CDC Declares U = U
Federal government agrees: HIV-positive people with suppressed viral load cannot transmit the virus to sexual partners
On September 27, 2017, marking National Gay Men’s HIV/AIDS Awareness Day, the U.S. Centers for Disease Control and Prevention (CDC) joined dozens of public health agencies and more than 400 organizations from sixty countries, announcing that it has finally embraced the concept of “U=U”—”Undetectable Equals Untransmittable.” That is, that HIV-positive people who have undetectable viral loads suppressed by HIV medications, who remain on retroviral therapy, cannot transmit the virus to sexual partners. The CDC said that data from three studies had convinced it that “People who take ART [antiretroviral therapy] daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”
This statement from the CDC is extremely important as it marks a break with the CDC’s previous acknowledging only that viral suppression “greatly reduces the chance” of HIV transmission. The change in wording is being attributed both to data such as that from the recent Opposites Attract study, as well as dozens of studies on more than 58,000 sex acts, which have shown that if a person is undetectable and stays on treatment, they cannot pass HIV on to a partner, and to the work of community groups such as the Prevention Access Campaign.
Bruce Richman, founder of the Prevention Access Campaign, told A&U, “The CDC statement is part of the overall HHS review process to update their communications with current science. It immediately changes lives. I was at a conference for people living with HIV in Ontario [when the statement was released]. A woman who had been married for twenty-two years and was always afraid she would pass HIV to her husband told me with tears in her eyes that learning she can’t transmit HIV is giving her a new lease on life and the hope of being intimate with her husband.”
Richman continued, “[The statement] provides the best argument for universal access to treatment and care, not only to save lives but also to stop new transmissions…[E]xpanding access to treatment and care improves the lives of people living with HIV and gets us closer to ending the epidemic. [We will] remember this moment as a turning point in what it means to live with HIV.”
The CDC’s statement has been hailed as a “breakthrough against stigma and for HIV prevention” by the HIV community. Dr. Anthony Fauci, head of the HIV/AIDS division at the National Institutes of Health, the first high-level figure to back the statement that “U=U,” said the CDC’s statement will help to dispel both societal stigma and personal stigma. “No one should ever underestimate the concern about social stigma—the pressure people put on themselves,” Dr. Fauci explained to the UK’s . “There are people out there who have guilt and fear about getting tested positive. They are afraid of the stigma of being positive, so they may not get tested. But now, if you know that by taking medication you are dangerous to nobody, that does have a profound impact psychologically. People won’t be afraid to get tested and start medication so they can suppress their viral load.”
Reporting by Hank Trout