Men Living with HIV
Men Living with HIV: Undetectable=Untransmittable
Advances in HIV treatment have given people living with HIV the tools to live long, healthy lives. Improvements in HIV medications means having HIV can be a manageable condition. When a person living with HIV is diagnosed early and participates in their medical care, they can live about as long as someone not living with HIV.
Taking your HIV medications as prescribed helps keep you healthy by lowering the amount of HIV in your blood to levels that cannot be detected (seen) by standard laboratory tests. This is called having an undetectable viral load. When you have a consistently undetectable viral load for six months or longer, you cannot pass HIV to your sexual partner. In short, Undetectable = Untransmittable (#UequalsU).
We also now know U=U applies to residual or very small amounts of HIV in tissues or bodily fluids like semen.
It is important to know that, even if your viral load is undetectable, your viral load can become detectable again if you stop taking HIV medication.
How is HIV transmitted?
How is HIV Transmitted?
HIV is transmitted, or spread, through contact with these body fluids:
- Blood (including blood from menstrual periods and any blood in saliva, urine, and feces).
- Semen (“cum”) and other sexual fluids from the penis (“pre-cum”).
- Vaginal fluids.
- Rectal fluids
HIV is not spread through contact with these body fluids:
- Saliva (spit)
- Feces (poop)
- Urine (pee)
Methods of transmission:
- Sex not protected by condoms or medications.
- Re-using or sharing needles or other works/equipment for injecting drugs, tattoos, or other substances.
- Perinatal transmission: during pregnancy, labor, delivery, or breastfeeding.
HIV is not spread by hugging, holding hands, kissing, drinking or eating from the same cups or utensils as a person living with HIV, or by using a toilet also used by someone living with HIV.
Taking your HIV medications and staying undetectable is not only good for your own health, it is the best defense against transmitting or passing HIV to another person.
For more on HIV transmission:
Preventing HIV Transmission
Treatment as Prevention (TasP):
One of the most effective ways to prevent passing HIV to a sexual partner is Treatment as Prevention (TasP), which means taking your HIV medications as prescribed by your medical provider and maintaining an undetectable viral load. TasP has been endorsed by several researchers: https://www.preventionaccess.org/undetectable.
An undetectable viral load/TasP works in preventing transmission of HIV and supporting you in having a healthy and an enjoyable sex life.
For real-life stories on TasP for sex, check out our blog: https://www.hiveonline.org/undetectable-uninfectious/
Pre-Exposure Prophylaxis (PrEP)
PrEP is an HIV prevention medication that a person without HIV takes to keep from getting HIV. PrEP works if taken daily. PrEP takes 7 days to start working before anal sex, and 20 days to start working before vaginal sex. PrEP is safe and effective. Most people can tolerate PrEP well, but it may have some mild side effects like nausea and headache when first starting.
Anyone taking PrEP should be seen by a medical provider for regular lab check-ups, including HIV/STI testing, Hepatitis B testing, and tests to make sure the kidneys are healthy. To find a PrEP provider, and for live chat about PrEP: https://www.pleaseprepme.org/. For more on PrEP: https://www.cdc.gov/hiv/basics/prep.html.
Post-Exposure Prophylaxis (PEP)
PEP is an emergency medication available by prescription that can stop HIV if started within 72 hours of exposure. If a person without HIV has been exposed to HIV within the last 72 hours they can go to a clinic or emergency room and ask for PEP. For more on PEP: https://www.cdc.gov/hiv/basics/pep.html.
Using a male or a female condom with lube when you have sex works to prevent HIV, pregnancy, and other sexually transmitted infections (STIs). For people living with HIV, using condoms can prevent other STIs.
Female condoms can increase pleasure for both partners due to heat-transmitting material, stimulation from the ring, wider size, and looser fit. To learn more about female condoms: http://www.nationalfccoalition.org/female-condoms.
For more on condoms as an HIV prevention method: http://www.thewellproject.org/hiv-information/talking-your-partner-about-condoms
Disclosure: Telling People Your HIV Status
HIV disclosure is telling someone that you are living with HIV. Disclosure is a journey. It can be stressful. It can be freeing. Disclosing to a family member or friend might be part of your plan to get support for your treatment and wellbeing. Disclosing to a sexual or intimate partner might be on your mind. Why disclose and why not disclose? The reasons are different for each person.
Having a support system can be helpful for disclosing your HIV status. If you’re not ready to tell close friends, family members, or other loved ones, consider joining an online support group or discussion forum. Your provider and/or social worker can help you make a plan, and they may ask you questions such as:
- How do you feel about disclosing your status?
- What are the benefits of disclosure?
- Why do you think of disclosing now?
- What are the worst things that could happen if you disclosed?
- What do you think it would look like to disclose?
- Have you ever imagined having a talk about disclosure? If so: how did you imagine doing it? How did you imagine it went?
- Where is the best place for you to disclose?
If you feel like disclosing is the right choice for you, the most important thing is that you feel as ready and prepared as possible to disclose to your partner(s) or others. Preparing for disclosure can include making a plan with your provider or social worker and/or role playing to become comfortable with the conversation. There are many ways to do it, and there is no perfect way.
Here is a video with people living with HIV talking about how they disclose:
We believe that no matter who, where, when or if you choose to disclose, disclosure is a choice. Trust yourself to make the best decision for you.
Laws related to HIV disclosure and HIV exposure are different in each state. Local practices may also be different for each provider and hospital or clinic setting. Ask your provider or a trusted advocate about local disclosure and exposure laws and provider practices. Here are some questions you can ask about disclosure:
- Who am I legally required to disclose my status to?
- I had condomless sex with someone before knowing my HIV status – do I need to tell them I’m living with HIV?
More resources on disclosing your HIV status:
HIV criminalization refers to criminal laws that punish people for not disclosing their HIV status before having sex, or for any potential HIV exposure. These laws are generally outdated, and many were passed before we had effective HIV prevention methods. Advocates are working to update the outdated laws.
For more resources on laws that protect you, job discrimination, housing discrimination, and other forms of discrimination:
There are many birth control (also called contraception or contraceptive) options available to you and your partner, depending on when and if you want to have a baby. Your doctor can support you in finding the best option for you.
For more on each method of contraception, visit:
For more info on HIV & contraception:
Thinking of having a baby? Advances in HIV treatment and prevention make starting a family an exciting and safe option for people living with HIV. Having a consistently undetectable viral load prevents HIV transmission to your partner when you have sex to conceive and also protects your baby.
There are several safer conception options available to you, depending on whom you plan to have a baby with:
- Man living with HIV and woman not living with HIV
- Man living with HIV and woman living with HIV
- Men living with HIV
- Trans men living with HIV
Join in to hear from men’s reproductive health champions as they share tips on integrating sexual & reproductive health conversations into care provision for all men living with HIV.
Join us *live* for a 1-hour discussion via Google+ Hangouts on Air:
Tuesday, June 13th, 2017
1 p.m. PT // 3p.m. CT // 4p.m. ET
Poppy and Ted, a serodifferent couple (Ted is living with HIV and Poppy isn’t), talk with their provider, Emily Miller, MD, MPH, about their options for having a baby.read more
Magic, a man living with HIV, asks Dr. Cori Blum about the risks of having a baby with his HIV negative partner, Annie.read more
Magic, a man living with HIV, and Annie, his HIV-negative partner, talk with Dr. Cori Blum, a family practice provider, about safer conception. Annie and Magic want to know, “What can we do to make the risks as little as possible?”read more
Dr. Cori Blum asks Magic, a man living with HIV, if he wants to have a baby.read more
HIVE hosted our 2nd Hangout on Air about HIV Prevention for women. Our focus in this Hangout was Safer Conception options, programs and policies for people affected by HIV.read more
Learn about the roles of PrEP (Pre-Exposure Prophylaxis), PEP (Post-Exposure Prophylaxis), TasP (Treatment as Prevention), male and female condoms, and more.read more
This awesome infographic is here courtesy of TheBody.com. Click on the image to zoom...read more
Dr. Lynn Matthews and Shannon Weber talk about sperm washing, PrEP, and TasP, and possible combinations of the three.read more
Prof. Vernazza is a true pioneer for safer conception: he started helping serodifferent couples who wanted to have babies in 1996. Watch this video to learn his recommendations on this topic.read more
Dr. Cori Blum talks with Shannon Weber about working with men living with HIV and building families.read more
Why YOU should give female condoms a chance. (Sara also demonstrates how to use one using a model vagina.)read more
“Reaching women through their HIV-positive male partners: The PRO Men Initiative”:read more
…But even that didn’t deter the dreams of pink-cheeked babies that had begun drifting through Hillsborough’s head…read more
When the shock finally wore off many months later, I realized HIV was only a small part of me and I was not going to allow this virus to define me.read more
Carolina tells her story of finding a provider who was willing to help her have her baby & how she did it.read more
Learn how HIV is transmitted from Dr. Lisa Fitzpatrick and Shannon Weber.read more
Learn what the female condom is, about successful roll-out, new products in the pipeline and why “female condom” is actually a narrowly defining name.read more
Shannon Weber and Lauren Poole address common questions that providers get regarding safer conception options for serodifferent couples where the man is living with HIV and the woman isn’t.read more
Dr. Annie Luetkemeyer and Clarissa Ospina talk about the importance of medication adherence for people living with HIV: "People can really live long healthy lives with HIV." Deon and Caroline, a serodifferent couple, share their experience, as do Zutty & Juancito, two...read more
Joseph, Zutty, Damion, Jimmy, and Deon are all men living with HIV. Caroline is Deon’s HIV-negative partner who is pregnant. They discuss what a healthy sex life (and a healthy life) means to all of them…read more
Zutty, Angela, & Deon, all people living with HIV, talk about how they disclose their HIV status.read more
PRO Hombres: Adherencia vídeo en español.read more