What undetectable means, and why it changes everything

If somebody has told you that the aim of treatment is to become undetectable, and you are not sure what that means or how long it takes, this is the short version.

What the word means

Viral load is the amount of HIV in your blood. Treatment brings it down, usually fast. When it falls below the level a laboratory test can measure, which in the UK is normally under 20 to 50 copies per millilitre depending on the test, you are described as undetectable.

The virus has not gone. It is being held down by the medication, which is why you keep taking it. But at that level it is doing no damage to your immune system and it cannot be passed on.

Undetectable equals untransmittable

Once your viral load has been undetectable for six months and you keep taking your treatment, you cannot pass HIV to a sexual partner. Not a small risk. No risk at all.

This is known as U=U, and it comes from large studies that followed thousands of couples where one partner had HIV and one did not, having sex without condoms, over years. There was not a single transmission from a partner who was undetectable.

It is worth reading that twice if you have spent the last few days assuming your sex life was over.

How long it takes

Most people reach undetectable within three to six months of starting treatment. Many get most of the way there much sooner than that: it is common for a viral load in the hundreds of thousands to drop to a few dozen within weeks.

How fast it happens for you depends on where you started and which combination you are on. Your clinic will test you and tell you.

What it does not mean

It does not mean cured, and it does not mean you can stop the tablets. Stop and the virus comes back.

It does not protect against other sexually transmitted infections, so testing for those carries on as normal.

If you are thinking about pregnancy or feeding a baby, the guidance is specific and worth going through with your clinic rather than reading online.

Where this comes from

Talkpositive is peer support, not a medical service. Anything about your own treatment belongs with your clinic, and they will not mind you asking.

If you would rather ask someone who has been through it

Talkpositive is a free, private community for people living with HIV. No real name needed, nothing public, nothing in search engines. Small rooms by what you are going through, and quiet one-to-one conversations that open only when both people have said hello.

Have a look at Talkpositive