Awareness and Acceptability of Undetectable = Untransmittable Among a U.S. National Sample of HIV-Negative Sexual and Gender Minorities

Carneiro, Pedro B.; Westmoreland, Drew; Patel, Viraj V.; Grov, Christian

doi:10.1007/s10461-020-02990-3

Cited by 27 publications

(29 citation statements)

References 15 publications

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“…To date, this is the only study we know of to examine U=U awareness among heterosexually active adults at increased risk of HIV in the US. The prevalence of U=U awareness in our study is lower when compared to assessments of awareness among gender and sexual minorities with and without HIV (70% -86%) [5][6][7] and other samples of PWH (85% -88%) 8,9 , a pattern also seen in Italy. 28 We expected awareness to be lower in this population because U=U awareness efforts in the U.S. have largely focused on reaching gender and sexual minorities and PWH and engagement in HIV prevention services in this population is relatively low.…”

Section: Discussioncontrasting

confidence: 84%

“…4 This galvanized an era of mass campaigning by community-based organizations and public health agencies aimed at increasing its awareness. Data demonstrate early success of U=U messaging with high awareness reported in gender and sexual minority populations [5][6][7] and PWH. 8,9 U=U messaging may positively influence HIV-related outcomes, with recent data indicating that PWH who were aware of U=U were more likely to self-report an undetectable viral load.…”

Section: Introductionmentioning

confidence: 85%

“…Efforts should also prioritize addressing individual hesitancies in U=U as data have shown that even if some people are aware of U=U, they may not necessarily perceive it to be accurate, or have trust and confidence in the message. 5,6,[36][37][38] There is also a need for more research on barriers to being aware of and endorsing U=U messaging among specific subpopulations at increased risk for HIV. For example, Meunier and colleagues categorized five stages of treatment as prevention adoption among MSM who exchange sex and recommended that efforts to promote treatment as prevention be tailored to each stage of adoption.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of U = U Awareness and Its Association with Anticipated HIV Stigma Among Low-Income Heterosexually Active Black and Latino Adults in New York City, 2019

Rivera

Carrillo

Braunstein

2021

AIDS Patient Care and STDs

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The fact that people with HIV (PWH) who have an undetectable viral load cannot sexually transmit HIV has been disseminated under the messaging "Undetectable = Untransmittable" (U=U). U=U messaging intends to destigmatize HIV by demonstrating that PWH can have healthy sexual lives. Among a sample of low-income heterosexually active Black and Latino adults, we aimed to 1) measure the prevalence of U=U awareness, and 2) determine its association with anticipated HIV stigma. Low-income heterosexually active adults were recruited via respondent driven sampling in New York City. Among Black and Latino participants who self-reported not having HIV, multiple linear regression was used to determine the association between U=U awareness with the following types of anticipated HIV stigma, as determined by principal component analyses: 1) general; 2) dating-related; and 3) sex-related. Of 485 participants, 35% were aware of U=U. Those who were aware reported less dating-related (adjusted B: −0.20; 95% CI: −0.37,−0.03) and sex-related (adjusted B: −0.15; 95% CI: −0.29, −0.002) anticipated HIV stigma. Although the prevalence of U=U awareness was much lower than reported in other populations (e.g., gender and sexual minorities, PWH), prevalence was moderate in our sample, given that awareness efforts have generally not focused on heterosexually active adults. Our findings provide preliminary evidence that U=U awareness may have an impact on anticipated HIV stigma related to dating and sex. Additional methods to disseminate U=U messaging and to dismantle HIV stigma in this population should be explored.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Prevalence of U = U Awareness and Its Association with Anticipated HIV Stigma Among Low-Income Heterosexually Active Black and Latino Adults in New York City, 2019

Rivera

Carrillo

Braunstein

2021

AIDS Patient Care and STDs

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“…In-depth interviews with sexual minority men in Vancouver revealed that participants without HIV were reluctant to incorporate a partner’s undetectable HIV status into their sexual decision-making, and the authors identified enduring “sexual stigma attached to HIV” even in the context of U = U [ 71 ]. In a 2017–2018 U.S. study of HIV-negative men and trans people who have sex with men, trust in U = U was associated with greater willingness to have condomless anal sex; yet just 42% of respondents who were aware of U = U indicated they trusted it [ 72 ].…”

Section: Resultsmentioning

confidence: 99%

Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and “Undetectable = Untransmittable”: A Systematic Review

et al. 2021

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People on HIV treatment with undetectable virus cannot transmit HIV sexually (Undetectable = Untransmittable, U = U). However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who could benefit from this information. We systematically reviewed the global literature on knowledge and attitudes related to TasP and interventions providing TasP or U = U information. We included studies of providers, patients, and communities from all regions of the world, published 2008–2020. We screened 885 papers and abstracts and identified 72 for inclusion. Studies in high-income settings reported high awareness of TasP but gaps in knowledge about the likelihood of transmission with undetectable HIV. Greater knowledge was associated with more positive attitudes towards TasP. Extant literature shows low awareness of TasP in Africa where 2 in 3 people with HIV live. The emerging evidence on interventions delivering information on TasP suggests beneficial impacts on knowledge, stigma, HIV testing, and viral suppression.Review was pre-registered at PROSPERO: CRD42020153725

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“…While only a handful of published studies have examined U = U acceptability among the general public, recent research suggests that misinformation, disbelief, and lack of education/ awareness all pose significant barriers to the U = U acceptance; [12][13][14][15] these and other studies have found that these gaps appear to be driven by limited engagement in HIV prevention or treatment services [e.g., HIV testing frequency, use of pre-exposure prophylaxis (PrEP), being prescribed, and adherent to ART]. [14][15][16]17 Among SMM-LHIV specifically, recent research examining perceived accuracy of U = U found that those who were not virally suppressed and who reported low ART adherence also reported lower levels of belief in U = U messaging. 18 Data also show that increased ART adherence and consistent monitoring of VL are associated with increased knowledge and trust of TasP among SMM-LHIV, in particular.…”

Section: Introductionmentioning

confidence: 99%

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

Rendina

Talan

Cienfuegos-Szalay

et al. 2020

AIDS Patient Care and STDs

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Research suggests that the science of undetectable viral load (VL) status and HIV transmission-conveyed with the slogan ''Undetectable = Untransmittable'' 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.

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Awareness and Acceptability of Undetectable = Untransmittable Among a U.S. National Sample of HIV-Negative Sexual and Gender Minorities

Cited by 27 publications

References 15 publications

Prevalence of U = U Awareness and Its Association with Anticipated HIV Stigma Among Low-Income Heterosexually Active Black and Latino Adults in New York City, 2019

Prevalence of U = U Awareness and Its Association with Anticipated HIV Stigma Among Low-Income Heterosexually Active Black and Latino Adults in New York City, 2019

Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and “Undetectable = Untransmittable”: A Systematic Review

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

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