Prevention for People Living with HIV
People living with HIV can take steps to protect their partners and maintain their own health. Learn about treatment as prevention, U=U, and other strategies.
People living with HIV can take steps to protect their partners and maintain their own health. Learn about treatment as prevention, U=U, and other strategies.
HIV prevention is not only for HIV-negative people. People living with HIV play a central role in preventing new infections — both by protecting their own health and by taking steps to prevent transmission to partners. HIV.gov calls this approach "prevention for people living with HIV" or "positive prevention."
The most powerful prevention tool available to people living with HIV is antiretroviral therapy (ART). When a person with HIV takes their medication consistently and achieves an undetectable viral load — meaning the amount of HIV in their blood is so low that standard tests cannot detect it — they cannot transmit HIV to sexual partners. This is the scientific principle known as U=U (Undetectable = Untransmittable).
The U=U message is supported by three landmark clinical trials: HPTN 052 (2011, 2016), PARTNER (2019), and PARTNER2 (2018). Together, these studies followed thousands of serodiscordant couples (one partner HIV-positive, one HIV-negative) over millions of sex acts and found zero linked HIV transmissions when the HIV-positive partner had an undetectable viral load.
To maintain an undetectable viral load, it is essential to:
Even when viral load is undetectable, additional prevention strategies can provide extra peace of mind and protect against other STIs:
Using condoms consistently and correctly reduces the risk of HIV and other STIs. This is especially important if your viral load is not yet undetectable, if you have missed doses, or if you have other STIs that could increase transmission risk.
If your HIV-negative partner wants additional protection, they can take PrEP (pre-exposure prophylaxis). PrEP reduces the risk of HIV infection by up to 99% when taken as prescribed. Many couples use both TasP and PrEP for maximum protection.
People living with HIV should be tested for other STIs (syphilis, gonorrhea, chlamydia, hepatitis C) at least once a year, or more frequently if sexually active with multiple partners. STIs can increase the risk of HIV transmission and can complicate HIV treatment.
If you use injection drugs, using clean needles and syringes every time reduces the risk of transmitting HIV and other bloodborne infections. Needle exchange programs provide free sterile equipment and other services.
Disclosing your HIV status to sexual partners is a personal decision, but it is also a legal issue in many states. HIV criminalization laws in more than 30 U.S. states require people with HIV to disclose their status to sexual partners before sex, regardless of whether transmission actually occurs or whether the person has an undetectable viral load.
The Center for HIV Law and Policy and Lambda Legal provide resources on HIV criminalization laws by state and advocacy for law reform. If you have questions about your legal rights and responsibilities, consider consulting with an HIV-knowledgeable attorney.
Regardless of legal requirements, open communication with partners about HIV status, prevention strategies, and testing history can strengthen trust and improve sexual health outcomes for everyone involved.
Living with HIV and navigating prevention conversations can be emotionally challenging. Anxiety about transmission, fear of rejection, and internalized stigma can all affect a person's ability to engage in prevention behaviors. Mental health support — including counseling, support groups, and peer networks — can help people living with HIV manage these challenges and maintain their health.
Organizations like The Well Project (for women living with HIV) and Positively Aware provide peer support and information specifically for people living with HIV.
Explore our resources on treatment, U=U, and living with HIV to learn more about staying healthy and protecting your partners.