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REVIEW (Open Access)

Undetectable=Untransmittable=Universal Access (U=U=U): transforming a foundational, community-led HIV/AIDS health informational advocacy campaign into a global HIV/AIDS health equity strategy and policy priority

Christian Hui https://orcid.org/0000-0002-6569-7422 A *
+ Author Affiliations
- Author Affiliations

A School of Public Policy and Democratic Innovation, Faculty of Arts, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada.

* Correspondence to: c6hui@torontomu.ca

Handling Editor: Vuyiseka Dubula

Sexual Health - https://doi.org/10.1071/SH23068
Submitted: 4 April 2023  Accepted: 14 June 2023   Published online: 11 July 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 4.0 International License (CC BY-NC)

Abstract

Background: Undetectable=Untransmittable (U=U) first emerged in 2016 as a health information campaign to promote rigorous scientific evidence that people living with HIV (PLHIV) on effective treatment who have reached an undetectable or suppressed viral load cannot pass on the virus sexually. Within 7 years, U=U underwent transformation from a global community-led, grassroots movement into a global HIV/AIDS health equity strategy and policy priority.

Methods: For this narrative review, a targeted literature search on ‘history’ + ‘Undetectable=Untransmittable’ and/or ‘U=U’ on Google and Google Scholar, in addition to a search of online documents on the Prevention Access Campaign (PAC) website, was conducted. The article utilises an interdisciplinary policy studies approach that recognises the roles of multi-stakeholder, especially that of the community and civil society, to effect policy change.

Results: The narrative review first provides a synopsis of the scientific origination of U=U. The second section highlights the progress and leadership on U=U led by the PAC and civil society partners and efforts of the PLHIV and ally communities in advocating for the broad recognition and dissemination of the evidence, which has proven to be a game-changer within the HIV/AIDS response. The third section spotlights the recent developments of U=U within the local, national, and multilateral spheres.

Conclusion: The article ends with recommendations for community and HIV/AIDS multi-stakeholders on how they can further integrate, implement, and strategically utilise U=U as an essential and complementary HIV/AIDS pillar to the current Global AIDS Strategy 2021–2026 to end inequalities to end AIDS by 2030.

Keywords: civil society, health equity, health promotion, HIV/AIDS, human rights, living with HIV, policy, undetectable, viral suppression.


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