Undetectable HIV Can’t Be Sexually Transmitted, and People Are Finally Starting to Believe It


A new study has found that Americans are increasingly beginning to understand that people living with undetectable HIV cannot sexually transmit the virus to others.

Researchers led by Hunter College and The Graduate Center, CUNY, Professor H. Jonathon Rendina (also a Graduate Center alumnus) surveyed nearly 112,000 “men who have sex with men” and found that 84% of those living with HIV know that U=U (which means “undetectable equals untransmittable”).

“This increased awareness and acceptance of the message will hopefully, over time, continue to lead to lower levels of HIV stigma. Which then hopefully will also enhance health,” Rendina, director of the Applied Intersectionality & Minority Stress Lab, tells SUM. “We hear a lot of stories about people living with HIV… who have felt afraid of having sex since they were diagnosed. Suddenly, now they realize they can have a happy, healthy sex life with partners of any HIV status as long as they’re able to maintain an undetectable status.”

The study titled, “Growing acceptability of Undetectable = Untransmittable but widespread misunderstanding of transmission risk,” was published in the Journal of Acquired Immune Deficiency Syndromes. The authors conducted the survey from November 2017 to September 2018, promoting the effort on social media. Although most people in the study living with HIV know U=U to be true, the researchers found that only 54% of HIV-negative participants believe U=U to be true.

“In the current study, HIV-negative participants who reported seeking HIV testing and prevention services, as well as those taking daily pre-exposure prophylaxis, or PrEP, were more likely to believe U=U was accurate,” researchers noted. “These findings suggest that U=U acceptance correlates to more frequent interactions with HIV prevention services.”

People who consistently take antiretroviral therapy as prescribed were most likely to understand that undetectable HIV cannot be transmitted sexually. The U.S. Centers for Disease Control and Prevention determined HIV treatment a 100% effective form of prevention, as people who use treatment to maintain an undetectable viral load are unable to transmit the virus.

They also found that even though acceptance of U=U has improved, people still struggle to understand that an undetectable man has zero risk of transmitting HIV to his HIV-negative partner.

“A growing number of sexual minority men believed that U=U is accurate, but our data suggest that most still overestimate the risk of HIV transmission from an undetectable partner which may be because people have trouble understanding the concept of risk,” Rendina said.

“All published studies point to undetectable viral load as being the most effective method of preventing sexual HIV transmission to date, 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.”