In recent years, a significant milestone has been the continued research and affirmation of a critical principle that remains timeless: HIV-infected individuals do not transmit the virus when they maintain viral suppression through medication. The resounding message remains ‘U=U,’ signifying ‘Undetectable equals Untransmissible.’ When a person achieves viral suppression through HIV medication, it means the virus becomes undetectable in their blood. In turn, an undetectable person does not pose a risk of transmitting HIV to another person. This revelation is a cause for celebration, offering a potent tool in our ongoing battle against the HIV epidemic. Yet, despite this breakthrough, the question lingers: Why haven’t we achieved widespread success in implementing this principle? The path forward appears clear—ensuring that everyone living with HIV achieves viral suppression and becomes undetectable. So, here is the reality fo the situation.
1. Everyone who is infected is not receiving treatment. Some people who have been diagnosed with HIV infection are not on treatment for one reason or another. Other people do not even know they are infected, and hence, are not on therapy. In the United States, it is estimated that out of all the individuals who are infected, approximately 1.2 million (in 2015), about 13% of these individuals are not aware they are infected. In addition to not getting the treatment to benefit their own health, they are able to infect other people. GET TESTED!
2. People who are prescribed treatment are not taking it properly. By not taking their medicines as prescribed, they do not have sufficient levels of medicine in their bloodstream to control HIV. There is virus replicating in their blood and tissues and they could pass the virus to someone else through unprotected sex, sharing needles for drug use, or having a baby.
So here’s some more good news. There are programs around the world that make HIV treatment available to people who have no resources to provide for their own medical care. Programs like PEPFAR (President’s Emergency Plan For AIDS Relief), established by President George W. Bush, provide medicines and health for HIV patients in developing countries in Africa, South/South-East Asia.
Here in the US, every state has an AIDS Drug Assistance Program (ADAP) which provides