Adam Shanley

OPINION:

Undetectable = untransmittable

Becoming ‘undetectable’ is a very important step for those living with HIV since it was first spoken about in the Swiss Statement nearly ten years ago. It’s empowering to know that having undetectable levels of virus in the blood not only means that the person is maintaining their good health, but also that it does not pose a risk of transmission to their sexual partners. This has had a profound emotional impact on many living with the virus. However, many continue to experience sexual and social rejection.

Why is it difficult for some HIV negative folk to accept the science and to step away from the stigma and scepticism? I believe the answer lies in the ‘Undetectable = Untransmittable’ message not representing a new learning for gay men, but instead an unlearning. We need to dismantle so much of what we have believed about transmission and about what it means to be HIV positive.

An understanding of the specifics of HIV as it is today, including the meaning of being undetectable, should be a basic standard for gay men, regardless of HIV status. Having casual conversation amongst peers and with our sexual partners is the next step but, as with many discussions concerning HIV, the topic can quickly take an ugly turn.

A person discussing their undetectable status should be commended. It means that they have been tested, are on treatment and are open about their sexual health. The notion that being undetectable will encourage HIV positive people to stop using condoms is yet again stigmatising, but glaringly removes all responsibility from the other partner.

We could alleviate these concerns if everyone protected themselves using the preventative methods that work for them, placing an equal responsibility on both partners regardless of status – be that condoms, PEP, PrEP, treatment as prevention and most importantly, getting tested.

Being undetectable is not just something positive people should be championing, it’s something for us all. Stigma interferes with health promotion by preventing people from getting tested, accessing treatment, disclosing their HIV status, having open and honest conversations, and talking about HIV and safer sex. In order for a conversation about HIV and HIV stigma to have functional meaning, assumptions and accusations need to become undetectable.

Adam Shanley is manager of the KnowNow Rapid Testing HIV Project