ASK ARIA: If my HIV is undetectable, do I still have to disclose my status?

Category: Advice

Author: Aria Vega

Hey Aria,

I’m a 45-year-old gay man who has been HIV-positive for most of my adult life. When I was younger, I got pretty experienced with disclosing my status to new partners and discussing safer sex practices with them. Then I was monogamously married for a while, which meant those conversations slowly petered out. Now I’m divorced and back on the dating scene, and it feels really different this time. It’s not just because of my age, but also my health status — my viral load is officially undetectable.

I know that an undetectable load means that I can’t pass the virus on to other people. But I’m unsure if this changes my obligation to inform new sex partners that I’m HIV-positive. If I can’t infect someone, do I really still have to let them know? Does it make a difference if they’re taking PrEP?

Sincerely,

Positively Single

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Dear Positively Single,

Thank you so much for this question! Though newer pandemics may have stolen the spotlight, HIV/AIDS still requires constant vigilance in order to protect our communities. This goes double for queer men, who are most at risk for contracting the virus in the US. It’s great that you’re taking this seriously.

As you know, an undetectable viral load of HIV is such that it won’t show up on a lab test. This occurs after prolonged treatment with antiretroviral therapy, or ART. And you’re totally right that “undetectable” means untransmissible via sex, or other means. So, in theory, what your partner doesn’t know won’t hurt them, right?

The thing is, science isn’t all that’s at play here. Everyone has the right to determine what level of risk they’re willing to subject themselves to during sex, and ethically speaking, you must always protect that right by disclosing your status. I know it’s not fun and it comes with the threat of rejection over something you can’t control but it’s still so important.

“Everyone has the right to determine what level of risk they’re willing to subject themselves to during sex…”

Perhaps the risk seems small to you but it might not seem as small to someone who’s immunocompromised or otherwise medically vulnerable. For this reason, knowing whether or not someone is taking PrEP (or pre-exposure prophylaxis, which helps prevent at-risk folks from contracting HIV) is beside the point, as they still have the right to make a fully informed choice.

Also consider that “undetectable” might not mean the same thing to everyone you bring it up with. While some folks may see it as a green light to skip using barriers, for others, the light could look yellow. Your viral load remaining beneath that threshold depends upon proper compliance with your ART; even one missed dose can cause your viral load to spike enough to be a transmission risk. Especially if someone doesn’t know you well, they could opt to play it safe.

No one has to explain their “no” to you, and I do recommend you resist the temptation to pry should it arise. Try your best not to take it personally and trust that the person is just looking out for their own health as best they can. Between COVID, monkeypox, and Lord knows what else, we are awash with anxiety-inducing pathogens these days, making many of us more selective about sex partners in general.

I’ll also pass along a piece of advice shared by sexual health advocate Tricia Wise, who I was lucky enough to have on the podcast earlier this month: encourage your partner to disclose their status too! It should be a conversation, not a one-sided confessional. Just because you have an STI doesn’t mean that you’re any less deserving of setting your own boundaries.

“Just because you have an STI doesn’t mean that you’re any less deserving of setting your own boundaries.”

We live in a culture that stigmatizes STIs, especially the ones that don’t have a cut-and-dried cure. Every time we talk openly about them, we help to neutralize that stigma, which leads to more people seeking access to tests and treatments. Not only does this help to keep down case rates but it also can alleviate so much of the shame that folks with STIs can internalize.

It may not feel like it, but you can play a key role in bringing this change about just by continuing to be attentive to your health and forthcoming with your new partners. I wish you so much luck in your post-divorce dating life, especially if you’re navigating The Apps for the first time. Don’t forget to stretch out your thumbs!

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Aria

Podcast Transcript: