An international survey of over 2,300 adults living with HIV found that a third of them had not discussed what an undetectable viral load was or the potential benefits of U=U (undetectable = untransmittable) on their lives with their HIV clinicians.
The research paper ‘Undetectable equals untransmittable (U = U): awareness and associations with health outcomes among people living with HIV in 25 countries’ published in the BMJ’s Sexually Transmitted Infections was written by Chinyere Okoli, with input from several community members and sponsored by ViiV Healthcare.
The survey was conducted in 25 countries covering Europe, North America Asia, Latin America, South Africa and Australia. The majority of participants were aged 30 or above and had achieved a high level of education. 29% of respondents were women and 29% were aged 50 or above.
Of those responding:
- 66% said that they had spoken with their HIV clinicians.
- 21% knew that their treatment could prevent them passing on HIV.
- 12% had not heard of U=U or that HIV treatment can prevent onwards transmission.
The highest number of reported conversations came from Switzerland (87%), Austria (84%) and Australia (80%) with the fewest reported conversations were in Asia (China, Japan, South Korea and Taiwan) at just 51%.
The survey’s authors were keen to understand the relationship between better conversations around U=U and overall health and wellbeing in the people with HIV who were surveyed, and when the data was analysed some interesting findings emerged.
Adherence. Suboptimal adherence to their HIV medication was reported by 20% of those who had spoken to their HIV clinicians about U=U but that almost doubled to 35% amongst those who had not heard of U=U at all.
Openness. Whilst 66% of those who’d discussed U=U with their HIV clinicians said that they would feel comfortable discussing HIV transmission with their clinic only 36% who were unaware of U=U felt able to have the same discussion.
Perception of health. When asked to rate their own health on a five-point system 61% of those who’d spoken to their HIV clinicians about U=U rated their health ‘Good’ or ‘Very Good’ – this dropped to 45% in those who were unaware of U=U.
The survey’s investigators write “Discussing U=U in clinical settings is vital because patients perceive information they hear directly from their healthcare providers as being more believable,”
“Since clinicians are likely the first professionals to whom a newly diagnosed person will turn for advice about their new health circumstance, it is essential to evaluate the extent to which healthcare professionals share information on U=U with their patients.”.
This is yet more evidence that the powerful message of U=U affects more than just sex lives. Discussing U=U in clinical settings not only helps to take away stigma and fear it also empowers people living with HIV to be more open with their clinics and take control of their health. Outcomes that are in everyone’s best interest.
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