Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV

TitleTreatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV
Publication TypePublication
Year of Publication2020
AuthorsH Rendina J, Talan AJ, Cienfuegos-Szalay J, Carter JA, Shalhav O
JournalAIDS Patient Care STDS
Volume34
Issue10
Pagination444-451
Date Published2020 10
ISSN1557-7449
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, Anti-HIV Agents, Female, HIV Infections, Homosexuality, Male, Humans, Male, Middle Aged, Social Stigma, Viral Load, Young Adult
Abstract

<p>Research suggests that the science of undetectable viral load (VL) status and HIV transmission-conveyed with the slogan "" or "U = U"-has gaps in acceptance despite robust scientific evidence. Nonetheless, growing acceptance of U = U creates conditions for a shift in the sociopolitical and personal implications of viral suppression. We conducted an online survey over a 23-month period in 2018 and 2019 among 30,361 adolescent and adult (aged 13-99) sexual minority men living with HIV (SMM-LHIV) across the United States. We examined the impact of U = U on self-image, potential for changing societal HIV stigma, whether SMM-LHIV had ever spoken with a provider about viral suppression and HIV transmission, and primary sources of hearing about U = U. Approximately 80% of SMM-LHIV reported that U = U was beneficial for their self-image and societal HIV stigma, 58.6% reported it made them feel "much better" about their own HIV status, and 40.6% reporting it had the potential to make HIV stigma "much better." The most consistent factors associated with these beliefs centered around care engagement, particularly self-reported viral suppression and excellent antiretroviral therapy adherence. Two-thirds reported ever talking to a provider about VL and HIV transmission, although the primary sources for having heard about U = U were HIV and lesbian, gay, bisexual, transgender, and queer (LGBTQ) news media and personal profiles on networking apps. These findings demonstrate the significant personal and social importance of U = U for SMM-LHIV that go above-and-beyond the well-documented health benefits of viral suppression, suggesting that providers should consider routinely initiating conversations with patients around the multifaceted benefits (personal health, sexual safety and intimacy, increased self-image, and reduced social stigma) of viral suppression.</p>

DOI10.1089/apc.2020.0137
Alternate JournalAIDS Patient Care STDS
PubMed ID33064015
PubMed Central IDPMC7585600
Grant ListU19 HD089875 / HD / NICHD NIH HHS / United States
R01 DA045613 / DA / NIDA NIH HHS / United States
UH3 AI133674 / AI / NIAID NIH HHS / United States
R34 DA043422 / DA / NIDA NIH HHS / United States
R01 MH114735 / MH / NIMH NIH HHS / United States
R25 GM060665 / GM / NIGMS NIH HHS / United States
UG3 AI133674 / AI / NIAID NIH HHS / United States