U=U stands for the words Undetectable and Untransmittable. It refers to new scientific documentation that changes everything we thought we knew about HIV and the ways in which the virus is transmitted, demonstrating that a person living with HIV who receives antiretroviral therapy and has achieved an untraceable viral load in his blood for at least 6 months, can not practically transmit the virus to a sexual partner, even during unprotected sexual intercourse.
What does ‛untraceable viral load’ mean?
The term viral load refers to the amount of the HIV virus that is detected in the blood of a HIV-positive individual.
In general, a higher the viral load means a larger chance of transmitting the virus. The antiretroviral treatment taken by HIV-positive people can reduce their viral load below 40 copies/ml in their blood. If this happens, they have reached the «untraceable viral load» and can’t transmit the virus to other people, at the same time improving their own health.
«Untraceable viral load» does not mean that the virus has been eradicated from the body of a HIV-positive person. Therefore, compliance with the medication regime and periodic measurement of the viral load are extremely important parameters for the success and the efficiency check of the therapy.
What do we mean with the phrase “Treatment as Prevention” for HIV?
By the term “Treatment as Prevention” (TasP) we mean the effect of the antiretroviral treatment, not only on the health of the HIV-positive person who is receiving it, but also with regard to the drastic reduction of their possibility to transmit the virus to others, either through sexual intercourse, by sharing equipment for injection drugs, or perinatally.
Antiretroviral therapy suppresses the reproduction of the HIV virus in blood, sperm, vaginal and anal fluids and as a result, it reduces the risk of transmission of the virus. When the virus content of the blood reaches untraceable levels, the risk of sexual transmission is practically nil.
Is HIV untraceable in all people who receive antiretroviral treatment?
In the overwhelming majority of cases, antiretroviral treatment regimens achieve an undetectable viral load within 6 months, if taken in accordance with the doctor’s advice.
In individuals who have an undetectable viral load for at least one year, with excellent compliance in treatment, it is unlikely that the virus will reproduce. If this does happen, we use the term “treatment or virological failure”; these cases however are extremely rare after prolonged repression of the virus, and can usually be ascribed to poor compliance with the antiretroviral treatment.