At the 13th annual HIV Treatment and Prevention Adherence conference, health care and service providers gathered to learn about new treatments for people living with HIV and the best clinical practices to support adherence to them. At their best, HIV providers serve as a trusted conduit for their patients from the research world to the very practical ways that the virus impacts their lives and those that they love.
For decades, HIV providers were trained to utilize fear-based messaging about transmitting HIV if 100% condom utilization was not followed. Now, these same clinicians can inform patients that HIV transmissions can be averted by being adherent to their medication or, in other words, undetectable equals untransmittable (U=U). This message is different: less stigmatizing and more empowering. The leading federal HIV expert in the U.S., Anthony Fauci, M.D., has stated: “The science really does verify and validate U=U. From a practical standpoint, the risk is zero. So, don’t worry about it.”
Leading researchers and clinicians who influence best practices for conversations about the direct and indirect impact of HIV infection and treatment agree that communications regarding transmission must shift.
“It is time that providers fully integrate U=U messaging into their clinical practices, Jose Zuniga, president of International Association of Providers of AIDS Care (IAPAC) told conference attendees. “[T]he rationale of doctors resistant to messaging is not based on science or evidence-based practices,” he said. He referenced countless stories from people living with HIV that they did not learn about U=U from their providers, and that some clinicians were not ready to accept the numerous peer-reviewed clinical trials confirming the science. Many HIV-positive people have been told about the benefits of treatment as prevention only years after their providers became aware of them.
“You are the gatekeepers of the science that let us [people living with HIV] know that we are not infectious, Bruce Richman, CEO of Prevention Access Campaign, said during his presentation. “People living with HIV must know that [U=U] is possible for them.”