Testing

Advances in HIV treatment options mean that HIV-positive people can live long and healthy lives. Research has shown that these same treatments mean that poz folks can lead active, healthy sex lives, without fear of HIV transmission to their HIV-negative partners.

 

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Viral Load: the amount of HIV present in each millilitre of blood. Viral load testing is a regular part of a health check-up for people who are HIV-positive.

Undetectable: describes a viral load level that has dropped below levels that can be seen on current HIV tests. This does not mean the virus is gone. In Ontario, this means less than 40 copies of the HIV virus per mL of blood.

When someone first becomes HIV-positive, the virus replicates quickly in their body. During this stage, their viral load is high, and it is easy for the virus to be transmitted to sexual partners. Almost half of all new HIV infections in Ontario happen while the newly-positive person is in this stage, and they often haven't found out yet that they have HIV. As time goes on, their viral load drops, and the use of HIV treatment medication can significantly lower their viral load.

The lower the viral load, the lower the risk of HIV transmission.

Taking HIV treatment is the best way to attain an undetectable viral load. New research shows that starting treatment as soon as possible can make it easier for HIV-positive people to get to an undetectable viral load sooner, and live longer and healthier lives. Research also shows us people living with HIV who are able to attain and maintain an undetectable viral load will not pass on the virus during sex, regardless of whether condoms were used.

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While Ontario defines undetectable as 40 copies of HIV per mL of blood, the Canadian legal system may define "low" viral load as 1,500 copies/mL, as it applies to laws around disclosure. Refer to our page on disclosure for more information on the law and HIV.

For some people, it can take a long time to get their viral load to undetectable levels, and some folks aren’t ever able to get there. For poz folks who have detectable viral loads, other prevention strategies, like using condoms, having sex with other HIV-positive people, or choosing HIV-negative partners that take PrEP, can help reduce anxiety and make sex feel even better.

Just because the research promotes early treatment, doesn’t mean that everyone is ready for it. Some people who are
HIV-positive may feel pressure to go on meds to achieve an undetectable viral load. Community supports, peers, and medical professionals might be helpful in supporting poz folks working through this decision.