Public Health Experts Affirm Virally Suppressed People Living With HIV Do Not Transmit the Virus

NASTADToday, NASTAD (National Alliance of State & Territorial AIDS Directors), a leading non-partisan non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. and around the world, published a new statement affirming that durably virally suppressed people living with HIV on antiretroviral therapy (ART) do not sexually transmit the virus. The statement accelerates NASTAD’s longstanding work to end HIV and promote policies and public health practice grounded in science.

”The science is clear that people living with HIV with a sustained undetectable viral load do not transmit the virus to others. What’s also clear is that we have the tools to end the HIV epidemic and HIV-related stigma and make new infections a thing of the past. Today, we tackle a major part of this work by raising awareness about the latest science of HIV transmission risk,” remarked NASTAD Executive Director Murray Penner.

“Until now, there hasn’t been anyone ensuring this life-changing information is communicated clearly and meaningfully to people living with HIV,” said Bruce Richman, Executive Director of Prevention Access Campaign and the Undetectable = Untransmittable Initiative. “NASTAD was the first non-profit to endorse the Prevention Access Campaign’s Consensus Statement last year representing a bold step toward sharing a message that will improve the social, sexual, and reproductive lives of millions of people living with HIV in the U.S. and around the world.”

  • The conclusive evidence about the highly effective preventative benefits of ART provides an unprecedented opportunity to improve the lives of people living with HIV, improve treatment uptake and adherence, and advocate for expanded access to treatment and care.
  • People living with HIV who are on ART and are durably virally suppressed are not only less likely to develop HIV-related complications, they also do not transmit the virus to others. This new evidence will help ameliorate decades of HIV-related stigma, discrimination, and criminalization by confirming that treatment is a powerful preventive intervention.
  • Zero new linked transmissions in the PARTNER study based on new findings and zero transmissions from virally suppressed partners in HPTN 052 trial studying whether ART can prevent sexual transmission of HIV equates to there being effectively no chance of sexual HIV transmission from people living with HIV who are on ART and durably virally suppressed.
  • An FAQ on the PARTNER study notes that STIs and likely small short-lived increases in viral load or ‘blips’ did not increase HIV transmission risk during sex in this study. STIs and viral blips have not been shown to increase transmission risk from an HIV positive person who is on ART and virally suppressed in any study or empirical evidence to date.
  • While viral suppression prevents the transmission of HIV, consistent and correct condom use and pre-exposure prophylaxis (PrEP) also prevent the transmission of HIV, and condoms provide additional protection for other sexually transmitted infections (STIs) and pregnancy.

These findings have been embraced by leading experts in the field, including:

“People living with HIV who achieve viral suppression are a fundamental part of ending new HIV infections in the United States and around the world in our lifetime. History will judge us by how well we respond to this unprecedented opportunity,” noted Dr. Demetre Daskalakis.

In conjunction with new and existing partners, NASTAD will continue to advocate at the national level to raise awareness about the latest science of HIV transmission risk and implement policies and practices grounded in our best science void of stigma and discrimination. Finally, NASTAD will continue to monitor the scientific landscape for advances that will enhance our understanding of how to reduce new HIV infections and optimize the quality of life for people living with HIV.