HIV: Treatment as Prevention

Caesar Djavaherian, MD, MS, FACEP
March 29, 2021
4 min

We’ve come a long way in helping to prevent and treat HIV since the first reported case here in the United States in 1981. The most recent reports from the Centers for Disease Control and Prevention (CDC) estimate that in 2018, just 36,400 new HIV infections occurred in the country, a number that is down by about two-thirds since the peak of the domestic epidemic in the mid-1980’s. 

However, there’s still a long way to go to eradicate the virus. To reach a point when HIV and AIDS are a cause of death only in history, we must address disparities in healthcare amongst minority and underserved communities, and reach at-risk individuals, namely transgender and bisexual men (who are most affected) to provide access to treatment.

Treatment as Prevention

Treatment as prevention, or TasP, is a concept in public health that promotes treatment (medication) as a way to prevent and reduce the likelihood of HIV illness, death, and transmission from an infected individual to others. If you’re living with HIV and you take medication exactly as prescribed, adhere to regular follow-ups with your physician, and are tested regularly to make sure your viral load is undetected, TasP is highly effective at preventing the spread of the virus—for you and potentially for others. 

ART for an undetectable viral load

HIV medicine is referred to as antiretroviral therapy, or ART. ART works to reduce viral load—the amount of virus in the blood of a person living with HIV. 

Viral suppression happens when HIV medication—ART—reduces the amount of HIV and prevents the virus from growing in the body, keeping a person living with HIV healthy and without illness. Suppression to the point of being undetectable is the goal with antiretroviral therapy. This undetectable point happens when your viral load is so suppressed, it doesn’t register on a standard lab test. 

Typically, when you take HIV medication on a daily basis, as prescribed, you can reach an undetectable viral load within six months from the start of treatment. 

Life-changing benefits of TasP

When an undetectable viral load is reached, people living with and diagnosed with HIV (people aware that they’re living with the virus) are able to live long, healthy lives. And, a major benefit of undetectable viral load via effective TasP is the preventative aspect. 

Two life-changing benefits to TasP:

If you’re pregnant and living with HIV, TasP can reduce the risk to transmission during pregnancy, labor, and delivery to one percent or less as long as:

  • You take HIV medication as prescribed throughout your pregnancy, labor, and delivery.
  • HIV medication is administered to your baby for a period of four to six weeks after delivery.

You can suppress and maintain an undetectable viral load through medication, which means you can effectively have zero risk of sexually transmitting the virus to your HIV-negative partner(s).

PrEP is a different yet highly effective HIV preventative method. 

The Pre-exposure Prophylaxis (PrEP) method is for those who don’t have HIV who want to be proactive in reducing their risk of getting HIV if exposed to the virus. As stated by, there are two FDA-approved medications for PrEP, prescribed for HIV-negative adults and adolsecents who are at high risk for getting HIV through sex or injection drug use. And as always with sexual intercourse, condoms reduce the risk of contracting HIV, along with other sexually-transmitted diseases.

Sharing your status

If you know you are diagnosed with HIV, it’s crucial you speak up and communicate your status with your current (and potential) partner(s). When you communicate with your partner, you can both make informed decisions about treatment and preventative plans. 

And, if you can’t quite find the words, we can help. When you access care with Carbon Health, your provider can notify your partner or partners that they have been exposed to the virus. We’re here for you now and down the road to help you through your treatment and prevention plan.

Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published, but it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Talk to your healthcare provider about questions you may have regarding your health or a medical condition, and before making changes to your healthcare routine.

Caesar Djavaherian, MD, MS, FACEP

As Carbon Health’s Chief Innovation Officer, Caesar Djavaherian, MD, MS, FACEP, guides clinical innovation through product development, service expansion, and partnerships with transformative companies working to improve the healthcare ecosystem. He is an emergency medicine physician, a former high school teacher, and a reformed academic researcher. Caesar co-founded Direct Urgent Care to deliver technology-enabled urgent care throughout the San Francisco Bay Area. He has practiced at New York-Presbyterian Hospital, the University Hospital of Columbia, and Weill Cornell Medicine. In his spare time, Caesar advises healthcare startups, cheers on the Warriors, tries various HIIT workouts, and daydreams about what the future of health will look like.