Undetectable = Untransmittable   Best Practices

Communities and organizations across the United States are allocating resources and coming up with new ideas to help communicate U=U, which The Lancet has said is the responsibility of every health care provider. We have compiled Best Practices from select key partners below to help provide examples of successful U=U campaigns and inspire future advocacy.

Baltimore City Health Department

Baltimore, Maryland

Contact: Adena Greenbaum (adena.greenbaum@baltimorecity.gov)

Organization: Baltimore City Health Department

Location: Baltimore, MD

Staff Size: 4

Budget: $200K-$300K

Mission: Create a U=U campaign that educates, empowers, and engages stakeholders to eradicate the stigma of living with HIV
Website: www.uequalsumaryland.org
Facebook: https://www.facebook.com/uequalsumaryland/
Twitter: https://twitter.com/UEqualsUMD
Instagram: https://www.instagram.com/UequalsUMD/


Description of program: In 2017, building on the success of the PAC’s U=U campaign and the U=U statement drafted in collaboration with the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS), members of the Baltimore City HIV Planning Group and Commission began this initiative by gathering local stakeholders in HIV prevention and care to form a coalition dedicated to developing and spreading the U=U message within Baltimore City and the state of Maryland.

The coalition includes representatives from over 12 organizations including: major health care providers, pharmacies, Federally Qualified Health Centers, community-based organizations, the Maryland Department of Health, and people living with HIV.

With support from the Baltimore City Health Department and the Maryland Department of Health, the coalition has collaborated together by:

  • Launching www.uequalsumaryland.org, a 12-page educational website which features interactive maps and directories for testing, medication adherence and getting PrEP; local U=U stories and news; downloadable educational and promotional materials, including full color posters; an interactive event calendar, which features local outreach events; and explainers detailing the science behind the U=U message. (December 2018)

  • Developing and maintaining a local U=U social media presence, which includes Facebook, Twitter and Instagram accounts, with approximately 30-40 total posts created each month. (December 2018; 400 total followers as of January 2019)

  • Implementing a local advertising campaign, which will feature billboards and interior/exterior bus & metro advertising; paid social media ads (Facebook/Instagram/SnapChat); paid dating app display and direct message ads; Mobile Location-Based Display advertising and local radio and Pandora spots. (March 2019)

  • Designing and distributing printed U=U materials, including informational rack cards, posters and giveaway materials, for free to community stakeholders. (Launched December 2018)

  • Planning a targeted, in-person outreach and event schedule with a dedicated team member, along with support from coalition members. Outreach will include presenting the U=U message to local youth, older adult, faith and LGBTQ groups, meetings and events. (Spring 2019)

Additionally, the U= U campaign in Baltimore proudly sponsored major city-wide events in 2019 to include Baltimore PRIDE, and the Baltimore AIDS Walk & Music Fesitval. 2019 also saw the coalition working with the Maryland Department of Health to help spread the U=U message to other health departments across the state.

Number of people reached: Through its social media presence, website, billboard campaign and outreach events, the U=U Campaign estimates reaching roughly 10,000-12,000 people monthly.

Budget spent on program: $200K-$300K in 2018-2019.

How do you evaluate the impact?:  We measure outreach through data from our web traffic, social media engagement, and the opportunity to contact through billboard campaigns. Our campaign is still in its infancy, with a recent launch date of December 2018. We plan to evaluate impact through knowledge, attitude and practices surveys, and social media tracking.

What have been some of the challenges and how did you overcome them?:

Our initial challenge was identifying sources of funding for this campaign. This was overcome through the expanded use of early intervention services funding. We also effectively partnered with a local FQHC, Chase Brexton Health Care, who already had the marketing/advertising infrastructure to move beyond the typical logistical challenges of starting a grassroots campaign. 

Another challenge is ensuring that the U=U Coalition is inclusive of a comprehensive cross-section of stakeholders to ensure that the direction of the campaign would be relevant and relatable to a diverse audience. To address this, we recruited members through the HIV Planning Group and Commission; continually recruit new Coalition members through our website, social media and outreach events; present at local community events; and utilize the vast network of HIV and non-HIV affiliated organizations in the City.


We have also found a challenge in presenting the science behind the U=U message, as it relates to other modes of transmitting the virus. We are seeking additional Technical Assistance on how to tackle these emerging issues. We also anticipate some challenges with conducting impact evaluation.  While we can collect process indicators and outcomes, measuring the full impact of the campaign could prove difficult.

Please describe the success of the program and include any related personal stories, media coverage, images, graphics, digital assets and collateral that best represent your work:

Our campaign successfully built relationships with a diverse group of HIV prevention and care stakeholders through a network of community representatives. The fact that the Baltimore City Health Department was able to allocate funding to support this community effort is also a strong success measure. The U=U Coalition proudly received the Governor’s Citation from the Governor of Maryland, Mr. Larry Hogan, in appreciation of its services to the citizens of Maryland. 

The U=U message continues to provide opportunities for learning, growth, and stigma reduction. 

AIDS Project Rhode Island

Providence, Rhode Island

Contact: Mikel Wadewitz, Ryan White Director – wadewitzmi@familyserviceri.org – 401-831-5522

Organization: AIDS Project Rhode Island (APRI)

Location: Providence, RI

Staff Size: 20 (we are a program of Family Service of RI, which has a staff of 250+); APRI and FSRI merged in 2008.

Budget:  N/A

Mission: APRI is dedicated to providing a compassionate, nonjudgmental, and collaborative response to the needs of people living with, affected by, and at risk for HIV.

Website: www.aidsprojectri.org

Facebook: AIDSProjectRI

Twitter: @AIDSProjectRI

Instagram: @hello_apri

Description of program:

U=U is an integral part of our messaging as an organization. It is incorporated into our brochures that describe our services and what we do; it’s part of our website with its own page; we have created postcards and posters about it (with posters in our main office and satellite testing locations); it is part of the programming we do in our Peer Navigation program; and it’s something our case managers discuss with clients and our HIV testing staff talk about with individuals coming to us for testing services.  We have not made it a “formal,” stand-alone program, but train our staff to understand it, share articles and news related to it, and regularly talk to clients about it.


Number of people reached:

APRI’s services reach about 1,000 people per year.

(There are approximately 2,600 people total in RI who are living with HIV.)


Budget spent on program:

This is incorporated as part of overall budget for collateral, program supplies, and personnel salary (to be put toward PR, social media, advertising, and more). It is not a specific line item, but rather folded into other areas, with U=U being a cornerstone of initiatives such as our peer support program, HIV/STI testing, training on HIV and aging, and much more.  We also look for ways to include U=U messaging and therefore collateral into grant applications, highlighting its importance for people who are HIV-positive as well as –negative. In general, however, postcards can be printed very cheaply, and information given to people coming to us for testing or services or via social media outlets is a “negligible cost.” We’d like to start including information on PrEP and U=U bundled with the safer-sex supplies we hand out and make it part of our e-communications when appropriate so our donor base knows about it, too.

How do you evaluate the impact?:  

At this point in time, we have not formally been evaluating only the impact of the U=U message, since it is weaved into so many other aspects of the services we provide. But we use any appropriate opportunity to speak to clients, the public, and other community providers about it—including at statewide meetings where other community providers are present, including medical providers. We try to keep it “top of mind” with others when we can.

If we have funding streams in the future to do more formal ad campaigns online or on transit/print/radio about U=U we will be able to measure impressions more accurately.


What have been some of the challenges and how did you overcome them?:

Money is, of course, always a problem. But as noted, there are cost-effective ways to continue to push the messages out to clients, their friends, etc.

One challenge is teaching others how to spread the message to their friend networks with accuracy and make sure that it’s easily understood. For some individuals, “untransmittable” and “undetectable” are not words they use every day, so there’s a learning curve. However, clients living with HIV also know how to express these terms in other ways. We look for ways to use language they are comfortable with and use that and come to us with any additional questions.

Lastly, there has not been much public-facing programming on U=U in Rhode Island. We continue to explore ways to put the message more front and center out in the community, which includes working with other providers, educating city council and other elected representatives, meeting with health care providers, and sharing information with our clients one on one. It makes the process longer because there’s no “easy” way to blast the information out to a wide audience all at once. We plan to make U=U part of our AIDS Run/Walk fundraiser and our presence at RI Pride this year.


Please describe the success of the program and include any related personal stories, media coverage, images, graphics, digital assets and collateral that best represent your work:

  • Digital assets (postcard and brochure)

  • We made U=U part of our new website, as well under “FAQs”: http://aidsprojectri.org/faqs/#u-u

  • The U=U poster artwork has also been adapted into print advertisements for the local LGBTQ publications Options and Get and will be a formal component of APRI’s presence at Rhode Island Pride, as well as at our annual AIDS Run/Walk for Life event in June.

Equitas Health

Columbus, OH