In July 2018, ASHM developed the evidence-based Guide for Clinicians and other Healthcare Providers to discuss Undetectable = Untransmittable (U=U) to inform clinicians and other healthcare service providers and better equip them to discuss with their patients how antiretroviral treatment (ART) for people living with HIV prevents onward sexual transmission of HIV to their partners and the issues that are relevant to this issue. It was first launched as part of a pre-conference to the 2018 International AIDS Conference in Amsterdam where the concept of U=U featured strongly in the conference discourse.
With the release over recent years of findings from three key studies looking at how HIV therapy prevents sexual transmission of HIV, it is now clear that for people who take treatment daily as prescribed and achieve and maintain an undetectable viral load there is effectively no risk of sexually transmitting the virus to an HIV-negative partner.
U=U is a health equity initiative led by the Prevention Access Campaign – supported by prominent and international community, clinical and research advocates including WHO, UNAIDS, US CDC & NIH as well as ASHM – to raise awareness of the evidence which makes it clear that for people who take ART daily as prescribed and achieve and maintain an undetectable viral load, there is effectively no risk1 of sexually transmitting the virus to an HIV-negative partner.
“These guidelines are excellent. Australia is setting the pace for other nations to follow.” says Bruce Richman, Founder of the Prevention Access Campaign “This is a major advance, not only for what it means about the central role played by people with HIV in ending new HIIV infections, but also because of the major, consequent affect it has on HIV stigma. The campaign message of U=U is helping reduce fear and prejudice that underpin HIV-related stigma.”
The main purpose of the Undetectable = Untransmittable campaign is to disseminate accurate and unambiguous information to people with HIV and those at risk, and challenge HIV-related organisations in government, civil-society and the private sector, to promote awareness and understanding of U=U. Clinicians may find that some patients have encountered this messaging prior to engaging in clinical care, and thus require professional support to understand what it means.
This on-line resource provides HIV prescribers and other health service providers in HIV services to discuss with patients the implications of U=U in their care, including:
Thanks to Michael Frommer who expertly led the preparation of this ground-breaking document on behalf of ASHM in collaboration with community based organisations, health care providers, the ASHM ARVG, states and territories Departments of Health who generously offered their inputs.
This guidance is available on-line and will be updated regularly as the evidence base expands to include other key populations and transmission routes.