Undetectable Viral Load Not a License For Unprotected Sex, Says Govt

HAVING undetectable viral load does not warrant unsafe sex practices as there are chances of transmitting the HIV virus, a Health Ministry official says.

By Kudakwashe Pembere in Kadoma

In an interview with Health Ministry HIV/TB public health specialist Dr Clorata Gwanzura said on their message with U=U an acronym for Undetectable = Untransmissible the goal is to ensure people are virally suppressed.

“As long as you are taking your medicines correctly and consistently, that is the result that you should see. However, there are various reasons that would cause a high viral load. In this country we test for viral load once every 12 months.

“In between the 12 months, between your two suppressed viral loads, it’s not 100 percent that your viral load is going to maintain the same level of not being detectable or being suppressed,” she said.

She added that people need to be wary of viral blips.

“There are things that cause what are sometimes called blips in the viral load, the amount of virus in your system. It is during those times that you have the potential or there is the risk of transmitting HIV.

“ So these blips sometimes you might not even know that you are having a blip at that time and these blips sometimes you have a severe infection, a short yet severe enough for it to challenge your immune system. You might get a blip at that point.

“There are also times where you might have a lapse when taking medication and have a blip. But because you are having two viral load tests between 12 months, you will never know you had a blip in between,” Dr Gwanzura explained.

Dr Gwanzura stressed on the importance of safe sex practices.

“So we still encourage people to stay safe, use protection when having sex. And if they want to have unprotected sex, say if they want to have baby, they need to go and see their health worker.

“At that point they will be assessed and have another viral load taken regardless of who is the one with the infection if it’s a sero-discordant couple.

“And then once it is established that they are safe, they are assisted on how they can fall pregnant without infecting the other person. We still encourage condom use, male and female and safe sex practice,” she said.

Blips can be defined as an increase from less than 50 copies/mL to above 200, 500 or even 1000 copies/mL.

Most blips are under 200 copies/mL. Blips can be caused by other infections, such as flu or herpes, or a recent vaccination.  Some blips are just lab errors.

According to AIDSMap having an undetectable viral load does not mean one is cured of HIV.

“If you stopped taking treatment, your viral load would increase and once again be detectable. Having an undetectable viral load does mean that there is not enough HIV in your body fluids to pass HIV on during sex. In other words, you are not infectious.

“For as long as your viral load stays undetectable, your chance of passing on HIV to a sexual partner is zero. As the campaign slogan puts it, ‘Undetectable equals Untransmittable’ or ‘U=U,” says the website.

Viral load at different stages

During the first few weeks after someone gets HIV, viral load is usually very high – typically several million ‘viral copies per millilitre of blood’ (copies/ml). There is a considerable risk of passing on HIV at this point. In fact, many people acquire HIV from someone who has only recently acquired it themselves (and does not know it).

After this period of early infection, viral load usually drops. A typical viral load in someone not taking treatment may be 50,000 copies/ml. There is still a considerable risk of passing HIV on.

After starting HIV treatment, viral load usually falls rapidly. Within three to six months, most people’s viral load has become undetectable (below 50 copies/ml).

You are recommended to wait until you’ve had at least two undetectable results in a row, over a six-month period, before relying on it. If you have maintained an undetectable viral load for at least six months and continue to have good adherence, the British HIV Association says that there is no risk of onward transmission of HIV.

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