I cannot transmit my HIV sexually. The reason? My viral load is undetectable. As a result, my HIV is untransmittable via sex. This fact has been proved by science. This fact should help to finally end HIV-related stigma.
As someone who has now lived with the virus longer than I have lived without it—and as someone who tested HIV positive before effective treatment—I can say with all certainty that the idea of Undetectable Equals Untransmittable, or U=U, has given me much-needed peace of mind.
More than I realized, truth be told. I had become used to believing that my virus was a threat; so therefore, I was a threat. I was so used to believing this that I had become numb to the toxicity of it. Being freed of that belief has given me hope. The fear others have of my HIV is the problem, not me.
The sad part of this story is that I knew that already. Anecdotal evidence for U=U has been around for decades. I am not alone in having many anecdotal stories related to U=U. Suffice it to say that this information was believed to be true by many people before now. The groundswell of belief was such that science had to find out for sure.
The happy ending to this story is that we are now on the other side of this quandary. No longer do any of us have to say we believe U=U without proof. Science has verified that undetectable equals untransmittable. U=U is a fact. Now the challenge is communicating the good news to all.
This moment wouldn’t be possible without the science, but even with the data, it most certainly would not have happened without the Prevention Access Campaign, which launched the inaugural U=U messaging in 2016. The activism of its founding executive director, Bruce Richman, and all the early supporters was key to its success.
Undoing dogma is an almost impossible task, but U=U is well on its way to achieving a sea change in how HIV itself and people living with the virus are perceived. For all those trying to find somebody to love, U=U removes a stubborn barrier. Click here to read how a global community became a movement and where it goes from here.
Although I am undetectable now and essentially have been since I started HIV treatment, there was a time when I was detectable. A long time, actually. For more than a decade after testing HIV positive, I was not on treatment. Doubts about the safety and efficacy of treatment were only part of why I declined.
The truth is that I wasn’t mentally ready to commit to daily pills for the rest of my life. Thankfully, I remained in relatively good physical health during those years, so I didn’t lose too much while I worked out my emotional baggage enough to get on and stay on treatment. I am eternally grateful I had the time to do so.
About half of Americans living with HIV are detectable. My reasons for being detectable were not unique, but they were also far from universal. For one example: Many people lack access to treatment. How does U=U affect those who are detectable? Click here to read how we can help ensure health equity for all people living with HIV.
This special issue of POZ on U=U would not have been complete without a conversation with Bruce. Click here for his insights.