U=U Now is The Time
A woman living with HIV tried to find love on a dating app for people with the same condition. After a series of unsuccessful attempts, she met a charming man in the park one sunny day. They hit it off, went on dates, and eventually became a couple, but unfortunately, they fell apart and broke up a few months later. A year after their split, they met again at a coffee shop. To her surprise, the man revealed he was now living with HIV. She confessed that she too had been living with HIV for five years.
She soon found herself in legal trouble for not disclosing her status before they had sex. Despite the challenges, her lawyer highlighted the scientific evidence that undetectable equals untransmittable (U=U). This gave her hope for a fair trial. Thanks to the science of U=U, the woman was cleared of any wrongdoing.
Sadly, even if someone with HIV is undetectable and cannot transmit the virus, there is still the possibility in some jurisdictions that they could face legal consequences for not disclosing their HIV status before sex. This example demonstrates the importance of increasing awareness of U=U beyond people living with HIV and their healthcare providers.
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Now is the time to lend our support to community-led initiatives that foster education and prevention. By uniting as a community, we can cultivate understanding. We can foster a sense of belonging and create confidence. We must work towards challenging and eliminating the stigma associated with HIV. Through open and honest dialogue, as well as dispelling misconceptions, we have the power to build a more compassionate society. It is essential for us to raise our voices and ensure that everyone is aware of the groundbreaking concept of U=U. We must share the advancements in treatment that prevent transmission. Empowerment and self-acceptance are pivotal for those living with HIV. U=U has instilled hope and inspiration in countless lives. All of us are needed to spread the message of U=U on a global scale.
It is unnerving to see how Black women are constantly not included in discussions about HIV, prevention, and U=U. This is especially disconcerting when we consider how many Black women and women of color are affected by the virus. Statistics show a disproportionate impact on Black women, with a higher rate of new HIV cases than the rest of the population. Black transgender women also face significant challenges due to HIV. We must not forget about the Indigenous community, who are often overlooked in these conversations. Partner violence and the absence of representation greatly contribute to the limited awareness of how HIV affects these groups.
The self-stigma associated with HIV can be overwhelming. It can consume one’s thoughts and emotions. It is a solitary and daunting experience, often leaving people feeling fear and isolation. However, it is important to recognize that no one with HIV should ever feel alone. There is a supportive community ready to embrace and uplift them. This community has the potential to add value to life. It can help shape identity in a space where people with HIV may have previously felt isolated. Ultimately, it can enable confidence and self-worth.
Now is the time to share the message of U=U and collectively transform the narrative surrounding HIV. With a total understanding of U=U, people will no longer bear the burden of shame.
Where are those who genuinely believe in the scientific evidence behind U=U?
Every person living with HIV deserves to know this empowering message, to help them experience a renewed piece of mind. Everyone must learn that people living with HIV can no longer transmit the virus when their viral load is undetectable. We should also not ostracize people who are grappling with an unforeseeable result.
U=U is an incredibly powerful prevention measure for people living with HIV. A prevention that no one thought could be possible years ago. It eliminates the risk of transmission to our sexual partners, making it a game-changer in the fight against HIV. It is essential for healthcare providers to actively share the U=U message with their clients. When someone receives their diagnosis and learns about U=U, it can be a life-altering moment for them. This is why it is crucial for everyone to openly discuss and promote U=U, as it empowers individuals to speak up and make a difference.
Now is the time for all people living with HIV to have access to information about their social, sexual, and reproductive health. We must not allow anyone to take that away. We must be the catalyst for change and advocate for what is right for people living with HIV. “Now is the time” for everyone to use their voices to spread awareness about U=U. Simply knowing about it brings a sense of self-worth and positivity to people with HIV. However, taking action and creating change not only benefits people with HIV. It also has a profound impact on the lives of others. This is the essence of U=U: transforming lives and making a difference.
Where are the people who were so eager to engage in conversations and learn more about U=U?
All of us must come together and actively work towards reducing the stigma and discrimination against people living with HIV. This includes prioritizing their mental health and overall well-being. It also means ensuring that the U=U message reaches those who need it the most. How can people say that they care about those who are living with HIV and then refuse to share U=U with them?
For more than four decades, there has been a prevailing fear surrounding HIV. This is largely due to a lack of understanding about its transmission. Later, it was revealed that the virus is primarily transmitted through sex. Unfortunately, this led to the misconception that only gay and bisexual men were at risk for HIV. This was then proven false. Additionally, it was widely believed that people living with HIV could never have condomless sex with their partners or have children. However, with the progress of scientific research and advances in medication, the landscape has changed significantly.
Why do so many people find it difficult to accept that HIV can no longer be transmitted through sex? Today, scientific evidence supports the concept of U=U. It has been proven through rigorous research. However, when scientific information contradicts deeply ingrained beliefs or values, people may feel discomfort. In an attempt to alleviate this, some people simply reject scientific facts, even when those facts are proven.
In 2008, the Swiss Federal Commission for HIV/AIDS issued a statement saying people living with HIV could not transmit HIV to their partners once they become virally suppressed. In 2016, the Partner 1 study, conducted from 2010 to 2014, published final results. In 2019, the Partner 2 study, carried out between 2010 and 2018, published results in The Lancet. The Opposites Attract Study took place from 2012 to 2015, and the HPTN 052 Study had final results published in 2016. Remarkably, all these studies have shown no transmission of HIV between serodiscordant couples, where one person was living with HIV and on effective treatment for the virus, while the other was HIV-negative.
Alison Rodger, a researcher in the Partner 2 study, emphasizes that there are no more excuses. The risk of sexual transmission is absolutely zero. This fact has been scientifically confirmed, and it is easy for us to access these studies and educate ourselves about them. If people embraced this truth, we could have made significant progress in supporting people living with HIV. However, there are still gaps in global awareness about U=U. Healthcare providers need to be more conscientious about spreading this message to ensure that all their clients are aware of it.
The Canadian Government emphasizes the importance of inclusivity when discussing U=U. Sharing this information with everyone will help create safer spaces for people living with HIV. It will normalize conversations about sexual health, and promote overall well-being and sex positivity. It is crucial to use clear and direct language like “can’t pass it on,” “no risk of transmission,” and “zero risk”. These will convey the message effectively. Negative attitudes and cautious statements implying any risk of transmission while on regular treatment will only weaken the impact of the message. The more we openly discuss U=U, the greater the positive influence it will have.
At the end of 2020, approximately 62,790 people lived in Canada with HIV. Canada successfully met the first and third 90-90-90 targets for that year, showing remarkable progress. It is estimated that 90% of those living with HIV were diagnosed, with 87% of those diagnosed receiving treatment. An estimated 95% of individuals on treatment also achieved a suppressed viral load. As a result, there were around 16,690 people in Canada who did not achieve viral suppression.
It is essential to determine which jurisdictions are actively conducting HIV testing in the community on an ongoing basis. Regular HIV testing is vital for people at a higher risk of contracting or being exposed to HIV. It is recommended to test at least every six months to a year. It is important to note that people who don’t know their HIV status are at a greater risk of severe medical complications and premature death. Therefore, early HIV diagnosis is of utmost importance. It is necessary to hold all levels of government accountable for not fulfilling their responsibilities. Many of them are failing to engage community-based organizations that have been working towards prevention efforts on the ground. Self-testing needs to be promoted. Testing should also be promoted at universities, colleges, other educational institutions, and in the communities most affected. However, HIV testing days alone are not enough to ensure there are conversations about testing and U=U.
Now is the time to let people who are living with HIV lead conversations and determine what is necessary for us. While we appreciate and value our allies, we must acknowledge that it is people living with HIV who are working towards reducing HIV transmissions and modernizing HIV criminalization laws. Our personal experiences can greatly influence and educate those who have recently been diagnosed. We can emphasize the importance of consistent adherence to medication. AIDS service organizations and health departments should be hiring people living with HIV as mentors. In these roles, we can give support and guidance to those who have just received their diagnosis. Certain non-governmental organizations receive funding from both the federal and provincial governments as they strive to make a positive impact in Canada. Just relying on funding isn’t enough when it comes to promoting the U=U message and giving assistance to people living with HIV facing challenges.
In 2018, Canada did just that when it became an early adopter of the U=U campaign. It was among the first countries to endorse it. The Minister of Health, Minister of Mental Health and Addictions, and Associate Minister of Health publicly declared Canada's support for a global declaration on U=U. This endorsement has since been integrated into their policies and programs. It serves as a fundamental part of tackling systemic inequities and reducing obstacles to healthcare. By prioritizing U=U, they have aimed to provide the necessary support for people affected by HIV. This enables them to lead healthy lives. Other countries can follow suit and endorse U=U too. U=U is about human life and that should mean something to people.
If it’s about human life, then why are people living with HIV still being criminalized for HIV? It is time to intensify efforts to update HIV criminalization laws across the globe. Criminalizing HIV is unjust, and these laws should never have been made in the first place. In the United States, 13 states have reformed or completely repealed their HIV criminalization laws. 13 states force people with HIV to disclose their status to sexual partners, and 14 states have maximum sentence lengths exceeding 10 years if someone does not.
According to the Center for HIV Law and Policy, as of 2023, over 30 states still have criminal laws about HIV or sexually transmitted disease status. Some states have made progress by modernizing or repealing their HIV criminal laws. These changes include requiring intent to transmit (whatever that means), engaging in conduct likely to result in transmission, and actual transmission. Some state reforms also provide defences for preventive measures like viral suppression, condom use, or partner PrEP use.
Shockingly, five states mandate people convicted under an HIV-specific law to register as sex offenders. A study done by UCLA’s Williams Institute shows that more than 63 percent of people on the state’s sex offender registry are listed only because of an HIV-related conviction. It’s shocking. Canada is also one of those countries that list people living with HIV as sex offenders when they are found guilty of sexual assault as a result of not disclosing their status. In Canada, there are roughly 220 people charged for HIV non-disclosure, even if the virus was not transmitted. Again, HIV should not be a crime at all.
Let’s not forget that Canada endorsed the global declaration on U=U—and that is great! In 2018, the prosecutorial guidelines of the Canadian federal government were revised to align with the scientific understanding of U=U. These said there should be no federal prosecutions where a person living with HIV has a suppressed viral load (under 200 copies/mL). The criminalization of HIV non-disclosure does not prevent HIV transmission. However, it does discourage people from getting tested, which is something we do not need. These laws also feed into stigma within our communities.
People living with HIV should not be viewed as criminals. It is crucial to keep working towards modernizing criminalization laws across the globe.
To truly advocate for change, we must express our desires but also take action at the same time. Despite the challenges posed by this virus, people living with HIV have shown that they can still voice their needs. Merely discussing what we want will not be enough to make a difference. Instead, consider forming a coalition group and collectively focus on the specific issues you wish to address. Take the time to outline the necessary tasks that will help achieve goals and mark them off as they are completed. How will we all engage politicians, health departments, and the HIV community and educate the public?
Now is the time to come together as a group of people living with HIV to have a significant impact and create positive change for all.