The message of Undetectable Equals Untransmittable (U=U), the fact that a person living with HIV with an undetectable viral load cannot transmit the virus sexually, is easy to understand. It’s a message that has been embraced by the world’s leading medical, scientific and public health institutions, including the World Health Organization, the President’s Emergency Plan for AIDS Relief, the Joint United Nations Programme on HIV/AIDS, the U.S. Centers for Disease Control and Prevention and the National Institutes of Health.
Yet, there are so many who have yet to hear the message. There are many challenges when it comes to getting the word out. The AIDS crisis of the 1980s and early ’90s left a collective societal scar, and the images from that time, publicized the world over of people ravaged from AIDS, are difficult to erase.
There is incredible progress with the acceptance of the U=U message, but we still have a long way to go. There are some countries that have wholeheartedly embraced U=U, while others are lagging behind. The U.S. federal government announced its full support of U=U at AIDS2020 in Montreal in July 2022 and all federal agencies now use language consistent with U=U messaging. Implementing this message into health departments and in local programs so that everyone can benefit from it is the next push in the United States.
While there has been progress in the spread of the information that U=U, far too many people, both those living with HIV and those who are HIV negative, haven’t heard the message, or even the concept of U=U. Those who are not engaged in the health care system and in care are often unaware of U=U, likely are not aware of the message and therefore do not benefit from it.
Only about 2/3 of people living with HIV in the United States are virally suppressed. It is the systemic issues and social determinants of health, including stigma, racism, homophobia, transphobia and medical mistrust, as well as barriers to housing, transportation, food security and achieving economic security, that impact people’s ability to benefit from U=U.
But there is hope. HIV service organizations across the country have embraced the message and promote it to their clients, and U=U is mentioned in advertising on television and print media for HIV medications. For those people living with HIV, U=U is really impactful. U=U changes people’s lives, erasing stigma and fear and allowing them to have pleasurable sex without fear of transmitting HIV to their sexual partners.
Getting the word out is the primary focus of U=U plus. The organization not only promotes the slogan but also is dedicated to providing people living with HIV in the United States all the tools needed to achieve an undetectable viral load. Their goal is to enhance, not exclude, the lives of all people living with HIV.
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