This Week in Sex: CDC Says Undetectable HIV Is Not Transmittable

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Roundups Sexual Health

This Week in Sex: CDC Says Undetectable HIV Is Not Transmittable

Martha Kempner

The nation's pre-eminent public health institute makes this overdue announcement; another college gets a vending machine that sells emergency contraception; and Italian ocean trash may tell tales of sex on (or near) the beach.

This Week in Sex is a summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

People With Almost No Viral Load for Six Months Can’t Give the Virus 

In a “Dear Colleague” letter marking National Gay Men’s HIV/AIDS Awareness Day in late September, the Centers for Disease Control and Prevention (CDC) noted that HIV-positive people with undetectable viral loads have “effectively no risk of sexually transmitting” the virus. This brings the CDC in line with other AIDS organizations who have been arguing that undetectable is equal to untransmissible.

Undetectable viral loads are the results of improvements in antiretroviral therapy (ART), a combination of drugs used to stop HIV from making of copies of itself. The fewer copies of the virus there are in a person’s body, the less damage it can do to the immune system. A person has reached viral suppression when there are fewer than 200 copies per milliliter of blood or the virus can’t be detected at all.

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Research has suggested that when a person reaches viral suppression for six months or longer, they are no longer at risk of transmitting the virus. In its letter, the CDC points out that there have been three different studies that cover “thousands of couples and many thousand acts of sex” that were otherwise unprotected—the couple didn’t use a condom and neither member was taking pre-exposure prophylaxis or PrEP. In these studies, there were no HIV-transmissions from a virally suppressed HIV-positive partner to an HIV-negative partner.

Some see the CDC as slow to make this announcement. Last year, more than 400 organizations worldwide signed a consensus letter stating that “HIV transmission from a person living with HIV (PLHIV), who is on Antiretroviral Therapy (ART) and has achieved an undetectable viral load in their blood for at least six months is negligible to non-existent.”

Nonetheless, advocates are excited that the country’s leading public health organization is now onboard with the message. Eric Sawyer, vice president of public affairs and policy at Gay Men’s Health Crisis, told Healthline: “We’re thrilled that the CDC has endorsed what we and many other HIV/AIDS organizations, researchers, and doctors have known for many years: If you’re HIV positive with an undetectable viral load, there is a negligible risk of HIV transmission.”

As HIV advocates frequently say, “treatment is prevention.” And the effects of treatment are being felt. The CDC notes that between 2010 and 2014, “HIV diagnoses fell among white gay and bisexual men and remained stable among African American gay and bisexual men after years of increases.”

Unfortunately, many people do not know their HIV status, and, therefore, are not being treated. For others, access to HIV treatment medication remains a challenge. The CDC recommends widespread testing and treatment as well as efforts to reduce the stigma that still surrounds HIV and AIDS.

Stanford Campus Gets Emergency Contraception Vending Machine

Stanford University in California joined a growing trend among college campuses recently when it installed a vending machine that includes emergency contraception (EC). The machine also sells male condoms, female condoms, and Advil.

Emergency contraception pills are a birth control method that can be used after intercourse. The pills work by preventing ovulation. Sperm can only live in a woman’s reproductive tract for up to five days. If there is no egg released during that time, a woman can’t get pregnant. (EC cannot prevent pregnancy if a woman had already ovulated before sex and cannot end an already established pregnancy). Because the goal is to prevent ovulation, EC should be taken as soon as possible after unprotected sex but can be taken up to five days later.

Students at Stanford worried that access to EC on campus was limited, especially over the weekend when the health center had limited hours. It is available over-the-counter at pharmacies off campus, but securing it requires access to transportation and not all pharmacies stock it.

Rachel Samuels, a former student at Stanford, told the San Jose Mercury News: “It was difficult for students who had an incident, or an assault, that happened on a Friday night—and no access to emergency contraception until Monday.” Samuels, now a graduate student at Georgetown University, started campaigning for the vending machine three years ago after noticing her brother’s school, Ponoma College, had one. Other schools, including Dartmouth and the University of California’s Davis and Santa Barbara campuses, have also installed such vending machines in the past few years.

The administration at Stanford was not resistant to the idea, but there were logistical and legal details to work out. Ultimately, the vending machine was installed in a gender-neutral bathroom in the student center, which is open every day from 7:30 a.m. to 2 a.m.  It sells generic EC pills called My Way for $25 a package and accepts credit cards.

When the Tide Brings in Dildos …

As sad as it is, it is rarely surprising when trash washes up on the beach. According to the Ocean Conservancy, 228,919,809 pounds of trash have been collected from oceans since 1985. Nonetheless, clean-up volunteers on a beach in Pozzuoli—a town near Naples on Italy’s western coast—were surprised when a dozen dildos washed up on shore.

The currents have washed up many things over the years including industrial waste and animal feed, but these lifelike plastic penises were something new. One clean-up volunteer told the Sun: “When we saw them, we started to laugh because we could not do anything else.”

Despite the humor in the moment, officials closed the beach to children while they cleaned up the mess and, perhaps, waited to see if the tide brought in any more dildos.

We’re not sure the threat of plastic penises is enough to warrant closing the beaches to young people. After all, bodily fluids that could be on a sex toy and potentially transmit sexually transmitted infections would almost certainly not survive an ocean voyage. And a penis is just a body part. We wonder what side Chief Brody and the mayor would come down on if this happened in Amity over the Fourth of July weekend.