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The Impact of Discovering U=U

Jason Tokumoto, MD, discusses recent developments in HIV treatment and prevention, focusing on the impact of “U=U.”

Segment Description: Jason Tokumoto, MD, infectious disease clinician at the University of California San Francisco Medical Center, discusses the impact of the discovery that U=U.

Interview Transcript (modified slightly for readability):

Contagion®: What do you consider the most significant recent developments in HIV treatment and prevention?

Tokumoto: I think this whole issue of what we call u equals u, which means undetectable equals untransmittable.

Which means that if an HIV positive person takes his or her medications, and the viral load is undetectable — and we defined undetectable as less than 200 copies per ml of the virus — that you will not transmit the virus to the HIV negative person.

That information is taken from sexual encounters. We don't know if that applies to exposure from blood. So an IV drug user, does that apply there? Not clear at this point. But definitely from a sexual standpoint. If your viral load is undetectable on medications, you're not going to give it to the negative person. And I think that's really huge. And what's interesting about that data is that the CDC [Centers for Disease Control and Prevention] was the last organization to accept that, the whole world had accepted that that was true based on good studies. But of course, the United States being more cautious, waited for a while to accept that data.

I think that's a huge difference because sex is something that you want to try to practice as naturally as possible. And I think this gives a little bit more freedom in terms of sexual practice, although you still should use condoms because condoms protect against other STDs. So you really should still be using condoms.