New push to promote U = U (undetectable = untransmittable) message

  • Jo Whelan
  • Medical News
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  • Healthcare professionals (HCPs) are being urged to step up promotion of the message that ‘undetectable = untransmittable’ (known as U = U). 
  • HCPs should discuss U = U proactively with all people living with HIV at appropriate points during care, the British HIV Association (BHIVA) has said in a new statement. This includes at diagnosis, when initiating treatment, to encourage adherence, when undetectable, and if planning to conceive.

‘We recommend consistent and unambiguous terminology when discussing U=U, such as "no risk" or "zero risk" of sexual transmission of HIV,’ the BHIVA says. Terms like ‘negligible risk’ and ‘minimal risk’ should be avoided.

Clinics should provide and display information explaining that taking ART to maintain an undetectable viral load is a highly effective strategy for preventing sexual transmission of HIV. The BHIVA also advise explaining the scientific evidence behind U=U, emphasising the importance of excellent adherence to ART, and highlighting that U=U is dependent on maintaining a sustained undetectable viral load.

The U=U consensus statement was launched by the Prevention Access Campaign in 2016 and has been endorsed by more than 771 organisations around the world. It states unambiguously that a person with sustained, undetectable levels of HIV virus in their blood cannot transmit HIV to their sexual partners.

A recent survey of BHIVA members highlighted a need to ensure the U=U message is consistently integrated into clinical care in the UK. Free resources to help raise the profile of U=U in UK clinics are available from HIV i-Base at, the BHIVA says.

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