HIV AIDS Stigma and education



U=U is a simple but hugely important campaign based on a solid foundation of scientific evidence. It has already been successful in influencing public opinion, causing more people with HIV (and their friends and families) to comprehend that they can live long, healthy lives, have children, and never have to worry about passing on their infection to others. The CDC officially backing the science behind the campaign is another key step towards U=U being the most important message of 2017 in the fight against HIV.

What is U=U?

Undetectable = Untransmittable

  • “All of us here at CATIE, and indeed around the world, are celebrating the most significant development in the HIV world since the advent of effective combination therapy 20 years ago – people living with HIV with sustained undetectable viral loads can confidently declare to their sexual partners ‘I’m not infectious!'” Laurie Edmiston, Executive Director, CATIE – Canadian AIDS Treatment Information Exchange  (January, 2017)

A community of people living with HIV collaborated with the leading researchers on HIV sexual transmission to answer a fundamental question about living with HIV and having an undetectable viral load: Will I pass on HIV to my sexual partner?  

The science is clear. People living with HIV can feel confident that if they have an undetectable viral load and take their medications properly, they will not pass on HIV to sexual partners (Undetectable = Untransmittable U=U).

U=U offers freedom and hope. For many people living with HIV and their partners, U=U opens up social, sexual, and reproductive choices they never thought would be possible. 

U=U is an unprecedented opportunity to transform the lives of people with HIV and the field:

  • Reduces the shame and fear of sexual transmission and opens up possibilities for conceiving children without alternative means of insemination.

  • Dismantles HIV stigma on the community, clinical, and personal level.

  • Encourages people living with HIV to start and stay on treatment to keep them and their partners healthy.

  • Strengthens advocacy for universal access to diagnostics, treatment, and care to save lives and bring us closer to ending the epidemic.

However, the majority of millions of people living with HIV do not know U=U, and many do not have access to the diagnostics, treatment, and care they need to get to and maintain an undetectable viral load. There are still confusing messages, outdated websites, and uninformed policy makers and healthcare workers who are not comfortable sharing this information, don’t yet know about it, or don’t yet realize the significance of it. 

Prevention Access Campaign’s U=U movement is changing that narrative by uniting with Community Partners around the world to ensure this groundbreaking research reaches the people and the field it was intended to benefit.

NOTE: An undetectable viral load is typically under 40 copies/ml depending on the diagnostic tests. However, studies show a person living with HIV on antiretroviral therapy (ART) with a viral load of 200 copies/ml or less also cannot sexually transmit HIV. This is called being “virally suppressed.” For the purposes of the U=U campaign and any Prevention Access Campaign materials, the term “undetectable” is used synonymously with the term “virally suppressed,” meaning a person living with HIV with a viral load of 200 copies/ml or less cannot transmit HIV. 

Now, let’s focus on how U=U should impact our delivery of HIV care services to people living with HIV. Here are some “musts” on my list.

  1. All people living with HIV must have access to this information. There is no acceptable reason to withhold it.
  2. All people working the HIV field, serving both HIV-positive and HIV-negative individuals, must know this information and share it (see #1.)
  3. This information must be shared widely through public health education and social marketing campaigns everywhere people are living with HIV.
  4. We must clearly and unequivocally state that viral suppression (undetectable = untransmittable) is safer sex. Period. Condoms do not need to be part of the equation here, and condoms are not the only means of having safer sex. Viral suppression in and of itself is safer sex. Period.
  5. While we celebrate loudly, we must take care to not create new ways to stigmatize people living with HIV. The truth is, not everyone living with HIV on ART will achieve an undetectable viral load for a whole host of biological or societal reasons. We must not shame or judge them. It is not a moral failing to have a detectable viral load. It does not make you a bad person. HIV is a tough customer, and the meds used to treat it don’t work for everyone all the time. And many people with HIV are struggling with behavioral health issues, homeless, poverty or other issues that get in the way of HIV treatment, and can’t be solved overnight.
  6. We must not coerce anyone living with HIV into treatment. While we know there are many benefits to ART — individual and community benefits — going on treatment MUST be a decision made freely by the individual.


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