Guest columnist Lindsay Marcus is the program coordinator for the AIDS Funding Collaborative. She’s responsible for the AFC’s discretionary grant making and community initiatives. She serves on the Board of Directors of the East End Neighborhood House and holds a Bachelor of Arts in Human Development and Family Studies and a master’s degree in Health Promotion from the Department of Applied Health Science, School of Public Health, Indiana University.
While HIV -- the human immunodeficiency virus -- is still an incurable infectious disease, due to excellent treatments now available, people living with HIV/AIDS who maintain an undetectable viral load cannot transmit HIV to their partners.
U=U (Undetectable Equals Untransmittable) is an international campaign to promote this important, yet often unknown message. The Cuyahoga County Board of Health, City of Cleveland Department of Public Health, CWRU/UH AIDS Clinical Research Site Community Advisory Board and AIDS Funding Collaborative are proud to support U=U and encourage other public and private partners to join in signing a consensus statement as an endorsement of the U=U message.
HIV is transmitted through bodily fluids during activities such as sex, needle sharing, birth and breastfeeding. The goal of HIV treatment is to achieve an undetectable viral load -- jargon for only having a very small amount of virus in the body, so small that it literally cannot be detected in a laboratory.
This is an extremely achievable goal.
Those who begin treatment soon after diagnosis can achieve an undetectable viral load in one to six months, and they can live a nearly normal lifespan. Today’s anti-viral medications are very effective, less toxic and have more tolerable side effects than treatments used earlier in the epidemic.
A 2011 clinical trial, called HIV Prevention Trials Network 052, is the foundational science behind U=U. It showed that anti-HIV medications can effectively eliminate the risk of sexual transmission. The trial found that among couples in which one partner is negative and the other has HIV suppressed on medication, new infection is prevented.
This science has existed for years and is endorsed by a growing list of organizations, including the World Health Organization, the Centers for Disease Control and Prevention, the National Institutes of Health and UNAIDS.
In Ohio, people living with HIV/AIDS are our friends and neighbors, as about 1,000 people in our state are diagnosed with HIV each year; about 160 of whom live in Cuyahoga County.
For people living with HIV/AIDS, knowing that they cannot sexually transmit HIV is an incredible incentive for adhering to, or for beginning, HIV treatment. U=U aims to improve the quality of life for those who have HIV/AIDS, by dramatically reducing the shame that continues to be associated with infection and reducing the fear of passing HIV on to a sexual partner.
The ability for people living with HIV/AIDS to build relationships is transformational. This is especially true for those who have experienced intense social stigma and isolation due to their diagnosis.
But U=U is not just about motivating people living with HIV/AIDS to get and stay on treatment, it also encourages sexual partners to share the responsibility by continuing to use condoms, considering Pre-Exposure Prophylaxis (PrEP) (a once-daily pill to prevent HIV) and other evidence-based harm-reduction practices such as needle exchanges for those who inject drugs.
Individuals who don’t know their HIV status have more reason than ever to get tested and make a prevention or care plan that meets their needs. And it’s important to note that not only do HIV medications, first and foremost, improve the health of people living with HIV/AIDS, they are also our key to reducing new infections through viral suppression.
It’s important to know that having an undetectable viral load does not prevent transmission of other sexually transmitted infections, nor does it prevent HIV transmission attributed to sharing needles or breastfeeding.
Endorsement of U=U is empowering for people living with HIV/AIDS, their partners and the greater community. We promote U=U and its foundational science as a critical part of ending HIV/AIDS.
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