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U=U

Undetectable = Untransmittable (U=U)

The landscape of HIV care entered a new paradigm within the last decade.[1,2] The Undetectable = Untransmittable public health campaign launched in 2016, and four ground-breaking studies published between 2016 and 2019, communicated that people living with HIV who take ART daily as prescribed and achieve and maintain an undetectable viral load cannot sexually transmit the virus to an HIV-negative partner.[1,2]

In Australia, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) has produced guidance for HCPs, which recommends all people living with HIV should be advised of U=U by their HCP and informed of the following:[2]

  1. People who keep their viral load at an undetectable level by consistently taking HIV medications will not pass HIV to others through sex.
  2. Newly diagnosed or previously diagnosed people living with HIV not currently taking ART should be encouraged to think about starting ART as soon as possible.
  3. HCPs should provide particular details about U=U to people with HIV as relevant and appropriate.
  4. People with HIV should be counselled to share research on U=U.
  5. All sexually active people living with HIV and their partners should be encouraged to consistently get tested regularly for bacterial STIs.

For full recommendations, please refer to U=U: ASHM Guidance for Healthcare Professionals, October 2020, available here

Data from the Australian cohort (N=120) of the Positive Perspectives Wave 2 study showed that HCPs have been communicating U=U at a high level compared to the global cohort (N=2,389):[3,4]

Prevalence of people living with HIV reporting being informed by their HCP of U=U[3,4]

Adapted from Positive Perspectives Study, Wave 2 Results Report[3] and Allan B et al. 2021[4]

There is room for improvement and a renewed cause for HCPs to continue communicating the U=U message.[4,5] People living with HIV in Positive Perspectives 2 who were notified by their HCP about U=U reported favourable health outcomes compared to people living with HIV who learnt about U=U elsewhere, or did not know about the message at all.[5]

Prevalence of self-reported health outcomes by source of information about U=U in people living with HIV (N=2,389)[3,5]

Adapted from Positive Perspectives Study, Wave 2 Results Report[3]

U=U is an empowering message that HCPs can share as part of an open and active dialogue with people living with HIV[3,5]

Find out more

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The Positive Perspectives Wave 2 study was sponsored by ViiV Healthcare.

This study could not have been completed without people living with HIV who have generously shared their time, experiences, and bodies, for the purposes of this research. Much of the fight against HIV and AIDS relies upon people living with HIV continuing to put themselves forward and this research and our fight against HIV and AIDS is indebted to those past and present.

References:

  1. McMahon JH et al. Med J Aust. 2021; 215(5): 201–2.
  2. ASHM. U=U: ASHM Guidance for Healthcare Professionals. October 2020. Available at: https://www.ashm.org.au/resources/uu-ashm-guidance-for-healthcare-professionals/ Accessed April 2024.
  3. ViiV Healthcare. Positive Perspectives Study, Wave 2 Results Report. June 2021. Available at: https://viivhealthcare.com/content/dam/cf-viiv/viiv-healthcare/en_GB/files/030821-updated-pp2-report-approved.pdf Accessed April 2024.
  4. Allan B et al. Popul Med. 2021; 31: 1–14.
  5. Okoli C et al. Sex Transm Infect. 2021; 97(1): 18–26.

NP-AU-HVX-WCNT-220003 | Date of preparation: April 2024.