IAS statement on U=U: Putting the science into action

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Undetectable Equals Untransmittable (U=U) is an established and scientifically sound and proven concept in HIV prevention. A staggering body of evidence has shown that people living with HIV who achieve and maintain an undetectable viral load by taking and adhering to antiretroviral therapy as prescribed cannot sexually transmit the virus to others. x

The landmark NIH-funded HPTN 052 clinical trial demonstrated no linked HIV transmissions among HIV-serodifferent heterosexual couples when the partner living with HIV had a durably suppressed viral load (defined as <200 copies/ml). PARTNER and Opposites Attract studies subsequently confirmed these results and extended them to men who have sex with men.

The scientific validation of the HIV treatment as prevention strategy, commonly known as U=U, has overwhelming been welcomed by leading researchers and global health agencies, including the NIH, CDC and UNAIDS. Beyond the science of preventing HIV transmission, U=U also impacts behavioural, sexual and social norms and challenges many laws that criminalize HIV exposure. Crucially, it can help reduce the pervasive stigma that many people living with HIV face as they embrace the paradigm of U=U in their daily lives and practices.

However, despite the unequivocal scientific evidence, those who have spoken publicly in support of U=U in Thailand have recently received an extreme backlash for ensuring this science is put into practice. Only by expanding truths and challenging long-held myths about HIV prevention – on the basis of established science – will inroads be made to end this epidemic.

The truth of U=U is calling on all of us to augment our approach towards HIV prevention. While it is not a silver bullet, it is recognizing that communities and frontline healthcare workers need to engage in a more nuanced conversation about HIV that more readily fits into the realities of peoples’ lives. To avoid misinformation, medical associations and establishments must uniformly and openly recognize U=U. The pre- and in-service training of a range of healthcare practitioners must ensure that the principles of U=U are understood across a range of diverse settings. Including an evidence-based U=U message within all client interactions will ensure that everyday prevention and the choices people make are grounded in science.

Communities of people who are living with and affected by HIV – those who are putting U=U into practice – must be embraced and supported in their use of this powerful prevention tool. The advancements in HIV over the past four decades have been grounded in science and this should continue as we evolve our understanding and response to the epidemic.

Stand up for science. Tweet your support in English or Thai here:

It is scientifically proven that people living with #HIV who maintain an undetectable viral load by taking antiretroviral therapy cannot sexually transmit the virus to others. Undetectable = Untransmittable (U=U) #UequalsU
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ลุกขึ้นสู้เพื่อความจริงทางวิทยาศาสตร์ ช่วยทวีตต่อเพื่อสนับสนุนเรา:

ข้อเท็จจริงทางวิทยาศาสตร์ได้พิสูจน์แล้วว่า คนอยู่ร่วมกับเชื้อเอชไอวี แล้วกินยาต้านไวรัสอย่างต่อเนื่อง จนกดปริมาณไวรัสให้ต่ำมากได้ถึงระดับที่ไม่สามารถตรวจหาไวรัสในเลือดพบ จะไม่สามารถถ่ายทอดเชื้อเอชไอวีให้ใครได้เลยทางเพศสัมพันธ์ #UequalsU 
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IAS President-Elect and Asia and the Pacific Islands Regional Representatives:

Adeeba Kamarulzaman
IAS President-Elect
Faculty of Medicine
University of Malaya
50603 Kuala Lumpur

Shuzo Matsushita
Centre for AIDS Research
Kumamoto University
2-1-1 Honjo
Kumamoto 860-0811

Sharon Lewin
Doherty Institute for Infection and Immunity
University of Melbourne
786-798 Elizabeth Street
Melbourne, Victoria
Australia 3010

Nittaya Phanuphak
The Thai Red Cross AIDS Research Centre
104 Rajdumri Road
Bangkok 10330

Ishwar Gilada
Unison Medicare & Research Centre
Maharukh Mansion, Alibhai
Premji Marg, Grant Road
Mumbai, Maharashtra 400007

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