For years, the legitimacy of being undetectable and what that means in the fight against HIV transmission has been questioned, criticized and rebuked. Although many doctors and HIV activists have said for years that having an undetectable viral load makes HIV transmission virtually impossible, this message was met with skepticism and even contempt from the outside community.
But now, according to a recent PARTNER study presented last week at the Conference of Retroviruses and Opportunistic Infections (CROI), gay men who are on treatment and undetectable do not transmit the HIV virus... at all.
The two-year scientific study finally tested the efficacy of an undetectable viral load where it counted the most -- in men who have sex with men. Previous studies had already purported a 96 percent reduction in transmission for those who were undetectable, but these results were primarily found in heterosexual couples and, therefore, were inconclusive in regards to gay men. Now, there is proof that treatment as prevention is incredibly effective when it comes to HIV transmission through anal sex.
In fact, Alison Rodger, one of the presenters at CROI, said "their best estimate is zero" when asked about the chance of a homosexual male with an undetectable viral load transmitting the virus.
You would think that with this new information, HIV and LGBT organizations around the country would rush to the presses to inform the masses that treatment is one of the best, if not the best, form of HIV prevention. But with just one look at the comments and criticisms already swirling around the release of this study, it's unlikely that will happen anytime soon.
Whenever any story about the effectiveness of treatment as prevention is discussed in the media, the conversation quickly turns from medical facts to character judgments. Whether the topic is Pre-exposure Prophylaxis (PrEP) or undetectable viral loads, the focus shifts to vicious and stigmatizing comments about how this information will just lead to more problems in the hands of HIV-positive men.
Here are some responses to a story on the CROI study posted on Instinct Magazine and Queerty online:
"This is going to create a big problem. HIV undetectable (people) will use it as excuse to bareback or skip their daily antiviral meds then become re-infected creating a super bug of HIV that current meds can't treat."
"How about use a (expletive) condom?!"
"I wouldn't play Mr. scientist with casual barebacking partners you meet on apps. First, most guys that infect others are not aware of their real HIV status -- meaning they don't test as often as they confidently believe to be "clean." And with those that are positive, you still don't know about their HIV med intake history."
Now, this is the point when I grab my pointer, slam it against the chalkboard and scream, "Stay on topic!"
This study isn't a free pass for stupid behavior. It doesn't promote bareback sex in lieu of condoms. And it most certainly does not encourage you to trust what people say when you don't even know their last names. But this study is a monumental and extraordinary step in the fight against HIV.
The efficacy of undetectable viral loads has nothing to do with how you protect yourself from HIV in your dating life. What it is about is encouraging the 25 percent of HIV-positive people who are unaware of their status to get tested. It's about arming people with the facts of HIV transmission to reduce the stigma surrounding the virus. It is for people who fall in love but feel divided by their sero-status. It's about becoming educated on the reality of HIV transmission, rather than just leading blindly through your sex life and hoping for the best.
Condoms are good. PrEP is good. But getting tested, becoming educated and taking control of your status is the only way we are going to stop the spread of HIV for good.
But for all you men on those "dating" apps, you just might start seeing "undetectable as of..." on many more of the profiles you browse. It is hoped these results will encourage more honesty, more transparency and less fear when it comes to sharing your status. And that is a damn good thing.