When it comes to the news that an undetectable viral load prevents people from transmitting HIV through sex—a concept dubbed Undetectable Equals Untransmittable, or U=U—something is getting lost in translation between the science and society.
First, the LGBTQ advocacy group GLAAD recently released its State of HIV Stigma report, showing that only about two thirds of Americans know about pre-exposure prophylaxis (PrEP), or pills that prevent HIV. Fewer, 42%, know about U=U. Essentially, Americans get a D on PrEP and an F on U=U.
Data presented at IDWeek 2021 show that American clinicians are especially guilty of not sharing the science with their patients. The Positive Perspectives 2 survey by ViiV Healthcare and U=U advocates surveyed 538 people in North America about their mental and sexual health as well as whether their providers had explained U=U.
Verdict: The good news is that 75% of gay people, 88% of those who identified as queer or bisexual and 100% of trans and nonbinary people said a provider had told them about U=U. But the bad news is that American clinicians, unlike their Mexican and Canadian colleagues, picked and chose which patients they explained the science to. While providers told most gay, queer and trans people about U=U, they told just 65% of cisgender men, heterosexual people and people living in rural areas.
This gap may have real implications for people’s health. Survey respondents who learned about U=U from a provider were more likely to have an undetectable viral load. Just 45% of Americans who had never talked to a provider about U=U had viral suppression, but that number rose to 64% for those who did so.