A new study concludes gay and bisexual men increasingly realize HIV undetectable = untransmittable (“U=U”). However, there’s still some way to go before everyone gets the message.
U=U means if someone is HIV-positive but medication has lowered the amount of HIV in their body to a level where it is consistently undetectable, there is zero risk of them transmitting the virus to sexual partners.
The study surveyed over 110,000 gay and bisexual men in the US. It took place between late 2017 and 2018. The results were published yesterday in the Journal of Acquired Immune Deficiency Syndrome (JAIDS).
It found that 53% of men said they believed the accuracy of U=U.
This was highest among men who are HIV-positive (84%), followed by HIV-negative men (54%). Those who didn’t know their status were less likely to accept the accuracy of U=U (just 39%).
In other words, those who have been tested, have spoken to a health counselor or have some knowledge of HIV, are understanding the science.
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HIV-negative men on PrEP and those in serodiscordant relationships were also significantly more likely to accept that U=U.
This contrasts with a Canadian study from 2012-2015. That study found 94% of HIV negative men to be ‘skeptical’ or unaware of the U=U message. A New York study of 2016-2017 also found that only 30% of HIV negative men and those unaware of their status had faith in the U=U message.
This new study suggests the message is slowly getting out there. It’s not coincidental that the U=U campaign began to pick up gear from 2016 onwards.
The research was carried out by scientists at the City University of New York (CUNY). Participants answered sliding-scale questions such as: “What is the risk that an HIV+ man who is currently undetectable could transmit HIV sexually to his partner through topping?” and similarly through “Bottoming?”
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The authors say that although finding U=U is more widely accepted, too many gay and bi men still believe it to be “inaccurate.”
Jonathan Rendina, PhD, MPH, Assistant Professor, Department of Psychology, Hunter College, and the study’s lead author, said in a statement: “All published studies point to undetectable viral load as being the most effective method to date of preventing sexual HIV transmission, but most of our messaging has focused on the level of risk being zero rather than describing it in terms of effectiveness, which is the way we usually talk about condoms and PrEP.”
“Describing U=U as being ‘100% effective’ in protecting against HIV transmission may enhance acceptability among the groups who have been slower to accept the message to date.”
The study was welcomed by Dr Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and one of the world’s leading experts on HIV.
“U=U has been validated repeatedly by numerous studies as a safe and effective means of preventing the sexual transmission of HIV,” Fauci said.
“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.”
Dr Rendina, told Queerty he wasn’t surprised by the study results, given how many organizations now promote the U=U message, including the CDC and NIAID: “If anything, I would have expected slightly higher acceptability – for example, there is still a sizeable proportion of men living with HIV who didn’t believe the science behind U=U.”
He says their data suggests most people hear about U=U via the media and social networks, rather than direct from health providers.
“[Which] highlights the important role providers play in successfully implementing this message.”
Does he think some people express uncertainty because they’re actually uncertain whether people are sticking to their medication?
“Within the questions about transmission risk, we asked people to imagine that their partner knew for sure that they were undetectable,” says Rendina. “So our hope is that this removed any effect of uncertainty about adherence.
“We do believe that there is at least some extent to which people might believe the science but not know if they can trust that their partners are durably suppressed, though we tried to rule out that uncertainty within this particular question.”
maleficent
wrong!
JamJewel
It’s getting effin crazy!
Couple of weeks ago, Queerty published a survey that said that the majority of HIV- gay men wouldn’t have sex with HIV+ men. Here comes this one from even longer ago that says that the majority of us believed the accuracy of U=U. So we are so effedup that we believe U=U but still won’t have sex with people in that situation?
tf3.0
Yes. Even if I believe the science…
Why would I believe the person? Even if he tells me that he is Undetectable, why would I believe him? Why would I put my health in his hands?
And if I have to exhaustively pour through his medical files to confirm?
maleficent
amen brother… but will never get support from the queens on here: cram. miss Chrissy and that big fu*cking idiot PWWO
lawkid15
I believe the science but I don’t believe people therefore I will never have sexual relations with anyone who is HIV-positive since I am HIV negative.
Heywood Jablowme
@lawkid15: What you really mean is “I believe the science but I don’t believe people therefore I will never have sexual relations with anyone who says he is HIV-positive but I’ll have sexual relations with any hot idiot who SAYS he is HIV negative but is lying or who hasn’t been tested recently (or ever).”
JamJewel
Coupla observations: 1. There must be a lot of celibate gay men. 2. Explains that other survey, “57% of gay men over the age of 45 are single.” 3. Heywood Jablowme encapsulates the dilemma: if you’re HIV+ and want to be sexually active, just lie, carry a bottle of PrEP and insist on condom use as there are a bunch of guys out there who’ll think that all that means something. 4. Be mindful of this passage from @David Hudson in Queerty November 17, 2019:
“If someone is HIV positive, knows their status, is on effective medication and has consistently had an undetectable viral load, they cannot pass on the virus. PrEP is also widely available in the US and several other countries to prevent people from acquiring HIV. And condoms are also, of course, widely available.”
djmcgamester
I’m still on the fence about PrEP but not because of the tiny, tiny, tiny percentage of people (like less than 1%) who might be infected. It’s because there is still a risk of contracting other STDs. That aside, I engaged in a lot of very risky behavior in the past, from guys I knew were poz and guys I had no idea of one way or the other. I was lucky in staying negative but the guys I knew who were poz were also undetectable.
Rocinante
I don’t know how old everyone here is but I am 52, negative, and lived a l young gay life of absolute terror. The new world with Prep is like a sexual revolution again. I understand this disease rather well as my manic view of it, rightfully at the time, made me become as educated as most doctors, more than some, on how it was and is transmitted. I recently sat in the room while my spouse was being looked at by the infectious disease doc that gives us Prep, we discussed these issues, other stds etc., if your not on Prep and sexually active outside of a relationship you are part of the problem. These other STDs are disruptive but they are not deadly. I personally have never had one, but if you are out having sexual fun, your bound to find one. I worry about life impacting longterm disease and death. We have turned a corner. And the tools to avoid that are there, just need to be responsible.
If Prep was free to every high risk group in the world, the disease would die a slow but sure death. Read up on the general mathematics of disease transmission on the CDCs website. Disrupt the transmission of a disease by even 50% has a much bigger impact on the overall transmission process. It’s a very interesting subject in general. So, regardless of our views on non-detectable, those people will help kill the transmission. The more positive people that are being treated plus negatives taking Prep, produce less new positives. Statistics is a good thing to understand.
Sister Bertha Bedderthanyu
I read back in April of this year that there was suppose to be a vaccine was coming out next year (2020) for a trial. There has been no mention of it since then and for some odd reason VERY little is coming up on google searches. The prevention (drugs priced so high the percentage of people getting government assistance to pay for them is in the ninety percent range) is worth far more than the cure to the pharmaceutical industry.