‘Zero’ Risk of HIV Transmission for Gay Men On Treatment

HIV treatment has become an incredibly effective means of preventing the progress of the AIDS virus that, just a few decades ago, devastated the gay community, among several other areas of society.

Now, a new wide-scale study published in the “Lancet” this month confirms what other smaller studies have demonstrated: that if gay men with HIV have an undetectable viral load as a result of using antiretrovirals, they are incapable of passing on the virus to their partners.

The eight year study involved 972  gay, male-identified couples where one partner was living with HIV while the other partner was not. These couples reported having sex without wearing condoms, meaning that without HIV antiretrovirals they would be classed as having “high risk” intercourse. During the course of the study 15 men became HIV-positive. However, genetic tests revealed that they contracted HIV from men outside of the relationship and not from their partners.

In fact, not a single case of new HIV happened among the serodifferent couples where the HIV-positive partner was on antiretrovirals.

The researchers conclude: “Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero.”

They venture that around 472 cases of HIV were prevented as a result of the HIV-positive partner receiving antiretroviral treatment.

Why is this finding important?

For one thing, the finding should reassure same-gender couples. Anal sexual intercourse is classed as one of the riskiest sexual behaviors for HIV transmission. Of course, not all gay men engage in this activity (similarly to how not all straight couples stick to vaginal sex), however this research reinforces that if an HIV-positive person’s viral load is undetectable, there is virtually no risk of transmission even for those who engage in condomless sex.

This is liberating, though of course it doesn’t mean there are no other risks from unprotected intercourse, for example gonorrhea and other STIs.

More than that, these findings also underscore why it is so critical we focus on improving diagnosis rates to ensure that people know their HIV status.

Co-researcher Alison Rodger, a professor at University College London, highlights this in her comments about the study: “We’ve got a way to go to get people easier access to testing and treatment, but if we could get global coverage, then we could really make headway in eliminating the virus. It was such a powerful result that we thought we just improve the quality of life for people with HIV.”

And that is one of the other major takeaways from this study.

The confirmation that “zero=zero”, meaning an undetectable viral load equals no chance of passing on the virus, is perhaps one of the most powerful pieces of news for people living with the virus. Many who contract HIV are now optimistic about living full and healthy lives, however people who are HIV-positive report a number of psychological pressures.

One is the burden of having to take medication for the rest of their lives—something that can be particularly pronounced for people who have drug-resistant HIV who are forced to take combinations of sometimes aggressive anti-retrovirals.

The other pressure is the worry of passing on the virus. This can lead to people having trouble with intimacy or forming romantic relationships. There is also a stigma attached to being HIV-positive that this research can help combat by driving home the message that being HIV-positive does not mean a person is at risk of infecting their sexual partners.

Researchers are now keen to couple the “zero=zero” message with calls to get tested, because by knowing our HIV status, we are empowered to prevent the spread of HIV whether we have the virus or not.

Photo credit: Getty Images.


heather g
heather g9 days ago

If women were the main victims of HIV, studies and cures would still be a long way off.

Graham P
Graham P11 days ago

Agree with Sue H a cure would be better.

Sue H
Sue H11 days ago

Good, but a Cure would be better!

Debbi W
Debbi W11 days ago

That is wonderful news.

Alea C
Alea C12 days ago


Elizabeth H
Elizabeth H12 days ago

Good news.

Dr. Jan Hill
Dr. Jan Hill12 days ago


Sherry Kohn
Sherry K12 days ago

Many thanks to you !

Danuta W
Danuta W12 days ago

Thanks for sharing.

JoAnn Paris
JoAnn P13 days ago

Thank you for this very interesting article.