Bob Leahy has been with the Undetectable = Untransmittable campaign in Canada from the beginning. Here he tells the remarkable story of how a movement led by people living with HIV changed the HIV message forever.
It was the domino effect. Once CATIE signed on to U = U, others quickly scrambled to do the same. Swamped, the small group of people living with HIV running the U = U campaign – more on them later – could hardly keep up. They were ecstatic. If people living with HIV had made a larger difference in the last twenty years, they said to each other, they couldn’t think of it.
Community members quickly took to social media to express their feelings. Peterborough, Ontario support worker Brittany Cameron talked to me about what many, including CATIE, were calling a game changer. “It’s true” she said. “It’s like an epiphany. And yes. I’ve had a few of those conversations. You actually have to let it sink in.”
The epiphany moment was a long time coming. The science behind it has moved slowly but relentlessly towards this point, starting in 1996 with the advent of antiretroviral therapy. The 2006 International AIDS conference saw BC’s Julio Montaner, and in a related article in the Lancet, first extol the prevention benefits of ART but treatment as prevention (TasP) largely failed to gain traction. The Swiss Statement in 2008 bolstered his case, but again the data was discredited. HPTN 052 was labelled as “the trial that changed everything”, but it didn’t. Nor did the beguiling results of PARTNER in 2014 and its subsequent update in 2016 in Durban change much sexual health messaging. Thus people living with HIV who had an undetectable viral load, or most of them, continued to believe they posed a risk to their negative partners.
If those people had been on ART since the beginning, like I had, that had been untrue for two decades.