV

U=YOU=U Improved health - ability to live a life free of additional health issues Empower PLHIV/you to know that you can live a healthy and normal life.

Evidence PARTNER 1 study (2014), nearly 900 couples (gay and straight) who had sex without condoms more than 58, 000 times. PARTNER 2 study presented in (July 2018), nearly 1000 gay couples who had sex more than 77, 000 times without condoms.

Evidence (Cont’d) According to i-base. info, there were ZERO-linked HIV transmission in the PARTNER 1 & 2 studies where one partner was HIV-positive and on ART with their HIV-negative partner

What does U=U involve? Taking ART everyday and adhere to treatment regime Attend all appointments including lab tests An undetectable viral load for at least 6 months

How can U=U not be a risk? When a patient’s/your viral load is undetectable there is too little virus in sexual fluids for the transmission of the virus for an infection to occur

Does U=U work with all HIV drugs? Yes, any HIV medication taken as prescribed reduces viral load. Undetectable will mean Untransmittable U=U

Does U=U work for everyone? Yes. The PARTNER studies included both gay and straight couples. In straight couples sometimes the man was positive, and in others the woman was.

SAFER SEX

SAFER SEX When a patient/you maintain(s) an undetectable viral load, it is unlikely to pass on the virus to the someone they have sex with. This is for oral, vaginal and anal sex. This is whether you have sex with or without condom.

SAFER SEX When an HIV-positive person who has an undetectable viral load has sex with an HIV-negative person, it is unlikely for he/she to pass on the virus. UNDETECTABLE HIV is sexually UNTRANSMITTABLE

SAFER SEX However, if the HIV patient has unprotected sex with someone who is HIV positive that has a detectable viral load, the strain of the virus can increase, hence your viral load can now become detectable. This weakens your immune system and in some cases you have to change your medication.

SAFER SEX When you have an undetectable viral load, you can still give and get other Sexually Transmitted Infections (STIs), such as chlamydia, herpes, gonorrhea and syphilis.

SAFER SEX Therefore it is important that the patient practice the THREE C’S – 1. CONSISTENT 2. CORRECT 3. CONDOM USE

HAVING A HEALTHY BABY HIV-positive mothers who has an undetectable viral can produce a healthy HIV-negative baby. If you want to have a baby and you’re undetectable, speak to a doctor who specializes in pregnancy and childbirth who has experience in HIV care.

HAVING A HEALTHY BABY HIV-positive mothers who have an undetectable viral load can produce a healthy HIV-negative baby. If a HIV patient wants to have a baby and they’re undetectable, they NEED to speak to a doctor who specializes in pregnancy and childbirth, and has experience in HIV care.

Pregnancy & Childbirth If a pregnant woman starts HIV treatment prior to or very early in her pregnancy and maintains an undetectable viral load, it is unlikely she will transmit the virus to her baby during pregnancy or during childbirth.

Recommendations Ø The mother gets HIV medication during pregnancy and the child gets HIV medication after birth up to 2 years. Ø Vaginal delivery is the most common and safest type of childbirth.

Recommendations (Cont’d) Ø Do a HIV conformity test after 2 years before taking the baby off the HIV medication to confirm whether the baby is HIV positive or negative

Recommendations (Cont’d) FEEDING THE BABY Ø Formula is recommended and not breastfeeding. Ø Although an undetectable viral load reduces the chance of the baby getting the virus, there are cases where the babies become HIV-positive from breastfeeding.

Benefits of U=U 1. Responds to and reduce HIV stigma and discrimination. 2. Motivate efforts of PLHIV to become virally suppressed and continue follow-up care. 3. When a person living with HIV is taking effective ART, the viral load becomes so low that it is undetectable.

Benefits of U=U 4. A HIV-positive person with an undetectable viral load will not pass on the virus. 5. Reduces the shame and fear of sexual transmission, enabling healthy sexual and reproductive lives. 6. Encourages people living with HIV to start and adhere to treatment, and maintain an undetectable viral load.

Benefits of U=U 7. Strengthens advocacy efforts for universal access to treatment and care. 8. Accelerates reforms in government policies and laws, especially the criminalization of HIV exposure and non-disclosure.

Benefits of U=U 9. Having an undetectable viral load is good for your immune system and help you live longer, healthy lives.

Food for thought 1. Having an undetectable viral load does not mean that PLHIV are cured of HIV. They still NEED to adhere to your medication and appointments 2. It is important that they always practice safer sex for every sexual act. If not, they can be infected with a sexually transmitted illness (STI).

Food for thought 3. Viral load levels should be monitored regularly to be sure that the HIV medications are working. They NEED to ensure that you do a viral load test at least once per year.

Food for thought (Cont’d) 4. If a HIV mother is undetectable and wishes to have a child, she NEEDS to talk to her doctor about her desire to have a child before having unprotected sex. 5. If a HIV patient partner is not aware of their HIV status and they’re thinking of having unprotected sex, they need to get professional advice on this matter before they do.

Treatment as Prevention (Tas. P) We now know that medications that TREAT HIV can also PREVENT HIV transmission. If you are HIV-positive and you take your HIV medication it suppresses the virus to an undetectable level, and it is unlikely that you will pass on the virus to people you have sex with.

Treatment as Prevention (Tas. P) Effective treatment can also prevent HIV transmission to a baby during pregnancy and birth, if the pregnant mother maintains an undetectable viral load while pregnant. Effective HIV treatment not only TREATS HIV but it can also PREVENT HIV.