World-first guidance sets a global standard for HIV prevention

17 NOVEMBER 2020

The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) has launched updated guidance for healthcare providers about the HIV-prevention method ‘U=U’, making Australia the first country in the world to adopt a national framework that unequivocally supports the science behind the U=U message.

The guidance has been launched during ASHM’s joint Australasian HIV & AIDS and Sexual Health Conferences, this year held virtually.

‘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 the first country in the world to support such strong language around 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.

To view the updated U=U: ASHM guidance for healthcare professionals, visit:


Quotes from Alexis Apostolellis, ASHM CEO

“While ASHM has been proud to be a global leader in advocating the U=U message to clinicians, this update is the first time we have stated unequivocally that U=U eliminates the risk of sexual HIV transmission.”

“Our previous guidance used the phrase ‘effectively no risk’ to talk about U=U, but with increasing evidence that how clinicians talk to their patients about U=U has a huge impact on their wellbeing, we realised the new guidance needed to be direct and unambiguous.”


Quotes from Brent Allan, ASHM advisor and author of the updated U=U guidelines

“Language is important, particularly when it comes to fighting HIV stigma. This updated guidance sends a clear message to people living with HIV that U=U works.”

“Healthcare providers play an enormously significant role in shaping how people living with HIV feel about their diagnosis. ASHM’s updated guidance will support healthcare providers to empower PLHIV by giving them the facts, which we now know leads to measurably better health outcomes.”


Quotes from Bruce Richman, Founding Executive Director of Prevention Access Campaign and the U=U campaign

“As the first organization to issue clear guidelines about communicating U=U for healthcare providers, ASHM has become a global model for how the community response to HIV and healthcare providers can work in tandem to ensure the best possible outcomes for people living with HIV.”



The 2020 Australasian HIV & AIDS and Sexual Health Conferences feature a live program running 16–20 November, and an on-demand program available all week. To view the conference program, visit:

ASHM is a peak organisation of health professionals in Australia and New Zealand who work in HIV, viral hepatitis, other BBVs and sexually transmissible infections. For more information on ASHM’s work, including policy engagement, education and resources, visit:



For more information or to arrange an interview, contact ASHM Media and Public Affairs Manager, Benjamin Riley: 0401 267 024 /