Two recent US studies find growing awareness and acceptability of the Undetectable = Untransmittable (U=U) message among men who have sex with men (MSM). However, a misunderstanding of transmission risk remains, with many still believing that HIV-positive partners can transmit the virus sexually, despite having an undetectable viral load.
While over half of a large sample of MSM from around the US perceived U=U to be accurate, the majority of those who thought so were HIV-positive men, while nearly 50% of HIV-negative men and those who did not know their status still perceived U=U as not completely accurate. This research was carried out by Dr Jonathon Rendina and colleagues at City University of New York and published yesterday in the Journal of Acquired Immune Deficiency Syndromes. According to another recent study by Dr Steven Meanly and colleagues at the University of Pennsylvania and published in the November issue of Sexually Transmitted Diseases, 70% of the young HIV-negative (or unaware of their status) MSM sampled in the US Mid-Atlantic region were aware of the U=U message. However, just over a third rated the statement as completely accurate.
There is now wide-ranging scientific consensus that those on successful antiretroviral therapy (ART) for six months or more with a suppressed viral load cannot transmit the virus sexually. Treatment as Prevention (TasP) for HIV is supported by the World Health Organization, US Centers for Disease Control and Prevention and various public health organisations worldwide. Many researchers and activists have aimed to spread this message far and wide, with some proclaiming that TasP or U=U is a human rights issue. It has legal, social, behavioural and public health implications; it could potentially reduce stigma towards those living with HIV.