A person living with HIV who takes antiretroviral treatment and whose virus is suppressed cannot transmit HIV to sexual partners. Undetectable = Untransmittable, or U=U, seeks to end stigma and HIV misinformation — and improve adherence to treatment.

What is Treatment as Prevention?

Decades of evidence has shown that antiretroviral (ARV) medication reduces the amount of HIV in an individual’s body and helps them stay healthy. When taken as directed, ARVs can suppress HIV to the point at which standard, rapid diagnostic HIV tests no longer detect the virus. When a person living with HIV’s levels are below a threshold level of detection, HIV cannot be transmitted onward to another person.

Undetectable = Untransmissible (U=U)

Studies have consistently shown that people who are on antiretroviral therapy (ART) and maintain an undetectable viral load for at least six months will not pass on the virus to their HIV-negative partners. This is true regardless of whether a condom was used or not.

A Liberating Finding

People living with HIV whose virus is suppressed and undetectable can be empowered in new or existing relationships. U=U reduces the stigma around being infected and can encourage more people living with HIV to seek out and remain on treatment.

Access to Testing for Viral Suppression

Promoting U=U messaging saves lives by increasing awareness of ART, promoting treatment, and highlighting its role in HIV prevention. But getting people onto treatment is only part of the story. To make viral suppression the norm, strong programs to support people’s adherence to ARVs and well-resourced programs that offer regular testing to confirm the virus is suppressed (called viral load monitoring) and other steps are urgently needed.

Advocacy for U=U

Strategies for ending the epidemic must expand awareness that effective treatment results in undetectable and untransmissible HIV. Enriched support for adherence and easy access to viral load monitoring are critical elements to HIV prevention.