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Talking to Your Doctor About U=U Is Good for Your Health

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People living with HIV are growing more comfortable discussing undetectability with their health professionals.

Knowledge is power, and a new global study shows that many people with HIV are living in strength.

Surveying nearly 2,400 people with HIV in 2019 and 2020, the recently released Positive Perspectives Study found a majority of respondents were well aware of Undetectable Equals Untransmittable (or U=U, for short), the medically recognized concept that if a person achieves and maintains viral suppression through their HIV regimen they cannot transmit the virus to anyone.

Connecting with people in over 25 countries and several continents, the survey found that two-thirds discussed U=U with their doctor or health care team. “These people were more likely to report a range of good health outcomes compared to those who were unaware of U=U or had learnt about it from other sources,” according to the HIV website

Specifically, those who talked about U=U with their medical professional were more likely to adhere to treatment, be virally suppressed, have positive outcomes in regard to their overall sexual health, and be actively engaged in their HIV care, and they were more likely to inform their sexual partners they’re living with HIV. For those who learned of or discussed U=U with nonmedical sources, the information was still beneficial, but their outcomes were not as strong as those of people who communicated with their doctors about it.

Black individuals, those with casual sex partners, and transgender people most often discussed U=U in health care settings, with 77 percent of trans participants indicating they spoke to their doctors about remaining undetectable and unable to transmit the virus. Men who had sex with women and people living in Asia had the lowest frequencies of discussing U=U with their doctors.

The differing rates of communication between individual groups suggest that “tailored” communication from doctors that consider cultural and community differences would be most effective. The Positive Perspectives Study also highlights how standardizing and possibly enforcing U=U discussions among health care professionals would wield enormous benefits, especially since a sizable amount of people with HIV are still not having this conversation with their health professionals.

“Providers caring for patients with HIV should universally inform their patients about U=U as part of their routine care,” Sarah Calabrese of George Washington University and Ken Mayer of the Harvard Medical School and Fenway Institute previously wrote in The Lancet HIV. “Conveying benefits and risks surrounding any treatment is fundamental to patients’ decision making, and this HIV treatment benefit should be no exception.”

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Neal Broverman