What does HIV U=U mean? What does HIV undetectable mean? Find out here!

Q: Can I spread HIV to my negative partner if I am undetectable?
A: No
Given the scientific evidence, HIV positive people with a suppressed viral load (less than 200 copies/ml) can not transmit the virus sexually. With or without a condom. Oral, vaginal, anal sex. Whether the partner takes PrEP or not. Undetectable = Untransmittable. This holds true ONLY if U is U (undetectable is undetectable)!

Q: Should I still wear a condom?
A: Yes / No
HIV can’t be spread (if U is U), BUT not wearing a condom puts you at risk for other STIs and possible pregnancies. It’s up to the couple if they want to use one.

►►► TIMELINE
0:00 Intro
1:02 What is HIV undetectable?
3:33 What is U=U?
7:53 Implications of U=U
9:52 Food for thought
10:33 Outro

►►► ABBREVIATIONS
U=U = Undetectable=Untransmittable
HIV = Human Immunodeficiency Virus
VL = viral load
ART = antiretroviral treatment
PrEP = Pre-exposure prophylaxis
PEP = Post-exposure prophylaxis
CDC = Centers for Disease Control and Prevention
NIH = National Institutes of Health

►►► SOURCES
It’s a LOT, I know, but I wanted to be as transparent as possible :)

(1) Selik&Linley 2018 Viral Loads Within 6 Weeks After Diagnosis of HIV Infection in Early and Later Stages: Observational Study Using National Surveillance Data

(2) When is someone most infectious?
Wawer+2005 Rates of HIV-1 Transmission per Coital Act, by Stage of HIV-1 Infection, in Rakai, Uganda
Hollingsworth, Anderson, Fraser 2008 HIV-1 Transmission, by Stage of Infection

(3) Do recently infected people spread HIV more than those who already know they have it?
(First source is a bit outdated, btw)
Marks+2006 Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA
Moore+2009 Number of Named Partners and Number of Partners Newly Diagnosed With HIV Infection Identified by Persons With Acute Versus Established HIV Infection

(4) Credit for plot: NIAID shorturl.at/qstxC
Vernazza+2000 Potent antiretroviral treatment of HIV-infection results in suppression of the seminal shedding of HIV
Graham+2007 Initiation of antiretroviral therapy leads to a rapid decline in cervical and vaginal HIV-1 shedding

(5) A Comparison of Two Ways to Manage Anti-HIV Treatment (The SMART Study) (2006)

(6) U=U posters
POZ: [ Ссылка ]
Terrence Higgins Trust: [ Ссылка ]
Russia: [ Ссылка ]
Switzerland: [ Ссылка ]
Planned Parenthood: shorturl.at/hpquE
Italy: [ Ссылка ]
I can’t transmit HIV to anyone: [ Ссылка ]
No soy un riesgo : [ Ссылка ]

(7) PARTNER 1 study
Rodger+2016 Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy

(8) Anal sex poses a higher transmission rate
Patel+2014 Estimating per-act HIV transmission risk: a systematic review

(9) PARTNER study (PARTNER 1+2 but geared towards the second part) (2019)
Rodger+2019 Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

(10) Opposites Attract
Bavinton+2018 Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study

(11) Swiss Statement (2008)
«Swiss Statement»: bilan deux ans après (sorry it’s only in French)

(12) Compilation of other studies. There are plenty more out there than what’s just listed ;)
HPTN 052 - Cohen+2011 Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Rakai Project Study Group - Quinn+2000 Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
Spain-based Study - Jesus+2005 Effectiveness of Highly Active Antiretroviral Therapy in Reducing Heterosexual Transmission of HIV
Thailand-based Study - Tovanabutra+2001 Male Viral Load and Heterosexual Transmission of HIV-1 Subtype E in Northern Thailand
Africa-based Study - Donnell+2010 Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis

(13) U=U widely accepted by 997 organizations in 102 countries as of 17 August 2020
[ Ссылка ]

(14) Aims of the U=U campaign
Check out Prevention Access: [ Ссылка ]

(15) Kalichman+2015 Sexual Behaviors and Transmission Risks among People Living with HIV: Beliefs, Perceptions, and Challenges to Using Treatments as Prevention

►►► OTHER HELPFUL LINKS

PARTNER Q&A: [ Ссылка ]

U=U in different languages: [ Ссылка ]

►►► THANKS FOR WATCHING :)

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