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EDITORIAL (Open Access)

U=U, PrEP and the unrealised promise of ending HIV-related stigma

Nathanael Wells https://orcid.org/0000-0002-2827-8480 A *
+ Author Affiliations
- Author Affiliations

A Kirby Institute, University of New South Wales, Kensington, NSW, Australia.

* Correspondence to: nwells@kirby.unsw.edu.au

Handling Editor: Brent Allan

Sexual Health - https://doi.org/10.1071/SH23045
Submitted: 6 March 2023  Accepted: 1 June 2023   Published online: 21 June 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

There is now widespread consensus that by reducing HIV viral load to undetectable levels, HIV treatment also eliminates the risk of HIV sexual transmission. Advocates have hoped that eliminating the risk of HIV will be accompanied by a reduction of HIV-related stigma. These hopes have yet to be realised and people living with HIV continue to report stigma and sexual rejection. The burden of challenging HIV-related stigma has largely fallen on people living with HIV. It is time for those who are HIV-negative to also take on some of the burden in challenging HIV stigma.

Keywords: HIV/AIDS, HIV prevention, HIV stigma, living with HIV, PrEP, sexual behaviours, social context, stigma.


References

[1]  Bavinton BR, Pinto AN, Phanuphak N, Grinsztejn B, Prestage GP, Zablotska-Manos IB, et al. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV 2018; 5 e438–e447.
Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study.Crossref | GoogleScholarGoogle Scholar |

[2]  Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016; 316 171–181.
Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar |

[3]  Ford OG, Rufurwadzo TG, Richman B, Green I, Alesi J. Adopting U = U to end stigma and discrimination. J Int AIDS Soc 2022; 25 e25891
Adopting U = U to end stigma and discrimination.Crossref | GoogleScholarGoogle Scholar |

[4]  Department of Health. Eighth national HIV strategy 2018–2022. Canberra: Australian Government; 2018. Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-1/$File/HIV-Eight-Nat-Strategy-2018-22.pdf [cited 7 February 2022]

[5]  World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing Hiv infection: recommendations for a public health approach. Geneva: World Health Organization; 2016. Available at https://www.deslibris.ca/ID/10089566 [cited 16 July 2021]

[6]  Bourne A, Norman T, Rule J, Power J. Sexual satisfaction among people living with HIV in Australia: enduring impacts of HIV-related stigma. Sunshine Coast; 2022. Available at https://www.publish.csiro.au/sh/pdf/shv19n5abs

[7]  Norman T, Power J, Rule J, Chen J, Bourne A. HIV futures 10: quality of life among people living with HIV in Australia. La Trobe; 2022. Available at https://opal.latrobe.edu.au/articles/report/HIV_Futures_10_Quality_of_Life_Among_People_Living_with_HIV_in_Australia/21397641 [cited 3 February 2023]

[8]  Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual suveillance report 2021. Sydney: Kirby Institute, UNSW; 2021.