U = U
Undectable Equals Untransmittable
Zero risk means zero risk.
U=U stands for Undetectable Equals Untransmittable
Undetectable is when someone living with HIV is taking their medication as prescribed and able to reach a point where the virus is suppressed to such low levels in the body it can not be detected on standard tests. An individual still needs to continue taking their medication to remain undetectable.
Undetectable=Untransmittable (U=U) is a breakthrough in HIV care and established that someone living with HIV who is undetectable can not transmit the virus to a partner through condomless sexual intercourse. Zero risk. This also applies to individuals who are virally suppressed with a viral load below 200 copies/mL.
It is important to note there is a crucial third “U” being Universality. If people do not have access to medication or care this puts a huge barrier for someone to become undetectable. Our services focus on improving testing access across Ontario, referring people to care, and helping them afford essential HIV medication.
Where's the proof?
Over several years, studies included thousands of cases of sexual intercourse between individuals who were undetectable and their negative partner. They found NO transmissions occurred between these partners. The links below provide the studies involved and statements released by leading health organizations:
We also know that for those currently with a detectable viral load, being on medication treatment can still reduce the risk of transmission as well.
U=U and Pregnancy
Someone who begins HIV treatment before or very early in pregnancy and maintains an undetectable viral load will not transmit HIV to their baby during pregnancy or delivery. This is why it is very important for anyone planning to have a baby to get tested and another reason to improve medication access. At this time, U=U does not apply to breastfeeding or chestfeeding.
Mandelbrot L, Tubiana R, Le Chenadec J, et al. No perinatal HIV-1 transmission from women with effective antiretroviral therapy starting before conception. Clinical Infectious Diseases. 2015;61:1715–1725.
Prevention Access Campaign
This is the organization that launched U=U and has worked tirelessly to share this important message across the world. Led by activist Bruce Richman, you can learn more about them and find supportive resources at their website and on their social media channels.
Education is an important way to fight stigma and we encourage website visitors to share the studies and information above with friends and family. The PrEP Clinic will be actively providing education on this topic and other stigma-busting topics across Ontario to as many people as we can.
What is something simple you can do if you are not living with HIV and want to support others? A good first step is considering how you converse with people – words matter. Stigmatizing language such as referring to some living with HIV solely by their medical condition, using derogatory slang such as asking if someone is “clean”, or shunning someone because of their status can be hurtful. Open minds and open hearts are a great place to start.