How U=U changes everything

1. How U=U changes everything Data and communicating about treatment as prevention Matthew Hodson Executive Director, NAM / aidsmap

3. Awareness of U=U across Europe • Only one in 10 (12%) understand the meaning of ‘undetectable’ • Around half (53%) believe that it would still be possible to transmit HIV to others if the treatment was having the best effect possible • Nearly half (47%) are aware that it is possible for women living with HIV who are undetectable to conceive HIV negative children ‘Is HIV Sorted?’ European survey Gilead, 2018.

5. Early data on TaP

6. Early messaging about TaP 2001 Gay Men Fighting AIDS campaign included the following: “If you are HIV positive, and have sex without a condom, there is less chance of passing on HIV if… • You have a low viral load” October 2001

7. The ‘Swiss Statement’ People with HIV are not sexually infectious (“ne transmettent pas le VIH par voiesexuelle”), as long as the following conditions are met: • The HIV-positive individual takes antiretroviral therapy consistently and as prescribed and is regularly followed by his/her doctor. • Viral load is 'undetectable' and has been so for at least six months. • The HIV-positive individual does not have any STIs January 2008

8. HPTN 052 study reported at IAS July 2011 Reported 96% reduction in risk. “These are important results to give to a serodiscordant couple.” - Myron Cohen. (Standing ovation)

9. PARTNER study (1st 2 years ), CROI March 2014 No transmissions occurred despite quite high levels of STIs. "Our best estimate is it's zero."

10. More from PARTNER, AIDS 2016 July 2016 “We can fairly safely say that the chance of transmission from a virally-suppressed HIV-positive person during heterosexual sex is negligible."

11. Opposites Attract, IAS 2017 July 2017 “This is demolishing HIV stigma and encouraging people to start treatment and bring an end to the epidemic.” U=U activism Consensus statement signed by IAS

12. PARTNER 2, AIDS 2018 July 2018 “We’re as confident now that undetectable gay men pose no risk of HIV transmission as we already were for heterosexuals. Zero transmissions mean zero risk.”

13. Reduction in HIV incidence

16. Don’t die of ignorance

20. Consensus statement on TaP: People living with HIV on ART with an undetectable viral load in their blood have a negligible risk of sexual transmission of HIV.  Depending on the drugs employed it may take as long as six months for the viral load to become undetectable. Continued and reliable HIV suppression requires selection of appropriate agents and excellent adherence to treatment.  HIV viral suppression should be monitored to assure both personal health and public health benefits.

30. Sharing the news that U=U is fundamental to HIV prevention, HIV treatment and support for people living with HIV

31. Thank youemail: matthew@nam.org.uktwitter: @Matthew_Hodson