U = U is an abbreviation for Undetectable = Untransmittable. People living with HIV who take their medication as prescribed can reduce and maintain the amount of HIV in their blood or viral load at an undetectable level. This means there are no risks of transmitting HIV to their partners even without the use of other prevention strategies such as condoms or PrEP (pre-exposure prophylaxis). This is known as untransmittable.
How do I achieve U = U ?
In order to achieve U = U, you must take your HIV medicine or antiretroviral treatment daily as prescribed by your healthcare provider. You must be self-disciplined and check all of the following:
- You must take antiretroviral treatment every day at the same exact time
- At the outset, take a test in three or six months in order to check whether you have achieved an undetectable viral load
- Continue to take HIV medicine without missing doses
If after six months you have not achieved an undetectable viral load even after following all of these steps, please consult with your healthcare provider for further treatment. It is possible that you may need to change your antiretroviral treatment.
What are the benefits of U = U?
If you are HIV positive, it is very important for you to start antiretroviral treatment as soon as possible, no matter how long you have had the virus. In addition to the risk of HIV continuing to harm your immune system (and thus putting you at risk of reaching the later stages of HIV, also known as AIDS), delaying treatment can put you at a higher risk of transmitting HIV to your partners.
If you are taking HIV medicine daily as prescribed, the amount of HIV in your blood, or viral load, can be suppressed to the point that a test cannot detect it. This status is known as having an undetectable viral load.
If you are HIV positive and your partner is HIV negative, (i.e. having a serodiscordant or mixed-status relationship), there will be no risk of HIV infection as long you have an undetectable viral load. Furthermore, if you are HIV positive and your viral load is undetectable, you will have no risk of transmitting HIV to your sexual partners.
It is expected that as more people living with HIV achieve an undetectable viral load, we will see the end of the HIV pandemic, as researchers have concluded that U=U is the most effective HIV prevention strategy.
In addition, taking HIV medicine daily as prescribed will also keep the amount of CD4 cells (i.e. white blood cells which the HIV catches and attacks), at a high level, meaning that you will be able to maintain your health at the same level with people who are HIV negative.
Mothers who are HIV positive and have an undetectable viral load will also lower the risk of transmitting HIV to their babies.
According to research, the more HIV-positive individuals achieving an undetectable viral load, the less stigma there will be associated with living with HIV. This is because achieving U=U may provide new motivation for HIV positive patients and thus help them with their self-image.
I have already achieved U = U. Will my status change over time?
As long as you take your HIV medicine daily as prescribed, there is no risk of your viral load rebounding to higher levels. This is, of course, taking the assumption that you are adhering to taking the HIV medicine daily without stopping.
If I forget to take my medicine, will I lose my U=U status?
If you miss your HIV medicine once or twice you will still be at U = U. If you miss a dose for 2-3 days in a row, then it is possible for your viral load to become detectable. If you find yourself missing HIV medicine for several days, you need to take another test to see if your viral load is still undetectable.
You need to have discipline in order to maintain your U=U. Not only is taking HIV medicine daily as prescribed important to maintaining U=U, it is also needed in order to avoid drug resistance. If you regularly miss your HIV medicine, then it is more than likely that the virus in your body will develop resistance towards the antiretroviral regimen.
If I achieve U = U, can I stop using condoms?
People who are HIV positive and have an undetectable viral load have no risk of transmitting HIV to their partners even without the use of other prevention strategies such as condoms or PrEP.
Nonetheless, please bear in mind that condoms are still effective in preventing other sexually transmitted infections other than HIV such as syphilis, gonorrhea, and chlamydia.