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RESEARCH ARTICLE (Open Access)
Contents Vol 21(3)

2023 Undetectable = Untransmittable global policy roundtable report: a multistakeholder perspective on Undetectable = Untransmittable research and policy priorities

N. Wells https://orcid.org/0000-0002-2827-8480 A * , B. Richman B , D. Grace https://orcid.org/0000-0002-9032-3959 C , B. Riley D , C. Hui https://orcid.org/0000-0002-6569-7422 E F , L. Vojnov G , L. Stackpool-Moore H , J. J. Ong https://orcid.org/0000-0001-5784-7403 I J , A. Dowell-Day D and B. Allan K
+ Author Affiliations
- Author Affiliations

A Kirby Institute, University of NSW, Sydney, NSW, Australia.

B Prevention Access Campaign, New York, NY, USA.

C Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

D ASHM Health, Sydney, NSW, Australia.

E School of Public Policy and Democratic Innovations, Toronto Metropolitan University, Toronto, ON, Canada.

F Ontario Positive Asians, Toronto, ON, Canada.

G World Health Organization, Geneva, Switzerland.

H Watipa, Sydney, NSW, Australia.

I Central Clinical School, Monash University, Melbourne, Vic., Australia.

J Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.

K Qthink Consulting, Malmsbury, Vic., Australia.

* Correspondence to: nwells@kirby.unsw.edu.au

Handling Editor: Jami Leichliter

Sexual Health 21, SH24017 https://doi.org/10.1071/SH24017
Submitted: 24 January 2024  Accepted: 1 May 2024  Published: 27 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Launched in 2016 by Prevention Access Campaign, the ‘Undetectable = Untransmittable’ (U=U) campaign empowers people living with HIV to live full social, sexual and reproductive lives, dismantle stigma, promote increased treatment access, and advocate for updated HIV guidelines.

Methods

Key priorities for promoting improvements to community-centred, evidence-informed U=U policy and research were the focus of a half-day global roundtable held in 2023 alongside the 12th International AIDS Society Conference in Brisbane, Australia. After a series of presentations, experts in U=U research, policymaking, advocacy and HIV clinical care participated in facilitated discussions, and detailed notes were taken on issues related to advancing U=U policy and research.

Results

Expert participants shared that knowledge and trust in U=U remains uneven, and is largely concentrated among people living with HIV, particularly those connected to gay and bisexual networks. It was agreed that there is a need to ensure all members of priority populations are explicitly included in U=U policies that promote U=U. Participants also identified a need for policymakers, healthcare professionals, advocates and researchers to work closely with community-based organisations to ensure the U=U message is relevant, useful, and utilised in the HIV response. Adopting language, such as ‘zero risk’, was identified as crucial when describing undetectable viral load as an effective HIV prevention strategy.

Conclusion

U=U can have significant benefits for the mental and physical wellbeing of people living with HIV. There is an urgent need to address the structural barriers to HIV care and treatment access to ensure the full benefits of U=U are realised.

Keywords: health equity, HIV, HIV prevention, HIV treatment, Prevention Access Campaign, stigma, U=U, undetectable viral load.

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