U=U: A guide for service providers


Key messages

“It’s very, very clear that the risk is zero. If you are on suppressive antiretroviral treatment, you are sexually non-infectious.”
- Dr Alison Rodger
Lead author of PARTNER study

1. Treatment provides health benefits

The first and most important goal of HIV treatment is to improve the health and well-being of all people living with HIV. Early diagnosis and early initiation of treatment play key roles in achieving this goal. However, treatment must be delivered with informed consent and without coercion, on an opt-in basis.

2. No one must be left behind

Supports must be in place to help those people living with HIV  who may experience challenges to accessing and taking treatment as prescribed. We must address the barriers to achieving and maintaining an undetectable viral load that people may face. These barriers disproportionately affect many groups, including Indigenous, racialized, substance-using, and newcomer communities. No one must be left behind.

3. People with an undetectable viral load can’t pass HIV on sexually

When a person achieves and maintains a viral load of less than 200 copies/ml of blood, they cannot transmit HIV sexually, regardless of whether or not they use a condom.

4. U=U has the potential to change what it means to live with HIV

The U=U message has the potential to change the way people with HIV, their friends, their families, and their coworkers think and talk about viral suppression and what it means to live with HIV.

5. HIV care should be understood holistically

HIV care should be understood holistically, as a tool to support physical, mental, emotional, and social well-being. It must also be culturally safe, committed to anti-oppression frameworks, trauma informed, and attentive to the specific needs of individuals and communities of people who live with or face systemic risk factors for HIV.

6. Barriers to care and treatment need to be removed

People living with HIV deserve universal access to HIV care and treatment. Barriers such as cost, immigration status, and geography must be addressed so that all people living with HIV have access to the treatment and care they need to experience optimal health.

7. U=U can help to end HIV-related stigma and discrimination

U=U is one of the best tools we have to dismantle HIV-related stigma and discrimination. There is no reason why people living with HIV should experience externally imposed stigma or self-stigma.