Undetectable? Putting Semen to Bed

I know that a person living with HIV who is on treatment and has an undetectable viral load cannot sexually transmit HIV. So, I was frustrated by a recent study that was causing people to worry.

The study, presented at the American Urological Association Meeting, showed that there can be HIV RNA and DNA in the semen of a person with HIV whose virus is undetectable in the blood. That’s been known for a long time, but the report made it sound like it was revolutionary. And the researcher made it sound like it was something that people living with HIV and their partners need to worry about. 

Don’t worry. It’s true that HIV RNA or DNA may be present in semen especially in the first year that someone is on treatment. But HIV RNA and DNA aren’t infectious.  They’re only genetic material, and not the whole virus. You need the whole virus in order for HIV to infect a living cell. It’s like finding a human leg on the ground and thinking it can walk. You need the whole body, not just a leg to walk. 

Dr. Carl W. Dieffenbach, Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, explained the sperm situation recently in ImStillJOsh. 

“We have known for decades that HIV genetic material exists in bodily fluids of those living with HIV who are virally suppressed. On its own, HIV genetic material, RNA or DNA, is not infectious. It is not ‘whole virus,’ which is needed for HIV to infect a living cell.”

Another study was published in Clinical Infectious Disease and reported in Infectious Disease Advisor  as “HIV RNA Replication in Semen Occurs During Antiretroviral Therapy” The headlines sound like the study is about HIV replication in semen. The journalist made it sound like new and scary information for people with HIV.

Don’t worry. The headline is misleading. The study is not about viral replication in semen.  It’s an important study that’s looking at the time it takes for people to get to undetectable viral loads using different types of treatment.  It looks at HIV RNA in the testes, which shows evidence of the virus. But, most importantly, HIV RNA is not infectious.

If your HIV is undetectable and you stay on your meds, you don’t need to worry.

So do whatever you’d like with your semen or your partner’s semen. It’s safe, and so is your undetectable partner.

Bruce Richman is the founding executive director of Prevention Access Campaign where he launched the Undetectable = Untransmittable campaign. He focuses on mobilizing other people living with HIV, allies and researchers to change the outdated and stigmatizing narratives about HIV transmission risk. Bruce was diagnosed in 2003 and became undetectable shortly after starting treatment in 2010. When he learned that meant he could not transmit HIV, Bruce committed to sharing the groundbreaking news to combat HIV stigma and improve the social, sexual, and reproductive lives of people with HIV.  Bruce received his J.D. from Harvard Law School and Ed.M. from Harvard Graduate School of Education.