What is U=U?

What is U=U?

Answer: U=U is shorthand for Undetectable = Untransmittable. U=U means that people living with HIV who take medication daily to control the virus can’t pass HIV through sex.

Here is how it works: When you take medication daily to treat HIV, you stop the virus from multiplying. When HIV can’t multiply freely, it leads to less virus in your body. The amount of virus in your body is called the viral load. When you have a low viral load – less than 200 copies – HIV becomes undetectable in your body. According to current research, maintaining an undetectable viral load for at least six months means you cannot transmit or pass HIV to partners when having sex. That means you are untransmittable.


What does Undetectable really mean?

Answer: Undetectable means there is so little HIV in your body it cannot be measured by a test.

Here is how it works: The medications used to treat HIV keep the virus from multiplying in your body. By taking medication daily, the levels of HIV get so low in your body that the test can’t even detect it, meaning you are undetectable. To stay undetectable, you must continue to take your HIV medication everyday as prescribed because HIV will start to multiply and grow again if you stop. Talk to your health care team about side effects, or anything else that makes it difficult for you to take your medication.  They can work with you to make taking your medicine as easy and worry-free as possible.


What is Treatment as Prevention?

Answer: Treatment as Prevention is another way of saying that treatment of HIV with medication not only keeps you healthy but also means you can’t pass HIV to others through sex.

Here is how it works: By taking HIV medication daily, and staying undetectable, you eliminate the chance of passing HIV to others through sex. Your HIV treatment also works as HIV prevention for your sex partners who don’t have HIV. In other words, taking your HIV medication daily helps you protect your health, and the people you care about.


How do I get undetectable?

Answer: Getting your viral load to undetectable is all about TLC.

Treatment – stay on treatment as prescribed

Labs – get your labs done regularly

Care – stay in care by going to all of your scheduled appointments


Here is how it works: If you have HIV, take your medication daily as prescribed by your health care team. For many people, this can be as simple as one pill once a day. After you start taking HIV medication, you should see your doctor regularly so they can retest your blood and let you know you are undetectable. Once you have stayed undetectable for at least six months then you can feel sure that you cannot pass the virus to others through sex.

Sometimes, circumstances in our lives can make reaching and staying undetectable very difficult. If you have something going on in your life that might prevent you from taking your medication or making it to your clinic appointments, talk to your health care team about it. They can connect you to services and resources that you may find useful and may help you reach your HIV treatment goals.


How do we know that U=U?

Answer: In recent years, a lot of scientific evidence has confirmed as fact that you can’t pass HIV through sex when you are on HIV medication daily as prescribed and are undetectable.

Here is how it works: Four different large scientific studies (HPTN 052, PARTNER, PARTNER 2, and Opposites Attract) followed and observed male-female and male-male couples where one person was HIV positive and the other person was HIV negative. Throughout these studies, after over 100,000 instances of sex without condoms, both anal and/or vaginal sex, not one person living with HIV who was undetectable and taking HIV medication daily as prescribed passed HIV to their negative partner.


What if I want to have kids?

Answer: U=U protects you and your partner, and your baby too.

Here is how it works: If you are pregnant and living with HIV, there is virtually no risk of passing HIV to your newborn if you are undetectable prior to becoming pregnant and stay undetectable throughout the pregnancy. To accomplish this, you need to continue to take HIV medication as prescribed during your pregnancy and a short course of HIV medication will be provided to your newborn as well, both of which are safe for you and your baby. Please see our list of recommended Specialty Centers where providers have expertise in women’s health, HIV, perinatal care and pediatrics all under one roof (http://publichealth.lacounty.gov/dhsp/Providers/HIV-SpecialtyCenters-PregnantWomen_2019.pdf).

Unfortunately, even with U=U, certain types of infant feeding can make it possible to pass HIV to the baby after birth. This includes breastfeeding and pre-chewing food for the infant. For this reason, breastfeeding and pre-chewing food are not recommended for parents living with HIV in the United States. Talk to your health care team about options available to assist you and your family.


What should I tell my sex partners who don’t have HIV?

Many people find it difficult to have conversations with sex partners about things like HIV and other sexually transmitted diseases (STDs). Knowing that you are not able to pass HIV to your sex partners might make that conversation easier for you. Tell them what you know about U=U, and how taking your medication daily can protect both of you! Or let us help and share this website or others like it.

Remember, having an undetectable viral load does not protect against other STDs like syphilis, chlamydia or gonorrhea, and it won’t prevent pregnancy. Talk openly with your partner about how you want to have healthy, pleasurable and worry-free sex with each other. This can mean using condoms, birth control, HIV treatment, Pre-Exposure Prophylaxis (PrEP), emergency Post Exposure Prophylaxis (PEP) or any combination of these. Together, couples can decide what options are best for them.


What if I am HIV negative?

PrEP is a way for people who don’t have HIV to prevent HIV infection by taking a pill every day. “PrEP” stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means “to prevent or control the spread of an infection or disease.” A combination of two HIV medicines (tenofovir and emtricitabine), sold under the name Truvada® (pronounced tru vá duh), is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who’s positive. You must take PrEP every day, as prescribed, for it to reduce your risk of becoming infected with HIV. For folks who don’t have HIV, this can be a great option for when you don’t know the status of your partner, if you or your partner has multiple partners, if you don’t know if your partner can maintain an undetectable viral load, or if you just feel more secure in your sex life with the added protection of PrEP.