Is the RNA there? Yes! Positivo's Undetectable Viral Load!

AIDS Antiretrovirals HIV HIV or Basic

Positivo's Undetectable Viral Load if I test myself? This is the million dollar question and the answer is YEA! AND…

… That is why it is positive for HIV even if undetectable!

If it is undetectable, you will still be positive for HIV. This is expected and does not mean that your treatment is not working. RNA, SoropositivoOrgEach year, the San Francisco AIDS Foundation conducts more than 15.000 HIV tests.

People from all over the bay - even from all over the world - access our services to discover their HIV status. Only a very small percentage of the tests we perform are positive, and we know how provide newly diagnosed people with support, resources and care to continue living a healthy life. However, we were perplexed when we found out that customers are looking for our HIV testing services. Especially when they are HIV positive and sometimes even care for and take HIV medications.


Why can people living with HIV get tested?

As we connect with all the people who are positive in one of our locations, we always ask why people do the HIV test whether they have been diagnosed in the past?

This happens for several reasons:

People can test with a partner for whom they have not yet been informed, they may have mental health problems that come into play.

Or they need a diagnostic letter to access services (such as a shelter bed).

Sometimes it is because they are confused about the information that an HIV test will provide.

Now that we know that undetectable is equal to non-transferable (U = U), idea some people may have the wrong notion of, being undetectable, will no longer be positive for HIV. They may think that if they test HIV negative on an HIV test, will be able to show this to their sexual partners as a way to "prove" that they are undetectable and non-transferable. Or you may think it will be easier to tell partners that they are HIV negative, instead of being undetectable and non-infectious.

The idea of ​​saying that you are HIV negative is bad for you. We need to use courage to face the facts and change the reality!

But I know that this has a great personal cost, that the pain and consequences of this posture can be overwhelming and I understand the feeling! I paid dearly, very dearly for such a provision. For me, it was worth it, it was very worth it! And without that it is not so for everyone. By the time I made this decision I had already lost everything, I had fled a huge city, with millions of inhabitants due to prejudice! And in the emotional field, my first “post-diagnosis” experience was disastrous!

If you are living with HIV and have an undetectable viral load, you will still be positive for HIV.

But, if you live with HIV, you take medications as prescribed every day, you have a viral load suppressed in a “durable” and sustained way, remaining undetectable for at least six months, you will not transmit HIV to sexual partners.

You are not infectious.

This is the meaning of I = I.

Here is why you will still be positive for HIV, even if it is undetectable. 😞

Testing positive for HIV antibody tests

Since the early days of the HIV epidemic, we have used antibody tests to test for HIV.

In the past, HIV testing was typically done first with an ELISA.

Or screening test, which was confirmed by a Western blot test that identifies specific antibodies. The most recent tests usually combine an antibody test with an antigen or protein test, which provides more sensitivity for early diagnosis.

Infection. Antibody tests are the most accessible and accessible HIV tests.

Testing costs also influence your choices

They are the most common types of HIV tests at test sites around the world, because they provide fast, on-site results.

Antibody tests do not detect HIV. Instead, they detect antibodies that the immune system makes in response to HIV infection.

Do you want to know more about the different types of HIV tests, how they work and how early do they detect HIV? Look this Avert easy-to-read guide ou read these CDC questions and answers.


Our immune systems develop antibodies in response to all pathogens. Whenever you get sick or contract any infection, your body creates a defense system and creates antibodies to try to fight that specific infection.

If these antibodies are successful, some infections will disappear, but antibodies never disappear. They will remain in your body, helping to protect you from getting the same infection in the future 😷.

In this way, antibodies allow our bodies to "remember" a specific infectious agent - like a specific flu strain - and then respond more quickly if we are exposed to it again in the future. Once we develop antibodies to a virus (or in response to a vaccine), we can have those antibodies for life or for many years.

Positive tests on nucleic acid tests.

In addition to antibody tests, we also have HIV tests that detect viral "RNA" - not necessarily live viruses, but parts of the virus's genetic material. These are called nucleic acid tests and are able to detect very early HIV infections. These tests are not used as often for screening as antibody tests (or antibody / antigen tests), because the results take longer and the test is more expensive.

Typically, "RNA" tests are used to confirm a positive HIV diagnosis after someone tests positive for the antibody test or to see if a person is responding well to treatment.

Some of these viral detection tests are able to detect viruses at very low levels. Some HIV "RNA" research trials (called ultra-sensitive tests) can measure HIV "RNA" levels down to single copy levels.

😰The Undetectable Count Does Not Imply In Absence. 😰

We often say that someone is “undetectable” if you have a viral load of less than 20 copies / mL or 50 copies / mL. Research studies have defined “undetectable” as any viral load below 200 copies / mL. I, Cláudio, see an immense ambiguity in this 200 count. I had an exam that showed 41 and my doctor scored "41" and was not undetectable. Without many details, there is a reason for that! And it's been known for a long time that the devil lives in the details.

Therefore, even if a person has a viral load less than 50 copies / mL or 20 copies / mL, viral “RNA” will still be detected with one of these viral detection tests.

"Detecting a very small amount of virus in one of these tests shows that a person is not cured," said Henry. “But it has no practical clinical significance as long as you are in effective therapy based on our current understanding. According to all clinical standards, if you have fewer than 50 copies, this is what matters. Having an HIV “RNA” level below 25, versus less than 50, for example, does not mean anything clinically with regard to current management or transmission risk assessment ”.

Once positive for HIV The viral load test will tell you if you are undetectable.

If you live with HIV and want to know if it is undetectable, the right test for you is called a viral load test. Similar to nucleic acid tests to detect HIV infection, HIV viral load tests measure the number of copies of HIV in a milliliter of blood. It is recommended that people living with HIV perform viral load tests in general every 3 to 6 months, Besides other lab tests that measure your CD4 count and more.

The bottom line is that if you’re living with HIV and has an undetectable viral load, it will still test positive for HIV if tested. But this is expected and does not mean that your treatment is not working or that you are not undetectable. As always, check with your health care professional if you have any questions about which HIV test is right for you or what types of tests will provide the answers you need to take better care of your health.

- The San Francisco AIDS Foundation offers a variety of free and confidential sexual health services. Including HIV and STD tests, link to HIV treatment, PrEP and more.

Translated by Cláudio Souza on April 24, 2020 from the original Here's why you test positive for HIV if you're undetectable written by Joshua O'Neal 7 June 2019

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