HIV Viral Load and Transmissibility of HIV Infection: Undetectable Equals Untransmittable

Robert W. Eisinger, PhD; Carl W. Dieffenbach, PhD; Anthony S. Fauci, MD

In 2016, the Prevention Access Campaign, a health equity initiative with the goal of ending the HIV/AIDS pandemic as well as HIV-related stigma, launched the Undetectable = Untransmittable (U = U) initiative. U = U signifies that individuals with HIV who receive antiretroviral therapy (ART) and have achieved and maintained an undetectable viral load cannot sexually transmit the virus to others. This concept, based on strong scientific evidence, has broad implications for treatment of HIV infection from a scientific and public health standpoint, for the self-esteem of individuals by reducing the stigma associated with HIV, and for certain legal aspects of HIV criminalization. In this Viewpoint, we examine the underlying science-based evidence supporting this important concept and the behavioral, social, and legal implications associated with the acceptance of the U = U concept.

January 14, 2019
Year of publication
2019
Resource types
Journal and research articles
Tags
Undetectable = Untransmittable (U=U), undetectable viral load, HIV prevention, treatment as prevention (TasP)

Similar Resources

The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the…

Adolescents newly diagnosed with HIV need to be rapidly incorporated into HIV care networks to have the best chances of remaining in care in the long term, research from the United States published in the June 1st edition of the Journal of Acquired Immune Deficiency Syndromes shows.

BACKGROUND:

Attrition along the HIV care continuum slows gains in mitigating the South African HIV epidemic. Understanding population-level gaps in HIV identification, linkage, retention in care and viral suppression is critical to target programming.

Early HIV diagnosis reduces morbidity, mortality, the probability of onward transmission, and their associated costs, but might increase cost because of earlier initiation of antiretroviral treatment (ART).

The Southern African HIV Clinicians Society’s biannual conference, held in Johannesburg, South Africa, from 24-27 October 2018, focused on clinical content for HIV and TB health care workers in the region and featured a wide range of topics…

Undetectable = untransmittable is the message of a new UNAIDS Explainer. With 20 years of evidence demonstrating that HIV treatment is highly effective in reducing the transmission of HIV, the evidence is now clear that people living with HIV with an undetectable viral load cannot transmit HIV…
Initiation of antiretroviral therapy (ART) following diagnosis of HIV infection at birth is an emerging area of paediatric HIV care. We present outcomes of HIV-infected infants identified at birth at Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa.

BACKGROUND:

The goal of virtual elimination of horizontal and mother-to-child HIV transmission in South Africa (SA) has been proposed, but there have been few systematic investigations of which interventions are likely to be most critical to reducing HIV incidence.

Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts have been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low.

This paper documents the development of the global and national monitoring and reporting systems for PMTCT and paediatric HIV care and treatment programmes, achievements and remaining challenges.