U=U Training

U equals U.

Have you heard about U=U or Undetectable equals Untransmittable? Great news, today’s technology has advanced so much a person living with HIV who has an undetectable viral load can not transmit HIV to their sexual partner, hence the phrase Undetectable = Untransmittable.

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Can't pass it on.

Combined data from 2008-2016 show that there were ZERO linked HIV transmissions after more than a hundred thousand condom-less sex acts within both heterosexual & male-male serodiscordant couples where the partner living with HIV had a durably undetectable viral load. The idea that someone living with HIV, who is both on treatment and virally suppressed, cannot transmit the virus to a sexual partner is revolutionary.

U=U messaging has the potential to reduce stigma toward people living with HIV (PLWHIV), including self-stigma; increase demand for HIV testing and antiretroviral therapy (ART), including early initiation of treatment; and improved adherence. The concept of U=U can also strengthen advocacy efforts for universal access to effective treatment and care. Messaging around U=U should be well integrated into HIV prevention, care, and treatment programs.

Potential Benefits Of U=U

More widespread understanding of U=U among PLHIV, their sex partners, and others at risk of HIV may offer several benefits, including that it:

Helps to reduce stigma and discrimination toward PLHIV, including self-stigma.
Increases understanding that a suppressed viral load is important to maintain the long term health of PLHIV.
Increases demand for HIV testing services.
Increases demand for early treatment initiation.
Improves treatment adherence.

Key Terms To Know.

Viral Load

A measure of the amount of HIV in the body.

Viral Suppression

When ART is taken long enough to reduce the ability of the virus to make copies of itself in someone’s body.

ART

Is the use of HIV medicines to treat HIV infection. Antiretroviral Therapy or ART is recommended for everyone who has HIV. ART helps people with HIV live longer, healthier lives and reduces the risk of HIV transmission.

Undetectable Viral Load

When someone is on ART and the virus level in their body is so low that standard blood test cannot detect it.

"Untransmittable"

HIV cannot be transmitted through sexual transmission when the viral load is below 200/ml

Backed By Research.

HPTN 052 Trail2

This trail found that immediate ART initiation reduced HIV transmission between serodiscordant couples by 93 percent.

From April 2005 to May 2015, the study enrolled 1,763 serodiscordant heterosexual couple from Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, United States, and Zimbabwe. A total of 78 partners became infected with HIV during the study; of these, 46 were virologically linked to the HIV- positive partner, 26 were not linked, and six could be traced. Among the 46 linked cases, three were in the immediate treatment arm while 43 were in the delayed arm. Transmission occurred when viral suppression had not been achieved, either due to the timing of treatment (HIV was transmitted shortly before or after treatment initiation by the index partner) or treatment failure. Learn more

PARTNER Study 3

This study found no documented cases of sexual HIV transmission among serodiscordant couples when the index partner was virally surpressed.

From September 2010 to May 2014, the study enrolled 1,166 HIV serodiscordant couple (both heterosexual couples and men who have sex with men) from 14 European countries. All couples reported condomless sex, and the index partner was virally suppressed. A total of 11 HIV-negative partners became HIV infected during the study period, but none of the infections were phylogentically linked (i.e., newly infected partner did not acquire HIV from the enrolled index partner), making the within-couple transmission rate zero. Learn more.

PARTNER 2 Study4In

PARTNER 2, the PARTNER study continue from 2014 to 2018 with MSM serodiscordant couples only and found no linked HIV transmissions. Learn more.

Opposites Attract Study6

This study from 2012 to 2015 found no instances of linked HIV transmission among 358 serodiscordant MSM couples from Australia, Thailand, and Brazil.

At baseline, 79.9 percent of the HIV – positive partners were on ART, and 77.9 percent were virally surpressed. About 57 percent reported anal sex with an outside partner during any point in the study follow-up period, and the study included a total of 16,889 acts of condomless anal sex. There were three new infections, but none of them were linked to the enrolled index partner. Learn more.