ASHM is set to release 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 updated U=U: ASHM guidance for healthcare professionals will be released on Tuesday 17 November, during ASHM's joint virtual Australasian HIV & AIDS and Sexual Health Conferences.


‘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


“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,” said ASHM CEO Alexis Apostolellis.


“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.”


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.