By: Jennifer McMillen Smith, MSSA, LISW-S, Division of Infectious Disease and medically reviewed by Ann Avery, Infectious Disease Physician at Metrohealth Medical Center
U=U, heard of it? Seen it somewhere? Maybe on social media or on someone's t-shirt, possibly. Wherever you’ve heard of it, we stan and are here to break it alllllllll down for you!
U=U is short for Undetectable = Untransmittable. Meaning, if you've reached undetectable HIV status, it's nearly impossible to transmit or pass HIV to anyone else through sex. You may only think of people living with HIV when you hear U=U, but it’s important for people who are not living with HIV too.. If your partner is a person not living with HIV, they are not at high risk for HIV when you’re undetectable. There is lots of research to support this from the National Institutes of Health, CDC, and the World Health Organization. Plus, we totes supports this.
Let's break U=U down in simpler terms
HIV is a virus. Undetectable refers to the viral load (the amount of HIV in the body) where a person is still living with HIV but has so little of the virus, they won't pass it to their partner(s). Undetectable status is usually reached when someone living with HIV takes their meds daily as their doctor prescribes. Taking meds on schedule, getting enough sleep and food, and exercising can help reach this point. There are exceptions and we should be absolutely clear about this; you will have to work with your medical team to figure out what meds work best for you. After some time, you can achieve undetectable status. Keeping your viral load undetectable by taking your HIV medicine every day helps you live a long, healthy life and it has the added benefit of protecting your partner.
U=U can work wonders for enhancing connection and intimacy between partners. There's a chance for stronger bonds and less worry when a partner living with HIV reaches undetectable status. For so long, we have had to rely on condoms and nothing else. Condoms are helpful but can kill the excitement sometimes. We still recommend using condoms, dental dams, water-based lube, and internal condoms (also called female condoms) to reduce the risk for other sexually transmitted infections (STIs). U=U says when communication is clear and honest between partners, the fun only skyrockets. U=U can be reassuring when planning for pregnancy and starting a family too. There’s so little risk for your sexual partner in removing condoms once undetectable for about 6 months. We suggest talking with your medical provider if you’re planning a pregnancy.
U=U combats stigma
Being undetectable does not determine your worth. You deserve love, respect, companionship, good sex, housing, and peace of mind regardless of your HIV status.
Stigma (which is usually based on fear and ignorance) causes people living with HIV to get treated badly. Because of a health status, people can lose friends and family, housing, jobs, and much more. Life is hard enough. Let’s get rid of HIV stigma for starters. People unaware of U=U think if you're living with HIV that means you’re at higher risk of transmitting HIV. U=U says different and says that that fear is not based in science and it's mostly ignorance. An undetectable status means you cannot transmit HIV. U=U stresses that people living with HIV can live long, healthy, and active lives.
Much of what the public knows that HIV was shaped by what we heard in the '80s and '90s. With so many of the advances made in science and medicine around the virus, we need to update our thinking too. U=U is a part of that updated thinking. PrEP (pre-exposure prophylaxis) is also part of that updated thinking.
We encourage you to engage with your medical provider, take your meds as prescribed, and to stay in care. Live your very best life.
U=U needs YOU!
You're already doing a great job and thank you for joining us at Positive Peers (please keep coming back).
Here are a few questions for you:
Are you in care?
When was the last time you had an appointment? Did you go?
In order for U=U to be effective, we have to play our part too. Experts recommend you see your HIV doctor and get your labs done at least once every six months.