Roughly half of HIV-negative men who have sex with men and 84 percent of HIV-positive men who have sex with men understand that the “Undetectable Equals Untransmittable” campaign, or U=U, means that individuals with undetectable viral loads are not at risk of transmitting HIV, according to a study involving 112,000 men across all 50 states.
The study was administered by the National Institutes of Health and led by researchers at Hunter College who gathered data from surveys posted on social media and mobile dating apps between November 2017 and September 2018. Researchers asked men who have sex with men what they thought about the accuracy of the slogan “Undetectable = Untransmittable” with regard to HIV-positive individuals transmitting HIV through sex.
Overall, 55 percent of men who identified as sexual minorities in the survey described the slogan as “completely accurate” or “somewhat accurate.” Fifty-four percent of HIV-negative participants and 39 percent of those unaware of their HIV status deemed the slogan to be accurate compared to 84 percent of those living with HIV.
The NIH noted that the study showed improvements from a similar survey conducted in 2016 and 2017 involving 12,200 men who have sex with men. That study found that only 30 percent of HIV-negative respondents and 64 percent of those living with HIV understood the slogan.
“U=U has been validated repeatedly by numerous studies as a safe and effective means of preventing the sexual transmission of HIV,” said Dr. Anthony S. Fauci, a longtime HIV/ AIDS researcher and the director of the NIH’s National Institute of Allergy and Infectious Diseases, which supported the study. “The increased understanding and acceptance of U=U is encouraging because HIV treatment as prevention is a foundation of efforts to end the epidemic in the United States and around the world. This public health message has the power to reduce stigma, protect the health of people living with HIV, and prevent sexual transmission of HIV to others.”
Among other questions, the survey asked individuals to rate the risk level of an HIV-positive but undetectable man transmitting the virus to an HIV-negative man through anal sex without a condom. Respondents were asked to answer that question on a scale of zero percent (no risk) to 100 percent (complete risk), and just ten percent said there was no risk when the insertive partner has HIV. Meanwhile 14 percent said there would be no risk of transmission when the receptive partner is HIV-positive but undetectable.
The survey included responses from men ranging from 13 to 88 years of age, with the median age being 32. Twenty-four percent of respondents identified as Latino and 14 percent identified as black. Seventy-nine percent identified as gay, 18 percent as bisexual, three percent as queer, and one percent as transgender.
The U=U campaign has grown in visibility in recent years. In 2017 the federal Centers for Disease Control and Prevention acknowledged that those with undetectable viral loads are not at risk for passing on the virus, and during a CNN presidential town hall dedicated to LGBTQ issues in October, host Anderson Cooper explained to viewers the meaning of U=U.
