For a long time in the history of HIV and AIDS, information was kept a mystery from people living with HIV, and it perpetuated stigma, discrimination and criminalization. If we knew sooner as much as we now know about Undetectable = Untransmittable or U=U, we might have saved millions lives.
In Washington, D.C., during AIDS Watch 2017, the news officially broke: Undetectable = Untransmittable. The message was endorsed by major players such as community-based organizations, medical professionals and the U.S. government represented by the Centers for Disease Control and Prevention and AIDS.gov. This is revolutionary: People living with HIV are the champions of U=U, and it's no longer possible to keep the community from important information related to HIV and AIDS.
The first day of AIDS Watch was marked by series of presentations, organizing and speeches, and U=U occupied 90% of the conversation, as it was stressed over and over. In the evening, Bruce Richman from Prevention Access Campaign organized a U=U gratitude reception to help excited participants chill out and let the U=U message sink in.
Related: Why, for HIV, Undetectable = Untransmittable
The excitement grew even greater; the reception room was full; and everyone willing was given a chance to be a star for five to 10 minutes to share with the audience what U=U meant for her or him without being interrupted or rushed. Interestingly, people who shared their testimonies were people living with HIV, and some were born with HIV, some were long-term survivors and some had been living with HIV for only a few years or even months -- i.e., "newcomers to the club."
No matter how long people had been living with HIV, the excitement, relief and joy were shared: Finally, people living with HIV are no longer deadly biological threats posing risks to society if only they have access to treatment and maintain an HIV undetectable status, and luckily people living with HIV are confident they may witness the end AIDS. This link will lead you to a video showing a part of the excitement at the U=U gratitude reception.
At the gratitude reception, we learned from all those who took the floor:
- U=U energizes and encourages people living with HIV to keep taking their antiretroviral treatment as they all aspire to reach an undetectable viral load. In return, people living with HIV stay alive and healthy and continue to be important members of the community.
- U=U helps people living with HIV to convince the world that when people living with HIV have access to treatment and maintain an undetectable viral load, they are no longer transmitting HIV to their partners. In return, people living with HIV will be able to focus on changing the dialogue about HIV-related stigma and the discriminatory culture and attitudes.
- U=U is a great argument for continuing to push the fight to end HIV criminalization laws, as U=U provides an incentive to people living with HIV to stay healthy and maintain an undetectable viral load to protect other people from contracting HIV.
- U=U is just the beginning; we still have a lot of work to do. For some communities U=U is a still a dream; it's a destination. Those communities are still facing challenges in ensuring that all people can have access to HIV testing and that those living with HIV can get antiretroviral treatment and maintain an undetectable viral load status. It's a collective call for all of us to end HIV services disparities and to break barriers preventing people from accessing HIV services, including HIV- and AIDS-related stigma, discrimination and criminalization.
- For women living with HIV who are at the age of procreation and desire to naturally have children, U=U won't be a full reality until we have enough research on breastfeeding and U=U. Women living with HIV receive mixed, confusing information. In developing countries, protocols recommend breastfeeding for women living with HIV, and in developed countries, protocols prohibit women from breastfeeding. On top of that, women are not allowed to obtain information and make their own informed choices. In many communities, women living with HIV desiring to have babies are still considered selfish for running the risk of transmitting HIV to an innocent baby. As men and women, we must advocate for more studies on U=U during pregnancy, childbirth and breastfeeding.
U=U faces some resistance, as HIV and AIDS has been around so long that people living with HIV have been told numerous times that they constitute a threat to society; governments have created criminalization laws in an effort to prevent people living with HIV from transmitting HIV; and, as people living with HIV, we have internalized that stigma, and we have discriminated against ourselves and excluded ourselves from society and created another space.
We never dreamed of getting an HIV/AIDS cure in our lifetimes given all that. For most of us, it's hard to believe that when we reach an HIV undetectable viral load we cannot transmit HIV. Thus, as a community of activists including people living with HIV and our allies who embrace U=U, we have to design strategies to bring on board those people living with HIV, health care providers and pharmaceutical companies that deny U=U.
It's no longer a mystery, we may see the end of the AIDS epidemic if only we commit to ending HIV criminalization laws, change the culture and attitudes towards people living with HIV and end HIV services disparities, ensuring that no one is left behind. By removing barriers, we can be reassured that U=U reaches its goal.
Tuyishime Claire Gasamagera is a motivational public speaker, life skills coach and visionary operations executive; fluent in over seven languages including English, French and Kinyarwanda; anti-AIDS activist, freelance writer, lobbyist and consultant with solid experience managing all levels of projects including fundraising, advocacy, budgeting and administration on the national, regional and global level.