Viral load in semen, vaginal fluid and rectal secretions

  • Most people on successful treatment will have a reduced viral load in both their blood and sexual fluids .
  • However, not all antiretroviral drugs penetrate the genital tract with equal efficiency, and a number of other factors can also affect viral load.
  • There are more studies on viral load in semen than either vaginal fluids or rectal secretions.

Most studies conducted so far have shown that the majority of men and women successfully treated with antiretrovirals experience parallel declines in viral load in both the blood and sexual fluids.

However, a minority of the men and women in these studies had more HIV in their sexual fluids than in their blood. This may be due to:

  • Drug levels not being high enough in sexual fluids.
  • Systemic drug levels not being high enough due to a variety of factors including adherence, gut absorption, drug-drug interactions, and resistance.
  • Inflammation (notably caused by an infection with a sexually transmitted infection).
  • In women, menstruation.

There are not enough data to reliably state that reductions of viral load in the blood are paralleled in rectal secretions.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.