It is impossible to have a modern conversation about HIV and HIV stigma without having the term “undetectable” used, misused, and abused. Those involved in HIV activism certainly have strong opinions on how the term – which refers to an HIV-positive person’s viral load once it becomes so low it is no longer detectable by current testing processes – should be used; and who isn’t using it correctly. Some herald the term as a badge of honor worn by those who are compliant with treatment and open about their HIV status. Others scold the same group of people for using the term as an excuse to engage in unsafe sexual behavior.
Neither oversimplified accolades nor mudslinging moral judgments should have a place in conversations about HIV stigma, prevention, and the state that is the end goal of compliance with medication. But many gay men are still unclear about what being “undetectable” truly constitutes. So, how do we get to a place where we can discuss what it does and doesn’t mean without all of us looking dirty in the end?
For those who are still unsure: An HIV-positive person can achieve undetectable viral levels after undergoing antiretroviral therapy. A person’s viral load affects both their own health and the chance that they will transmit HIV. According to a study in The New England Journal of Medicine, early antiretroviral therapy reduced the likelihood of transmission by 96 percent. Once antiretroviral meds help a person achieve an undetectable viral load, it is possible to remain at this level provided the person continues to take the medication as directed.