EXPLORING THE POWER OF UNDETECTABLE = UNTRANSMITTABLE (U=U) FOR HIV
WHAT IS U=U (UNDETECTABLE = UNTRANSMITTABLE)?
U=U is a simple, concise and impactful abbreviation for Undetectable = Untransmittable. It signifies that individuals with HIV, undergoing treatment and maintaining an undetectable viral load, cannot transmit the virus to an HIV-negative partner. U=U holds significant power in the battle against HIV stigma, raising awareness about the efficacy of antiretroviral therapies (ARTs) within communities and empowering people living with HIV in their sexual relationships. This groundbreaking movement has significantly contributed to reshaping perceptions about HIV and encouraging a sense of empowerment for people living with HIV.1
Watch an extract of one of our Science on the Sofa episodes to learn more about U=U.
The roots of U=U can be traced back to Bruce Richman and the Prevention Access Campaign (PAC), founded in 2016, with the mission of transforming the global understanding of HIV transmission. Bruce Richman has described U=U as a “simple equation (that) has profound implications for everyone living with HIV and for economies and governments around the world.” The PAC emphasised that achieving and maintaining an undetectable viral load plays a key role in preventing the transmission of HIV.2
“We now have the power in our hands to end the HIV epidemic by 2030.”
The U=U message is simple; if people living with HIV regularly take their medications, they can reach an undetectable viral load, preventing the transmission of the virus to their HIV-negative sexual partners. This holds true even in scenarios where condoms are not used and partners are not using pre-exposure prophylaxis (PrEP).1
While HIV stigma remains a global issue, U=U has played a key role in helping to fight against HIV stigma by reshaping societal attitudes and empowering people living with HIV. U=U addresses misconceptions that have allowed people living with HIV to engage in relationships without the constant fear of viral transmission. It serves as a powerful reminder of the impact of antiretroviral therapy (ART), encouraging individuals to pursue treatment, adhere to medication, and communicate openly about their HIV status in relationships.1
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definitionAbbreviations:
U=U, undetectable=untransmittable; ART, antiretroviral therapy; PAC, prevention access campaign; PrEP, pre-exposure prophylaxis; WHO, world health organisation; CDC, Centres for Disease Control and Prevention; HCP, healthcare professional.


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References:
- World Health Organisation. People living with HIV with an undetectable viral load cannot transmit HIV sexually. https://www.who.int/docs/default-source/searo/hiv-hepatitis/joint-moph-unaids-who-uu.pdf?sfvrsn=8378cd0_2
- Multinational Undetectable = Untransmittable (U=U) Call-To-Action. Prevention Access Campaign. Accessed 11th December 2023. https://preventionaccess.org/c2a/
- Gunn JKL, Patterson W, Anderson BJ, Swain CA. Understanding the Risk of Human Immunodeficiency Virus (HIV) Virologic Failure in the Era of Undetectable Equals Untransmittable. AIDS Behav. 2021;25(7):2259-2265. doi:10.1007/s10461-020-03154-z
- World Health Organization. The role of HIV viral suppression in improving individual health and reducing transmission. https://www.who.int/publications/i/item/9789240055179
- Tuaillon E, Kania D, Pisoni A, et al. Dried Blood Spot Tests for the Diagnosis and Therapeutic Monitoring of HIV and Viral Hepatitis B and C. Front Microbiol. 2020;11:373. Published 2020 Mar 9. doi:10.3389/fmicb.2020.00373
- Remien RH, Stirratt MJ, Nguyen N, Robbins RN, Pala AN, Mellins CA. Mental health and HIV/AIDS: the need for an integrated response. AIDS. 2019;33(9):1411-1420. doi:10.1097/QAD.0000000000002227
- Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016;375(9):830-839. doi:10.1056/NEJMoa1600693
- Rodger AJ, Cambiano V, Bruun T, et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy [published correction appears in JAMA. 2016 Aug 9;316(6):667] [published correction appears in JAMA. 2016 Nov 15;316(19):2048]. JAMA. 2016;316(2):171-181. doi:10.1001/jama.2016.5148
- Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019;393(10189):2428-2438. doi:10.1016/S0140-6736(19)30418-0
- Bavinton BR, Pinto AN, Phanuphak N, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study [published correction appears in Lancet HIV. 2018 Oct;5(10):e545]. Lancet HIV. 2018;5(8):e438-e447. doi:10.1016/S2352-3018(18)30132-2
- Eriksen J, Albert J, Axelsson M, et al. Contagiousness in treated HIV-1 infection. Infect Dis (Lond). 2021;53(1):1-8. doi:10.1080/23744235.2020.1831696
- Sadiq U, Shrestha U, Guzman N. Prevention of Opportunistic Infections in HIV/AIDS. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513345/
- King KC, Strony R. Needlestick. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493147/
- Blood Donor Counselling: Implementation Guidelines. Geneva: World Health Organization; 2014. Annex 5, HIV infection: information for blood donors. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310571/
- May MT, Gompels M, Delpech V, et al. Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy. AIDS. 2014;28(8):1193-1202. doi:10.1097/QAD.0000000000000243
- Your voice. A guide to disclosure and HIV. HIV Scotland. Accessed 12 December 2023. https://www.nat.org.uk/sites/default/files/publications/YourVoice.pdf
NP-GBL-HVX-COCO-240010 | June 2025
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