Question

Will viral load be detectable in genital fluids if it is undetectable in blood?

3 November 2021. Related: Adherence, CD4 and viral load, HIV transmission.

Good day I have my HIV VL tested every 6 months and been undetectable for 13 years. What are the chances that I still have a detectable VL in my semen and whether it is infectious, because genital fluids are not tested.

Answer

Answer: Simon Collins

Hi there

Thanks for your question – and great you have been doing so well.

viral load fluctuates at low levels for all of us. This happens both in blood and in genital fluids.

However, the fluctuation is not high enough to be infectious, especially if your viral load has been undetectable for so many years.

We know this because there were no transmissions in the PARTNER studies which would also have included low level fluctuations between viral load levels. The PARTNER studies were also only testing blood and not genital fluids.

There is only a small risk that viral load might be detectable in semen. The risk is even lower that this would be infectious. And we have results from PARTNER to show that this isn\t a risk to your partners.

This isn’t something to worry about :)