How we talk about U=U and the importance of precise language

Bob Leahy on what words to use and what words to avoid when describing risk and ability to transmit applicable to an undetectable viral load – and why that’s important

The language of HIV has evolved at an accelerated pace in recent years. It can be a struggle to keep up, to use the right words which are not only precise in meaning but don’t offend. And precision in language has never been more important around communicating that Undetectable = Untransmittable.

The campaign’s message has now reached over 60 countries around the globe, with endorsements from over 400 organizations. Journalists have covered the topic regularly, from CNN down. But do they always get it right, describe exactly what is new to many about the risk of sexual transmission when one is virally suppressed? Unfortunately, no.

Why is that important? Because more often than not, sloppy or imprecise language leaves the unwitting reader with the impression that people with an undetectable viral load DO in fact pose a risk to their partners, however small. The science just doesn’t bear that out.

“Last month, the global medical and scientific community at the forefront of HIV research and care came together in Paris for the ninth International AIDS Society Conference, where they announced – unequivocally – that an undetectable HIV viral load means HIV is untransmittable.” Dr. Julio Montaner, UBC-Killam Professor of Medicine; UBC-St. Paul’s Hospital Foundation chair in AIDS Research Editorial (August, 2017)

So that we are all on the same page, linguistically speaking, is what in journalism is called a “style guide”. HIV style guides exist already but need updating. Here’s one from HIVPlus mag. It tells writers what terms are OK to use and what are not. Different publications have their own variations. For example, at PositiveLite.com we no longer use “HIV/AIDS” when “HIV” is almost always more appropriate. We don’t use “PHA| or “PWLHIV” or similar; we use “people living with HIV” instead because we think it’s more respectful.