Three years ago, Prevention Access Campaign launched a campaign called Undetectable = Untransmittable (U=U). Their founder and Executive Director, Bruce Richman, speaks here about his own journey into awareness and the absolute necessity to get the fact shared as widely as possible.

U=U means that a person living with HIV who is on treatment and has an undetectable viral load cannot sexually transmit HIV. 

Could you tell us about your own realisation of the U=U fact?

I was told in 2012 by my HIV doctor after I thought I might have transmitted HIV to someone. Even though the condom broke with this guy, it was impossible for me to give him HIV. It was amazing.

He told me because he viewed me to be someone who he could trust with the information; a privileged white man. I quickly realised that most people were not being told this, and I became outraged. It is incredibly unjust and unethical to cherry-pick which people living with HIV deserve to know this information and who don’t.

What impact did that knowledge have on you?

It felt liberating knowing that I could love and live without fear, that I could have sex again without constantly worrying about the possibility of passing on HIV to my partner. I had stopped myself from getting too close to anyone because I was afraid of giving HIV to someone I love. Now I felt I could have relationships and sex and even conceive a child if I wanted, just like everyone else.

But, at the same time, the fact that this message was being kept from most people living with HIV, especially communities that were already marginalised by the health care systems was incredibly infuriating. That groundswell of evidence since the beginning of ARVs proved U=U just wasn’t getting out from the realm of science to the public. I had to do something to ensure all people with HIV know about this life-changing and radical fact and can access the treatment and care to benefit from it.

#TuesdayThoughts: The #UequalsU message is being used globally to fight #HIV stigma, but it is also a powerful tool to advocate for viral load testing and treatment in places where access to both are a challenge. #UequalsU is a right, not a privilege. pic.twitter.com/6Q8KxgOJFF

— Prevention Access (@PreventionAC) August 20, 2019

How did the Prevention Access Campaign come about?

We officially launched U=U in the Summer of 2016 when we issued a Consensus Statement to confirm U=U as our primary advocacy tool. We used the consensus statement to recruit influencers and over 900 organisations from 98 countries to sign on to the campaign and endorse U=U. And we started our advocacy to urge the US federal health departments, including the CDC, to update their assessment of our risk which I’m proud to say they updated just a year later.

It was a historic change in what it means to live with HIV, and it came about because of this unique collaboration between people with HIV and the people who care about us around the world.

Is stigma still a major hurdle for both HIV activists and People Living With HIV?

Absolutely. Stigma is literally killing people. Think about this – right now, millions of people living with HIV are suffering because they and others think they’re infectious. And they’re not. They’re suffering from social rejection, isolation, depression, substance abuse, suicide, intimate partner violence, prosecution and murder. Their lives are at risk because people think they’re a risk.

We need to treat HIV stigma as a public health crisis and U=U as an immediate and effective response.

Looking for ways to share #UequalsU? Check out https://t.co/x6lk1wmX6b for customizable, downloadable posters, GIFs, and videos to educate about U=U and encourage engagement in care. pic.twitter.com/X220oFq7Vn

— Prevention Access (@PreventionAC) August 21, 2019

In the three years since Bruce Richman and PAC began to share the U=U message, 886 organisations from nearly 100 countries have joined the rapidly growing movement. U=U as a prevention method is unequivocally verified by numerous studies and recently estimated as 100% effective by the US Centers for Disease Control and Prevention (CDC).

PAC has called on multi-sector global stakeholders to make new commitments to increase the reach and availability of public health information on U=U, especially aimed at engaging communities disproportionately affected by HIV, and called on government leaders to take action to ensure U=U is clearly communicated and incorporated into national HIV programs.

You can follow Bruce Richman on Twitter here.