“By making HIV-positive people believe that they cannot transmit the virus because they are undetectable, this messaging can have adverse effects on the latter, who may develop irresponsible behavior by having more and more unprotected sexual encounters,” says a communications specialist
In August 2020, the Panos Institute launched the Endetektab = Entransmisib (E=E) campaign. It recommends that people living with HIV/AIDS also known as PLWHA, take their antiretroviral medication regularly until they become undetectable.
“Being undetectable means that the test has found a minuscule amount of the virus in the PLWHA’s blood, according to the commercial. The PLWHA cannot transmit the virus during sex.”
Therefore, an undetectable HIV-positive person can have sex without a condom, according to Dr. Emmanuel Bélimaire. The HIV/AIDS specialist confirms this in a video posted on the Panos Institute page, at the beginning of the campaign. In addition, the radio advert makes no mention of this contraceptive method.
Ralph Emmanuel François, a communications specialist, believes that this commercial can be dangerous. “By making HIV-positive people believe that they cannot transmit the virus because they are undetectable, this messaging can have adverse effects on the latter, who may develop irresponsible behavior by having more and more unprotected sexual encounters,” he says.
According to the specialist, the advertisement is not correct from the standpoint of the psychology of communication. It gives PLWHAs the impression that they can have sex without a condom and they may not take the time to inform their partners that they are HIV-positive.
Less critical, Marketing professor, Beaunel Beauzile tries to explain what the ad omits by explaining the ads objective, which is to persuade people living with HIV to take their medication. He believes a new, more suggestive advertisement could be based exclusively on condom use in the future.
The university professor believes E=E advertising is specialized. It speaks to PLWHAs first and foremost. By targeting them, we suppose that they already have some information about their disease, including the need to wear a condom during sex.
But, for Emmanuel François, in this case, it is too specialized. “We forget that PLWHAs are ordinary people even if they need special assistance. So, as with any other person, they need to be reminded that when it comes to sex, HIV is not the only virus you can contract.”
Of the approximately 150,000 people living with HIV/AIDS, only about 128,000 are under a doctor’s supervision. This is according to Sabine Lustin, executive director of Promoteurs Objectif Zéro SIDA (POZ), an institution working in the fight against HIV/AIDS.
So, while she agrees with the campaign, the doctor still thinks condoms should not be neglected. “There is no such thing as zero risk,” she says.
Even on regular treatment, two PLWHA who have sex without a condom are not guaranteed protection. They can share their viruses.
According to Sabine Lustin, a person can be infected with two types of HIV. The first, called HIV 1, is found all over the world. HIV 2 is mainly found in West Africa and parts of Europe.
HIV 1 infection leads more quickly to AIDS. But when it comes to treatment, some classes of drugs don’t work as well for someone infected with HIV 2. “This is usually one of the reasons why a treatment does not work,” says Sabine Lustin.
For example, when two PLWHAs have sex without a condom, there is a risk if one of them is taking drugs that the other’s germs can resist.
Similarly, if sex occurs between a regular PLWHA and an irregular PLWHA, the viral load of the former will increase. This is why it is strongly discouraged from having sex without a condom with someone whose status is unknown.
Depending on the type of HIV, 1 or 2, there are different treatment regimes, explains Jean Laurent Mathurin, coordinator of the second site of the GHESKIO centers. “The same antiretrovirals are not always found because each has its side effects on the body. To choose them, the doctor bases themselves on the patient’s pathologies while ensuring that their strain of HIV will not affect the regimen.”
On the other hand, an HIV-positive person is also exposed to other sexually transmitted infections, against which their immune system has to fight.
One of the particularities of HIV is that it has no symptoms directly related to the infection itself. As a result, the infected person often does not know that they are infected. The virus slowly kills the immune system’s defense against other diseases that are naturally present in the body. After destroying everything and leaving the body defenseless, it takes 12 to 20 years to reach the AIDS stage.
A simple disease can cause great damage once it has reached this stage.
This is why Sabine Lustin and Jean Laurent Mathurin warn against irresponsible behavior. E=E encourages regularity in taking medication because it prevents HIV from multiplying. But being undetectable is not a ticket to sex without a condom.