U=U and Treatment as Prevention (TasP)

U = U undetectable means untransmissableAs well as being good for your health, ART also protects your partners.

An undetectable viral load on ART stops the risk of HIV, even without condoms.

This is called U=U or Undetectable = Untransmittable.

Your HIV doctor should talk about this.

  • The PARTNER studies and the Opposites Attract study both reported zero transmissions from the positive partner with an undetectable viral load.
  • Couples in these studies – both gay and straight – had sex more than 100,000 times without condoms.

This means condoms are only important if you want to protect against pregnancy and some STIs.

U=U should reduce worry and anxiety over HIV.

It should also help reduce fear and stigma about HIV.

ART as prevention

UK guidelines recommend that every HIV doctor 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.

Public health and personal choice

U=U has changed the approach to HIV and ART.

But 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 to prevent transmission.

  • Most HIV positive people never put their partners at risk.
  • Most new infections come from people who do not yet know they are HIV positive. This is because viral will be higher when not on ART, especially in early infection.
  • Greater awareness of U=U can improve our lives. It is good to no longer have to worry about whether our partners are at risk.
  • ART makes it easier to have relationships without the fear of HIV.

We are both HIV positive and not using condoms is a special part of our relationship. We are both on treatment and have no resistance.

We don’t usually have other partners, but agree to use condoms if this happens, so that we would reduce the risk of STIs…

— Steve, Manchester.

I am positive and so is my partner.

I am happier to continue using condoms.

This is because I feel better to be in control of this part of my life.

At least I don’t have to worry about my health if he decides to have other partners…

— Paula, London.

Last updated: 1 June 2022.