Understanding HIV viral load is crucial for successful treatment.
When it comes to treating HIV (human immunodeficiency virus), one of the most important numbers your doctor will watch is your HIV viral load. Basically, this refers to how much HIV is in your bloodstream. When you treat HIV, this number stays low, which can help prevent HIV from progressing to AIDS (acquired immunodeficiency syndrome).
Treatment for HIV has come a long way, but there are still a lot of myths about the disease. Understanding HIV viral load better is crucial for combating the stigma, improving awareness, and improving treatment outcomes.
What to Know About HIV Viral Load
1. The goal is “undetectable” viral load
Undetectable viral load means there are so few viral particles in your bloodstream that a standard blood test won’t detect it. People who maintain an undetectable viral load are able to live relatively normal lives. They generally have a reduced risk of transmitting the virus to others or getting really sick from a simple cold.
2. You have to stick to your treatment
The way to keep your HIV viral load low is through antiretroviral therapy (ART). ART medications help prevent HIV from replicating in the blood, thus keeping your viral load low. In order for them to work, you have to take them consistently, and take them exactly as prescribed by your doctor. (Find out how to tell if your HIV medications are working here.)
3. ART treats but does not “cure” HIV
As of now, there is not a cure for HIV. Although ART medicines are great at preventing the virus from replicating, it cannot yet completely destroy it. HIV tends to find places in the body to hide. If you were to stop taking your HIV medications, the “hidden” virus would then be able to re-emerge and begin replicating. This would cause your viral load to increase.
If you keep your viral load low, however, your life won’t be that different from someone without HIV.
4. It’s a myth that people with HIV can’t have sex
People with an undetectable HIV viral load have a lower risk of transmitting the virus to others. As long as someone is taking their HIV medicines as prescribed (and having regular visits with their doctor to confirm their viral load and CD4 levels), it is likely safe for them to have sexual relationships.
Experts still recommend using condoms with new or multiple partners to protect you from other sexually transmitted infections. If you’re in a monogamous, long-term relationship (and have an undetectable viral load), it’s likely safe to have sex without a condom. Learn more about sex with an undetectable viral load here.
5. It’s a myth that HIV is a death sentence
Back in the 1980s—when scientists didn’t yet know much about HIV or how to treat it—it was unlikely to survive HIV/AIDS. In that time, it was common for people to die within years or even months after their diagnosis.
Thanks to scientific advances for understanding, preventing, and treating HIV, this diagnosis is no longer a death sentence. Most patients today are able to find a medication that works for them and fits with their lifestyle. By keeping their HIV viral load low, it’s unlikely for the HIV to progress. As a result, people who get treatment for HIV tend to live similar life spans as those without HIV.
Stella A. Safo, MD, is an HIV primary care physician and assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai Hospital.