HIV factsheet: U = U for health professionals

U = U (Undetectable = Untransmittable)

Early initiation of antiretroviral therapy (ART) improves overall health and prevents sexual transmission of HIV. The goal of treatment is to achieve and maintain an undetectable viral load. Studies have shown that effective ART prevents sexual transmission of HIVFootnote 1, Footnote 2, Footnote 3, Footnote 4, Footnote 5.

People living with HIV who take ART and who achieve and maintain an undetectable viral load have effectively no risk of transmitting HIV sexually.

Integrate U = U into routine HIV care

Condoms are the only effective strategy to help prevent other STIs.

What is:

Viral load: amount of HIV in the blood.

Undetectable: viral load less than 40 to 50 copies/ml and cannot be detected by standard tests.

Untransmittable: when an undetectable viral load prevents the sexual transmission of HIV.

Discuss the benefits of HIV treatment. U = U can transform lives and reduce stigma.

Resources

Footnotes

Footnote 1

Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493-505.

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Footnote 2

Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375(9):830-839.

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Footnote 3

Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016;316(2):171-181.

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Footnote 4

Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019;393(10189):2428-2438.

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Footnote 5

Bavinton BR, Pinto AN, Phanuphak N, Grinsztejn B, Prestage GP, Zablotska-Manos IB, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018;5(8):e438-e447.

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