A Positive Tomorrow’s Message About UequalsU
We are proud to support and endorse the UequalsU campaign started by the Prevention Access Campaign. People living with HIV who have an undetectable viral load can now rest assured that they will not pass on the virus to their sexual partners. This new information will help to end HIV stigma and discrimination within our communities. This gives us hope, and proof, that we are evolving in the understanding of the virus and helps us to continue to improve upon the way those living with the virus are treated. The key to preventing transmission is for the positive partner to be undectactable for at least 6 months and remains compliant to their HIV treatment.
The largest study supporting the evidence that an undetectable person cannot transmit HIV is the Partner Study (HPTN 052). In the study 1,763 serodiscordant (mixed HIV status) couples were studied to see the likelyhood of the virus passing from an undetectable partner. The study lasted for more than four years and throughout the study there were only 8 instances of transmission. Four of those instances occured before the positive partner reached an undetectable viral load at the beginning of treatment. The remaining infections occurred after the positive partner became detectable again due to non-adherence to treatment and treatment failure.
We urge those in our communities to overcome their fears of those living with the virus and to accept the message of the UequalsU campaign. It is also our wish that those partaking in sexual activities protect themselves and their partners, and seek to remind everyone that even when there is no chance of passing on HIV, there are other STD’s and STI’s aside from HIV. Stay healthy, stay safe, and stay informed in all aspects of your sexual lives.
There is now evidence-based confirmation that the risk of HIV transmission from a person living with HIV (PLHIV), who is on Antiretroviral Therapy (ART) and has achieved an undetectable viral load in their blood for at least 6 months is negligible to non-existent. While HIV is not always transmitted even with a detectable viral load, when the partner with HIV has an undetectable viral load this both protects their own health and prevents new HIV infections.[i]
However, the majority of PLHIV, medical providers and those potentially at risk of acquiring HIV are not aware of the extent to which successful treatment prevents HIV transmission.[ii] Much of the messaging about HIV transmission risk is based on outdated research and is influenced by agency or funding restraints and politics which perpetuate sex-negativity, HIV-related stigma and discrimination.
The consensus statement below, addressing HIV transmission risk from PLHIV who have an undetectable viral load, is endorsed by principal investigators from each of the leading studies that examined this issue. It is important that PLHIV, their intimate partners and their healthcare providers have accurate information about risks of sexual transmission of HIV from those successfully on ART.
At the same time, it is important to recognize that many PLHIV may not be in a position to reach an undetectable status because of factors limiting treatment access (e.g., inadequate health systems, poverty, racism, denial, stigma, discrimination, and criminalization), pre-existing ART treatment resulting in resistance or ART toxicities. Some may choose not to be treated or may not be ready to start treatment.
Understanding that successful ART prevents transmission can help reduce HIV-related stigma and encourage PLHIV to initiate and adhere to a successful treatment regimen.
The consensus statement has been endorsed by:
Dr. Myron Cohen – Principal Investigator, HPTN 052; Chief, Division of Infectious Diseases, UNC School of Medicine, North Carolina, USA
Dr. Demetre C. Daskalakis, MPH – Assistant Commissioner, Bureau of HIV/AIDS Prevention and Control New York City Department of Health and Mental Hygiene, New York, USA
Dr. Andrew Grulich – Principal Investigator, Opposites Attract; Head of HIV Epidemiology and Prevention Program, Kirby Institute, University of New South Wales, Australia
Dr. Jens Lundgren – Co-principal Investigator, PARTNER; Professor, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark
Dr. Mona Loutfy, MPH – Lead author on Canadian consensus statement on HIV and its transmission in the context of the criminal law; Associate Professor, Division of Infectious Diseases, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
Dr. Julio Montaner – Director of the British Columbia Centre for Excellence in HIV/AIDS; Director of IDC and Physician Program Director for HIV/AIDS PHC, Vancouver BC, Canada
Dr. Pietro Vernazza – Executive Committee, PARTNER; Author, Swiss Statement 2008, Update 2016; Chief of the Infectious Disease Division, Cantonal Hospital in St. Gallen, Switzerland
The following Community Partners have signed on to the U=U campaign as of May 10, 2017: