HIV Treatment as Prevention (TasP)

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Staying adherent to HIV treatment is not only important for the health of a person with HIV. It is also can unlock the power of HIV meds for prevention. There have been no cases of HIV transmission from a person who has undetectable viral load. The risk of acquiring HIV from someone with undetectable viral load is virtually zero. Thus, adherence to an HIV treatment regimen is one of the most important methods of HIV prevention. This strategy is now known as treatment as prevention (TasP).

Learn more from this adapted selection from "Introduction to ART," a booklet published by HIV i-Base, a British treatment activist group. It is also available in a pocket version.

HIV antiretroviral therapy (ART) reduces the chance of transmitting HIV. With an undetectable viral load, in many cases this risk is close to zero. Although this has been known for many years, there is now much better evidence, including for gay men as well as heterosexual couples.

The PARTNER study reported no transmissions from the positive partner with an undetectable viral load. This was after 44,500 times that people had vaginal or anal sex without condoms. This study is still ongoing for gay men because there were more heterosexual couples in the first part of the study.

Study HPTN 052 -- also in couples where one person was positive and the other was negative -- showed that this protection for ART continues for years when viral load is undetectable.

These facts should improve the quality of life both for anyone who is worried about HIV. It should reduce any anxiety for couples where one partner is positive and the other is negative, even if they still chose to use condoms. Condoms are still important if you want to protect against pregnancy and some STIs.

All HIV doctors should talk about how ART reduces the risk of transmission. Taking ART will benefit your own health and reduce the risk of sexually transmitting HIV.

TasP is changing the approach to HIV treatment. But it is important to understand the difference between public and personal benefits of ART. Your decision to use ART should always be your personal choice. If you do not want to take ART for your own health, you should not be under pressure to take ART for TasP.

Many HIV positive people do not put others at risk. This relates to their choice of sexual activity including condom use or they have partners who are also positive.

Most new infections are likely to currently come from people who are not yet diagnosed. This is related to people being most infectious in early infection, or having a high viral load in later infection.

An undetectable viral load can reduce the anxiety and worry even when you are using condoms.

Many HIV positive people on ART like the feeling they are not infectious. Many people stop having sex after they are diagnosed because of this fear. ART makes it easier to continue to date and have full relationships.