After hundreds of other experts and HIV organizations have already signed on to a pledge that recognizes that people living with HIV whose treatement has brought their viral load to an undetectable level — which is nearly half of all HIV-positive people in the U.S. — cannot transmit HIV to any other person, the Centers for Disease Control and Prevention has come out with the definitive statement on the subject.
In recognition of National Gay Men’s HIV/AIDS Awareness Day, the CDC memo stated, “On this day, we join together in taking actions to prevent HIV among gay and bisexual men and ensure that all gay and bisexual men living with HIV get the care they need to stay healthy.” Gay and bisexual men, the CDC noted, continue to be disproportionately affected by HIV, with, “more than 26,000 gay and bisexual men received an HIV diagnosis in 2015, representing two-thirds of all new diagnoses in the United States, and diagnoses increased among Hispanic/Latino gay and bisexual men from 2010 to 2014.”
Although these findings are certainly disappointing, the letter’s key paragraph is not. Noting that research has shown that antiretroviral therapy both keeps people living with HIV healthy and has a preventative effect, the CDC writes, “When [antiretroviral treatment] results in viral suppression, defined as less than 200 copies/ml or undetectable levels, it prevents sexual HIV transmission.”
In other words, having one’s HIV suppressed to undetectable levels prevents transmission.
“Across three different studies, including thousands of couples and many thousand acts of sex without a condom or pre-exposure prophylaxis (PrEP),” the statement continues, “no HIV transmissions to an HIV-negative partner were observed when the HIV-positive person was virally suppressed. This means that 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 an HIV-negative partner.”
That is a remarkable statement, as Bruce Richman, executive director of UequalsU.org and the Prevention Access Campaign tells us. “This is the moment we have been waiting for! The CDC agreed today there is ‘effectively no risk‘ of sexually transmitting HIV when on treatment and undetectable.”
No risk means zero risk that someone with HIV can sexually transmit the virsus to their HIV-negative partner, even if they are not using condoms or PrEP.
Richman says congratulations are in order to “all the pioneering people and partners in this community and in the city, state, and federal health departments who worked together outside and inside the system to make this change. What a beautiful moment! The CDC’s new and unequivocal language is a result of [the U.S. Department of Health and Human Services’s] unprecedented review of transmission risk messaging across departments which will be rolling out core messaging in the coming weeks and months.”
Richman, whose Prevention Access Campaign has led the educational effort around the Undetectable=Untransmittable message, points to the other people living with HIV, who “have been leading the way for this change here in the U.S. and around the world. Our experience as part of the review process and as early as last summer with HHS, [National Institutes of Health], and CDC has been productive and positive even when the gaps in our positions seemed wide. We especially appreciate their integrity, commitment, and decisive action during a time when our health and human rights have been continually under assault.”
At this year’s U.S. Conference on AIDS, Richman notes that Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, “confirmed ‘the science really does verify and validate U=U (Undetectable = Untransmittable)’ in follow-up to his statements at [the 2017 International AIDS Society].”
Now, Richman adds, “It’s time to make history and share this news!” He calls on other HIV and LGBT organizations to join “nearly 400 organizations from 56 countries that have signed on as part of a growing and vibrant U=U Community Partner network. Resources on U=U messaging in the U.S. and around the world as well as the related issues of unequal access, social determinants of health, and HIV criminalization are on our website.”
Author: Savas Abadsidis