Undetectable: HIV treatment that’s a vital part of prevention
How achieving undetectable status can make the risk of transmitting the virus to a partner almost non-existent
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Your support makes all the difference.Since the original World Aids Day was marked in 1988, there have been such dramatic scientific advances for HIV treatment that the focus on prevention could hardly look more different.
In early 2017, a number of sexual health clinics in London reported a decrease in new HIV diagnoses, especially among gay, bisexual and other men who have sex with men. Last month, Public Health England (PHE) confirmed that, for the first time since the beginning of the UK epidemic, the number of HIV diagnoses in gay and bisexual men has fallen, making it one of the first countries to witness a substantial decline in HIV diagnoses among this group. Public health experts have declared this to be the most significant development in the UK HIV epidemic in 20 years, since effective antiretroviral treatment first became widely available.
Promoting combination prevention
Undetectable is not new, with the first scientific statement referencing the part it plays in preventing HIV dating back to 2008. But only now, in 2017, have organisations including the US Centers for Disease Control and UNAIDS finally made official statements confirming that people with HIV who are Undetectable cannot transmit HIV.
This is also the first year that the ground-breaking HIV prevention campaign by London boroughs, known as Do It London, has included Undetectable. While previously the campaign focused on condoms and the importance of HIV testing, the latest phase of Do It London looks at combination prevention including not only condoms and testing, but also Undetectable and the availability of Pre-Exposure Prophylaxis (PrEP), which involves HIV-negative people considered at high-risk of HIV acquisition using antiretroviral medication as prevention.
“People with an undetectable viral load have levels of virus that are not transmissible to their sexual partners, even if having sex without condoms. This is a key element of prevention, and part of our progress towards eliminating HIV transmission,” says Paul Steinberg, lead commissioner of the London HIV Prevention Programme.
“This is a new and important message for us to get across to the public in our new campaign. We aim not only to influence people’s behaviour around sexual health, but also to educate them about what undetectable actually means. It’s part of our approach to combat the long and damaging history of HIV-related stigma and discrimination which is unfortunately as old – and as harmful – as the epidemic itself.”
Beating targets
The latest statistics show we are on the right path, with 2016 having seen London exceed the global UNAIDS 90-90-90 targets with 90 per cent of people living with HIV infection diagnosed, 97 per cent of people diagnosed receiving treatment and 97 per cent of those receiving treatment virally suppressed.
Becoming HIV undetectable is a key marker of living well with HIV. Last month’s PHE report highlighted the continuing decline in the number of people diagnosed with Aids and the low numbers of people who die of HIV-related causes in the UK.
In fact, last year, the PARTNER study reported zero HIV transmissions among couples where one partner is HIV positive and the other HIV negative, who had condomless sex more than 58,000 times.
Despite all this progress, the number of diagnoses made at a late stage of HIV infection in the UK remains high, particularly among heterosexual men and women. This is why 2018 will see new efforts to promote early diagnosis through regular testing – and why Do It London campaigns have, since they began just two years ago, had HIV testing at the core of their message to the public.”
For more information on the campaign, visit doitlondon.org