What Evidence Is There to Support U=U?


W. David Hardy, MD, discusses the Undetectable Equals Untransmittable (U=U) movement.

Segment Description: W. David Hardy, MD, adjunct professor of medicine in the Division of Infectious Disease at Johns Hopkins University, discusses the Undetectable Equals Untransmittable (U=U) movement.

Interview transcript (modified slightly for readability):

Contagion®: What evidence is there to support U=U?

W. David Hardy, MD: What is the evidence that is supporting undetectable equals [untransmittable]? The evidence is actually very strong. There have been several large, international studies, one done primarily in Africa but also in other parts of the world as well and also one done in Europe called the PARTNER 1 and 2 study. Both of these studies ask the question, “if a person is HIV positive, is on medication, and their viral load is undetectable, can they transmit the virus to their uninfected partner with whom they have regular sex?” Both studies, called HPTN 062 and also the PARTNER 1 and 2 studies, proved that when a person's viral load is undetectable there is negligible or really an inability to transmit the virus to an uninfected person.

The data are very strong. The data are very complete. It has been looked at every way up and down and it's very true.

How is the HIV positive community dealing with this information? I would say they're dealing with it really really great. For them the science is the bedrock of what they can use as a way to try to really improve upon their lives and how does you U=U improve people's lives for [those who are] HIV positive? It takes away some of the stigma of being HIV positive and I think that right there is probably the biggest part of how U=U is being welcomed by the HIV-positive community.

Because they no longer have to feel like they could transmit this virus to someone else—their loved ones, their sexual partners—because they're doing something very actively in terms of taking the medication every day. It has served to be a very important motivator for persons to take the medication on a daily basis, to maintain high adherence, because it's an extra bonus of not only feeling better and doing better yourself but also taking away that feeling that you could be infecting another person.

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