POSITIVE PERSPECTIVES ON UNDETECTABLE = UNTRANSMITTABLE
U=U = Us Too
Sadly, obstacles at the personal, institutional, and societal levels still block the way to U=U for many. We should recognise that the proportion of PLHIV who reported having the conversation with their HCPs in PP2 varied by region (highest in Australia and lowest in Asia) and demographics (highest in men who have sex with men, followed by women, and then men who have sex with women). 7 We also need to understand that communicating U=U will not only help improve the health of PLHIV, it will also help combat the criminalisation they face and safeguard their human rights. 8 For example, in the US, a man named Kerry Thomas is serving 30 years in prison for consensual sex where both parties agreed that he used condoms and his medical records show that he had an undetectable viral load at the time. 9, 10
There are similar cases all around the world. Sharing the U=U message will help overturn these cases and prevent them from happening again. Finally, we must engage with people who distrust science and experts and help them reach a place where U=U is understood, accepted, and passed on. Or in other words, to beat the virus, we need messages that can themselves go viral.
- The Denver Principles. https://actupny.org/documents/Denver.html
- PARTNER study, JAMA. 2016;316(2):171-181. doi:10.1001/jama.2016.5148
- Undetectable Equals Untransmittable: Building Hope and Ending HIV Stigma Insights from initial. https://www.thewellproject.org/hiv-information/undetectable-equals-untransmittable-building-hope-and-ending-hiv-stigma
- HIV Treatment as Prevention. https://www.cdc.gov/hiv/risk/art/index.html
- The Science is Clear: with HIV, Undetectable Equals Untransmittable. https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable#:~:text=WHAT%3A,the%20National%20Institutes%20of%20Health.
- Eisinger RW, et al. HIV Viral Load and Transmissibility of HIV Infection Undetectable Equals Untransmittable. JAMA. 2019;321(5):451 452. doi:10.1001/jama.2018.21167
- Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. https://aidsinfo.nih.gov/guidelines
- Okoli C, Van de Velde N, Richman B, Allan B, Castellanos E, Young B, Brough G, Eremin A, Corbelli GM, Mc Britton M, Hardy WD, de Los Rios P. Undetectable equals untransmittable (U = U): awareness and associations with health outcomes among people living with HIV in 25 countries. Sex Transm Infect. 2020 Jul 30:sextrans-2020-054551. doi: 10.1136/sextrans-2020-054551. Epub ahead of print. PMID: 32732335.
- Sinoussi FB, et al. Journal of the International AIDS Society. 2018, 21:e25161
- State v Thomas. https://caselaw.findlaw.com/id-court-of-appeals/1458804.html
- Breaking: Kerry Thomas HIV Criminalization Appeal Dismissed. https://www.hivplusmag.com/stigma/2016/5/05/breaking-kerry-thomas-hiv-criminalization-appeal-dismissed