‘Undetectable equals untransmissible’, or U=U, refers to the fact that people who take antiretroviral therapy for HIV daily as prescribed, and who achieve and maintain an undetectable viral load, cannot sexually transmit the virus to an HIV-negative partner.


U=U: ASHM guidance for healthcare professionals draws on the latest evidence to inform healthcare providers about U=U and provides recommendations for speaking about U=U to all patients, including those newly diagnosed with HIV.

Key changes in this third edition of the guidance include:

  • Removing any ambiguity from the message that patients maintaining a ‘durable viral suppression’ (defined as less than 200 HIV RNA copies per mL of blood) eliminates the risk of sexual transmission of HIV, making Australia one of the first countries in the world to support such strong language in support of U=U
  • Strengthening our support for the priority of getting people living with HIV (PLHIV) onto effective anti-retroviral treatment as soon as possible after their diagnosis, to ensure better health outcomes
  • Highlighting emerging evidence that healthcare providers talking to HIV-positive patients about U=U has a positive impact on self-reported mental, sexual and overall health and wellbeing

In particular, the update draws on evidence from the Positive Perspectives 2 study presented earlier this year at the International AIDS Conference (AIDS 2020), demonstrating that positive health outcomes arise when PLHIV are informed about U=U by their healthcare provider.

When ASHM launched the first version of this document in 2018, it was the first clinical guidance on U=U to be published globally. This update represents ASHM’s ongoing commitment to ensuring healthcare providers have access to the latest clinical evidence about U=U, and that they understand its role in HIV prevention, reducing HIV stigma and improving the health and wellbeing of people living with HIV.


Download the Guidelines