Those with undetectable HIV at ‘effectively no risk’ of transmitting virus, CDC says - Sensationalist Headlines

[url]https://www.nbcnews.com/feature/nbc-out/those-undetectable-hiv-effectively-no-risk-transmitting-virus-cdc-says-n805916[/url] [quote] Following the lead of hundreds of HIV experts and prevention organizations around the world, the Centers for Disease Control and Prevention (CDC) this week stated there is “effectively no risk” of an HIV-positive person with an undetectable viral load — the amount of HIV in blood — sexually transmitting the virus to an HIV-negative partner. Bruce Richman, executive director of the Prevention Access Campaign’s Undetectable=Untransmittable initiative, called the CDC’s statement “remarkable.” "This is the moment we have been waiting for,” Richman said in an interview with HIV Plus magazine. “The CDC agreed ... there is 'effectively no risk' of sexually transmitting HIV when on treatment and undetectable. The overwhelming data clearly shows that taking our medication daily protects our health and our partners.” The goals of the Undetectable=Untransmittable campaign are to “help reduce HIV-related stigma” and encourage people living with HIV to “initiate and adhere to a successful treatment regimen.” [/quote] This may seem like kind of a given, but it's actually a huge deal that the CDC has come out and said this - it's a huge step forward for ending the stigma of HIV

I'm hoping that one day soon, people will get to read in the news (and eventually books) that this was dealt with. Just like polio, influenza, and all the deadly diseases before it.

so can gay men donate blood already or is that still a problem?

It's amazing to see how far we've come in treating HIV. From forty years ago where it was a death sentence to now, where you'd be better off than if you had diabetes.

Still, currently it's only at best an isolation that is highly reliant on constant medication that's not available to everyone. Only a step, but a great one, to an actual possibility of a cure!

Ah, the benefits of universal healthcare... Not too keen on virology, but IIRC retrovirii like the HIV are quite stable, and don't have the crazy mutation rate stuff like the flu virus has, so once a vaccine is developed, it'd be pretty much over. Just gotta look for different retrovirii for gene therapy.

this year i heard there is group of children in Africa which were born with HIV and their system built up autoimmunity against it preventing the infection to spread i guess it mean it's dormant, not sure if they active carriers or not at all

[QUOTE=Dwarden;52734091]this year i heard there is group of children in Africa which were born with HIV and their system built up autoimmunity against it preventing the infection to spread i guess it mean it's dormant, not sure if they active carriers or not at all[/QUOTE] So HIV works by converting itself into DNA and forcing host cells to read and replicate it. So when they say 'untransmittable HIV,' they mean to say that the host cells refuse to run the DNA code despite carrying it. Being naturally untransmittable seems really strange since HIV abuses asexual reproduction; sexual reproduction seems to have 'DNA locks' in place that throws out alien code, while asexual doesn't. I wonder what the genetic mutation is that made them resistant.

[QUOTE=Revenge282;52733622]I'm hoping that one day soon, people will get to read in the news (and eventually books) that this was dealt with. Just like polio, influenza, and all the deadly diseases before it.[/QUOTE] HIV is only prominent in the developing cities of Africa, otherwise its not a big deal, and for those that do have it death by manslaughter or bathroom is much more likely given the window of 10 to even 30 years before the disease goes AIDS and kills them. It's not all that deadly in general.

personally i'd still be avoiding sex with people who have HIV/AIDS (much like I would the same for any other person with an STD) to be honest

[QUOTE=ForgottenKane;52734156]So HIV works by converting itself into DNA and forcing host cells to read and replicate it. So when they say 'untransmittable HIV,' they mean to say that the host cells refuse to run the DNA code despite carrying it. Being naturally untransmittable seems really strange since HIV abuses asexual reproduction; sexual reproduction seems to have 'DNA locks' in place that throws out alien code, while asexual doesn't. I wonder what the genetic mutation is that made them resistant.[/QUOTE] Not quite. Once integrated into the host cell's DNA, the viral DNA is transcribed and translated regardless. Anti-retroviral therapy targets several key points of the viral life cycle. Entry inhibitors block the viral envelope proteins from binding to cell surface receptors, thus preventing entry of the viral particle to the cell. Reverse transcriptase inhibitors inhibit the conversion of the single-stranded viral RNA into double-stranded DNA, which must happen if the viral genome is to be integrated into the host cell's DNA. Integrase inhibitors prevent integration of the double-stranded viral DNA into the host cell DNA by directly blocking the enzyme responsible for this step. If all of the above fail, the last targetable step is the assembly and release of a mature viral particle. The viral genome codes for several proteins. Importantly, two of the gene products are polyproteins known as Gag and Gag-Pol. Gag arises from normal transcription of the [I]gag[/I] gene, whereas Gag-Pol arises from a ribosomal frameshift towards the end of the [I]gag[/I] gene. These two proteins are packaged into the virus as it buds off the host cell. As of now, the viral particle is still inactive as it lacks working structural and functional enzymes. However, one of the proteins in the Gag-Pol polyprotein is the viral protease, and this protein catalyses the cleavage of both polyproteins into their mature forms. This is the enzyme that is targeted by viral protease inhibitors.

[QUOTE=Sobotnik;52734264]personally i'd still be avoiding sex with people who have AIDS (much like I would the same for any other person with an STD) to be honest[/QUOTE] HIV isn't AIDS.

[QUOTE=Bradyns;52734470]HIV isn't AIDS.[/QUOTE] Still going to avoid regardless

[QUOTE=Sobotnik;52734896]Still going to avoid regardless[/QUOTE] You're more at risk of catching something from someone who is unaware they're infected with something than someone who has HIV and is on a regimen for it. Especially in the UK where it is well managed. If I recall correctly currently Chlamydia and treatment-resistant Gonorrhoea are on the rise here in the UK, and we're also suffering from a massive problem with HPV which is the number one sexually transmitted disease in the county.

Has anyone here actually had an STD scare or something similar? I'm wondering how prevalent this sort of stuff is for the whole facepunch-community demographic now that the forum no longer consists of just 15 year olds who like Garry's Mod.

[QUOTE=McSkinny;52736027]Has anyone here actually had an STD scare or something similar? I'm wondering how prevalent this sort of stuff is for the whole facepunch-community demographic now that the forum no longer consists of just 15 year olds who like Garry's Mod.[/QUOTE] I know there's at least the guy from canada with a hot dog avatar that has it and his bf afaik.

Which one is it? Detectable or undetectable?? I mean it must just boil down to certain tests that are more extensive are the difference between truly detecting or not detecting, right? The definition of below 200 ml of copies in the blood doesn't make it clear as to how a doctor might still diagnose having it. [QUOTE=McSkinny;52736027]Has anyone here actually had an STD scare or something similar? I'm wondering how prevalent this sort of stuff is for the whole facepunch-community demographic now that the forum no longer consists of just 15 year olds who like Garry's Mod.[/QUOTE] It's pretty much the complete opposite, but I avoided contracting herpes from two separate girls. One had HSV-2, the other HSV-1. Dated both long enough to have plenty of potential exposure. I guess if they're not literally having an outbreak that very moment, or within that week really, you're generally clear. Plus, even if you do get it, it sounds like at worst it typically is just essentially an comfortably painful skin rash. It's pretty much nothing in comparison to having HIV turn in to AIDES and get you sick because your immune system is failing. Now I wonder if this concept sort of carries over to other STDs? If the virus is of low enough concentrations, it probably would be less contagious (if that is even the right word...maybe transmittable makes more sense for STDs).

[QUOTE=NO ONE;52736865] Now I wonder if this concept sort of carries over to other STDs? If the virus is of low enough concentrations, it probably would be less contagious (if that is even the right word...maybe transmittable makes more sense for STDs).[/QUOTE] Most virus' tend to be highly virulent, hence the name, and are able to infect with only an extremely small "initial dose". As pointed out above, they hijack the host cell's machinery to replicate themselves, so a few infected cells is often enough to develop into a full blown infection. Ebola, for example, is especially remarkable because only a single virion is enough to cause death in 80%+ of cases. As for you, it's certainly possible you didn't think you "caught herpes" because you're already infected yourself, and are simply asymptomatic. There's a lot of diseases, even really fucking nasty ones like TB, that make full use of carrier hosts in order to spread. The benefit being of course that asymptomatic infections allows for easy spreading. Virulence differs pretty fucking heavily based on what pathogen it is, and there's exceptions in every pathogenic clade. For example, there's a parasite that's sexually transmitted.

[QUOTE=NO ONE;52736865]Which one is it? Detectable or undetectable?? I mean it must just boil down to certain tests that are more extensive are the difference between truly detecting or not detecting, right? The definition of below 200 ml of copies in the blood doesn't make it clear as to how a doctor might still diagnose having it. It's pretty much the complete opposite, but I avoided contracting herpes from two separate girls. One had HSV-2, the other HSV-1. Dated both long enough to have plenty of potential exposure. I guess if they're not literally having an outbreak that very moment, or within that week really, you're generally clear. Plus, even if you do get it, it sounds like at worst it typically is just essentially an comfortably painful skin rash. It's pretty much nothing in comparison to having HIV turn in to AIDES and get you sick because your immune system is failing. Now I wonder if this concept sort of carries over to other STDs? If the virus is of low enough concentrations, it probably would be less contagious (if that is even the right word...maybe transmittable makes more sense for STDs).[/QUOTE] Most people have HSV-1. Practically it reads like they feel similar to canker sores, with HSV-1 sores growing outside the mouth sometimes, and many people don't even know the difference between the two. HSV-2 is pretty fucked tho, I wouldn't want shit growing on or around my junk.

[QUOTE=The Aussie;52736928]Most virus' tend to be highly virulent, hence the name, and are able to infect with only an extremely small "initial dose". As pointed out above, they hijack the host cell's machinery to replicate themselves, so a few infected cells is often enough to develop into a full blown infection. Ebola, for example, is especially remarkable because only a single virion is enough to cause death in 80%+ of cases. As for you, it's certainly possible you didn't think you "caught herpes" because you're already infected yourself, and are simply asymptomatic. There's a lot of diseases, even really fucking nasty ones like TB, that make full use of carrier hosts in order to spread. The benefit being of course that asymptomatic infections allows for easy spreading. Virulence differs pretty fucking heavily based on what pathogen it is, and there's exceptions in every pathogenic clade. For example, there's a parasite that's sexually transmitted.[/QUOTE] I guess I forgot viruses work in that manner. It's been a while since I had to really think about the actual details of how viruses, diseases, and bacteria all spread. I can only confirm my lack of herpes from the 2 blood tests I took, which also tested for pretty much the whole list of other STDs you can get. Typically they don't like to test for it with just blood, preferring a local swab culture, but I guess there is a blood test method. You kind of have to ask for it, because again, it's not preferable since *sometimes* it gives false readings. With HIV and a few others I can't recall, blood is much more reliable though. HIV can be asymptomatic too, which is why sometimes it's one of the only ways of really knowing if someone has it, if I recall. Although, from all the doctors I've talked with, generally if something seems like a symptom, something isn't alright. With STDs, I don't think asymptomatic people are the majority of people that are carriers of something.

I assumed that if it's "undetectable", that means you don't have it? :v:

[QUOTE=Berman Slick;52738848]Heyyyy that's me, schmowzow! :D I already had a thread on the topic, kinda :v consensus was reached around late [URL="https://facepunch.com/showthread.php?t=1555946"]February[/URL] this year (my doc gave me the inside scoop early), but glad to see the CDC is jumping on board. It's pretty fantastic, the wonders of medicine. My doctor, Brian Conway, is a pioneer in the field (awarded the Order of Canada for being such a pimp) and has been a great perspective on the whole thing while I dealt with my diagnosis and treatment. What killed my uncle in the 90s doesn't affect me at all, as the medicine suppresses any and all viral replication, therefore ailments. Better yet, it's 100% free in Canada. Saves me $1200+ a month. I am HIV Positive, yes, but am treated and undetectable, so there is no detectable virus in my blood. That means HIV does not replicate in my body, nor does it have any tangible effect on my immune system, though it's still written into my DNA. Shit, if I catch a cold from someone (which is a rarity these days), I get over it in 3-5 days and they still deal with theirs 3 weeks later. I'm a very healthy person, and HIV makes no impact on that. That said, doctors still don't know how having HIV over most of your life (diagnosed at 18) will affect the body, nor how the medicine will react long term. My (I recently proposed~) fiance is Negative. When we started getting serious we went to my doctor to discuss potentially getting my fiance on PrEP (effectively taking HIV meds while you're negative, which protects you against getting it), my doctor said "Boys, don't waste your money on condoms. I was just at a seminar, confirming my research.." and filled us in on the U=U consensus (Undetectable = Untransmissable). My lover won't catch it, and doesn't worry about it one bit. Since day one I've been very open about it all, as I am with all of my partners, and he said he trusted the science behind it. He took steps to learn about it as I did, and we've never used condoms. Is it a risk? From the outside, yes, but he said he trusted me and being with me was worth it, even if he did catch it. Looks like that won't ever happen! Even early on in my treatment Dr Conway said I wouldn't have to worry, and that with medication I'd be untransmissable and healthy. It just took the completion of a myriad of studies to prove it, and he was right.[/QUOTE] i'm still baffled as to why you don't use condoms, it's an extremely minor inconvenience to take

[QUOTE=McSkinny;52736027]Has anyone here actually had an STD scare or something similar? I'm wondering how prevalent this sort of stuff is for the whole facepunch-community demographic now that the forum no longer consists of just 15 year olds who like Garry's Mod.[/QUOTE] I've had chlamydia before. Wasn't the end of the world. Nearly everyone who's had sex likely has HPV, and nearly everyone in the world has HSV-1. There's just this crazy stigma about STD's in general since people are uneducated. Just don't be stupid and you don't have to worry.

[QUOTE=Sobotnik;52738935]i'm still baffled as to why you don't use condoms, it's an extremely minor inconvenience to take[/QUOTE] Because they're in a long term relationship and presumably have already been tested for other STD's. Why bother with condoms if there's no chance of STD transmission or pregnancy?

[QUOTE=Berman Slick;52739072]Because we don't need them anymore? We both much prefer bareback (who doesn't?) and A) Risk of transmission is technically non-existent B) Him even getting HIV means one pill a day, for free, no known complications C) We're in a closed marriage, so there's no external factors to worry about It's money we're not spending (shit my doctor told me not to lol), time we're not wasting mucking with them, and [sp]kinks redacted[/sp].[/quote] but that's money at taxpayers expense. you know, money that could go to other medical conditions? why would you regard this so flippantly? a condom is a cheap and simple thing that massively reduces the risk of catching an STD and there's practically no fucking difference. are you really so stupid as to say "It doesn't matter if my boyfriend catches HIV because the government will give him free pills and as long as he takes one everyday he won't develop horrible complications as a result" ? [quote]Heck, of the 10 or so partners I've had in the past few years, only 1 wanted me to pull out, whereas the others didn't want condoms at all, nor did they want me to pull out.[/quote] this probably explains where the HIV came from [quote]It shouldn't be that hard to fathom, 0% transmission risk = no condoms. Technically I don't even have HIV, according to bloodwork etc[/quote] minus the fact you have to take medication regularly [quote]I understand your reasoning, but "condoms are an extremely major inconvenience for us", all things considered[/QUOTE] bareback sex isn't worth HIV lol like the overall attitude i'm getting is you're being really fucking selfish about it. your partner doesn't have HIV, and yet you have the balls to go "oh its not that bad" when you have to take $1200 of medicines and if your partner catches it (a disease which is extremely easy to avoid getting if you wear condoms) that's another $1200 getting wasted on subsidising your risky sexual behaviours just because you refuse to use condoms a condom doesn't even change the feeling if you're receiving, it makes no fucking sense your argument

[QUOTE=Berman Slick;52739733]Taxes I pay, and I'm pretty sure HIV is a pretty serious condition that needs treating. Canada is collectivist. We look after our own, no questions asked. Worst case scenario, he goes on medication, but his life isn't horribly derailed. That's the point, that it's no longer a life-ending condition. It's "impossible" to catch from me, and it's easily treatable.[/quote] no dude my point is that you are saying "it's no big deal that he gets HIV" when it's something that requires a constant regimen of very expensive medicines to treat. yes the government pays for it but this is a collective cost you impose. its incredibly dumb to say "it doesn't matter if he gets HIV because somebody else is going to pay for his medication". the total sum of resources isn't unlimited and you can't just say that its fine to spend thousands of dollars on these drugs to keep you alive. [quote]That's how medication works. You take it. No, it sure isn't. That's why it's great that I can't transmit it, eh? It's almost like the HIV isn't an issue.[/quote] you still have HIV and have to take medicine though, that's the point. if your partner gets HIV haven't you considered the possibility that government-funded programs can end, that drugs might eventually stop working, or the problems associated with how you need to take a pill every day (without forgetting to take them, the risk of economic disruption, storms, supply shortages, etc)? [quote]Calling my sexual behaviours "risky" without even knowing what they are is a bold, unfounded claim, and you're why the stigma is so bad. I was a good kid who got fucked over by someone he trusted, and in the end of the day I got stuck with a pill a day and a new respect for my body and others'. Oh, that and ignorant twats talking out their ass about something they have no idea about, assuming I'm a slut or a junkie.[/quote] i'm telling you that you can just use a condom. it's very simple and easy to i mean i'm not talking about putting you in fucking quarantine or even saying you can't have sex. it's a thin piece of latex that has done more for sexual health than practically every single drug developed to tackle STDs in the past 80 years has combined its literally just a thin piece of latex that costs a few cents to make and its simple and easy to use. [quote]You've never taken a dick before, have you?[/QUOTE] feels a bit like taking a shit, what's your point

[QUOTE=Berman Slick;52739928]Is that all? At least your tone is a little less hostile, thank you. What I choose to do with my body, and what my fiance chooses to do with his, are our choices. Choices we make after much careful thought and foresight. I understand your desire to limit the spread of such a disease, but it's taken care of. We'll be fine. The risk is managed.[/quote] what is even this bullshit "risk is managed" thing? we've managed to reduce many diseases through active prevention measures (ranging from cleaning water to pasteurising food). the idea of the whole "risk is managed" is why we now have loads of new STDs mutating and evolving a resistance to drugs, and HIV is no exception to the laws of nature. "managing" isn't a viable longterm solution when a much simpler method (people with STDs using condoms) is not only available but cheap and widespread. [quote]Wait, there is a 0% risk of transmission, as confirmed the world over.[/quote] you literally stated earlier that it wasn't 0% (but very low). the risk is low, but you have to watch out because infection is a black swan event. yes you are right about 99.9% of the time, but the 0.01% of the time you are wrong somebody gets HIV. [quote]There's no risk anymore. And if the Canadian government suddenly decides "all people with HIV are fucked, enjoy death or life-long debt", as you propose, then-- nah, that wont happen :/ The drugs won't just "stop working", and I don't worry about "what if"s like those because in that case, pretty much anybody who needs meds is fucked in general. [sp]Besides, I know exactly what room/what floor ARVs are kept in St. Paul's Hospital in Vancouver, and know people that work there/know how to get in, so if the world goes to shit I can just raid it. I legit talked with them about apocalypse scenarios etc and they're on board[/sp][/quote] except i really don't think you get my point governments go in and out of power all the time, policies change, etc. this is about life not just in the immediate future but decades from now as well (not to mention the whole natural disasters thing) anything could happen. you are putting your future self at incredible risk and vulnerable for the sake of some bareback sex when you are young. this is a drug you need to take all the time, and that is something that actively reduces your freedom STDS develop resistances to drugs all the time too. you mentioned your partner getting on prep, which has been successful around the world. but have you considered that there are now strains of HIV developing resistance to it? [url]https://www.poz.com/article/second-man-contracts-rare-hiv-strain-apparently-adhering-prep[/url] HIV is still spreading (the USA has about 50k new cases a year). HIV is still mutating. HIV is still developing drug resistance. Every single time a new person is infected or a mutation develops, the harder it is to control in the future. One day scientists won't be able to produce better drugs. by continuing to have sex while refusing to use a condom (fucking why? what the hell is wrong with them?), and then claiming that there is no risk, you are contributing to the false idea that people can have sex as much as they like and it doesn't matter because there will be no consequences for doing so because drugs will fix/prevent it. get some skin in the game.

[QUOTE=Berman Slick;52740055]I mean, no, but okay. The point is far past you, so never mind[/QUOTE] no offense but it sounds less like you're defending your position and more like you have a kink for this sort of thing, safe sex is always important

I think the idea here is that Sobotnik is questioning why you would take even a remote chance with it. We understand the risks are close to zero (don't say that they are 0%, because nothing in this field is), but when your defense is "it's not as bad as you think", and "there is medicine to save us", that isn't very solid. So plan B is to fall on to the tax payer's dime for expensive medicine for life. Yeah, you pay taxes too, but that doesn't offset anything. You should be doing everything in your power to remove yourself from the possibility of spreading a disease. On the other hand, Berman Slick doing what he's doing is probably statistically as safe as two clean partners. He doesn't have a great reasoning for his Plan B scenario, but with what the situation is, he likely doesn't need to.

Sorry but I'm inclined to go with the medical professionals on this one, if they say there's no risk of transmitting then I'm taking their word for it. If you think there's a legitimate risk involved in unprotected sex between two long-term partners where one has undetectable HIV, you might as well cover your body in cling wrap to stop the "technically non-zero" chance of an HIV-infected terrorist exploding into giblets and the infected blood getting into a micro-laceration on your skin while you're walking to work.