“Undetectable = Untransmittable U=U" campaign aims, and is having success in – changing forever the way organizations and people with HIV talk and think about viral undetectability and infectiousness. Little is more likely to help demolish the stigma against HIV than spreading the U=U news to their partners, family, and community. It offers them and all of us hope."
Gus Cairns, Editor, NAM aidsmap (February, 2017)
It's a game changer for people living with HIV and for the field that people on effective treatment cannot transmit HIV, but it's still widely unknown.
There are many reasons why HIV information providers (e.g., AIDS service organizations, community-based organizations, healthcare providers, HIV communications agencies, public health departments, and HIV/AIDS media outlets) were not communicating U=U to people living with HIV and the general public. One of the main reasons is because the scientific studies (HPTN 052, PARTNER, Opposites Attract) were promoted independently and there very few widely promoted sources on what the overall clinical and empirical evidence meant to people with HIV and to the field itself. Although there were indeed sources that confirmed U=U, they were limited to circulation within the HIV research community or found in interviews in print and video. One such source was a position paper from the European AIDS Treatment Group from 2015:
"EATG calls for much better public information to be made available in Europe and globally about the prevention benefits of antiretroviral therapy (ART), and in particular (about) the fact that HIV-positive people with undetectable viral loads are not infectious. Widespread ignorance of this fact helps perpetuate stigma against and criminalisation of people living with HIV and it should be the subject of a funded public awareness campaign, possibly to run in conjunction with a PrEP awareness campaign."European AIDS Treatment Group (EATG) (October, 2015)
Additionally, when information providers understood that U=U, the impact of the longstanding systemic racism, patriarchy and homophobia in medicine and public health have given public health entities and medical providers a license to take agency away from their constituencies, especially marginalized groups, and to treat people of color differently. For instance, health care providers have provided the U=U information on a case-by-case basis to patients whom they deem are “responsible” which leaves people living with HIV, and especially marginalized communities, vulnerable to the potential bias and prejudice of healthcare workers.
U=U works with our grassroots Community Partner networks to empower all people with HIV and their providers with the U=U information to use in ways that work for them, not only in fighting HIV stigma but also in advocacy for the treatment and services that will enable communities to get to U=U. U=U is a global force to ensure this information is equitably distributed.
PAC breaks through the politics, stigma and phobias that interfere with the free flow of information so people with and vulnerable to HIV can make informed decisions about their sexual and reproductive health based on science not stigma. PAC works closely with our Community Partners to change the narrative about people with HIV and HIV prevention through three primary channels:
RESEARCH & ADVOCACY
In 2016, PAC took the initiative to collaborate with the leading researchers on sexual transmission of HIV to create the first globally endorsed Consensus Statement on the risk of sexual transmission from a person with HIV on ART with an undetectable viral load. That groundbreaking Consensus Statement has been an important advocacy tool to build a critical mass of influential endorsers and over 900 Community Partners from nearly 100 countries who have united to ensure the U=U message reaches the people and field it was intended to benefit.
That Consensus Statement along with our educational and advocacy tools to communicate the research-based U=U messaging about HIV transmission risk in ways that are relevant and culturally appropriate for the communities they serve.
Our S4 initiative trains and supports people with HIV and allies to identify, report and resolve issues related to accuracy, bias, and stigma wherever and whenever they find them. S4 agents educate in their communities including healthcare providers, AIDS service organizations, churches, and healthcare associations to change the narrative to update with the science in ways that are localized and authentic for their constituencies.