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Updated Australian guidance for health care providers about “undetectable = untransmittable” for HIV

James H McMahon, Brent Allan, Daniel Grace and Nic Holas
Med J Aust 2021; 215 (5): . || doi: 10.5694/mja2.51211
Published online: 6 September 2021

Whether the U = U message is received with scepticism or not, it is clear it is radically challenging the stigma associated with HIV

“Undetectable = untransmittable” (U = U) is a public health campaign that summarises the scientific advances confirming that an undetectable human immunodeficiency virus (HIV) viral load means there is no risk of the sexual transmission of HIV. U = U was launched in 2016, with an international consensus statement from researchers, people with HIV and community partners, to summarise the science around HIV treatment to prevent transmission and improve the lives of people with HIV.1


  • 1 Alfred Health, Melbourne, VIC
  • 2 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Sydney, NSW
  • 3 University of Toronto, Toronto, Canada
  • 4 The Institute of Many, Melbourne, VIC


Correspondence: james.mcmahon@monash.edu

Acknowledgements: 

We thank Chinyere Okoli for their advice for this work.

Competing interests:

James McMahon’s institution received funding for the conduct of clinical trials by Gilead, ViiV and Merck. Brent Allan is affiliated with the industry liaison forum of the International AIDS Society, which receives funding from Gilead, ViiV, Merck, Abbott and Janssen.

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  • 2. Vernazza P, Bernard EJ. HIV is not transmitted under fully suppressive therapy: the Swiss statement — eight years later. Swiss Med Wkly 2016; 146: w14246.
  • 3. Vernazza P, Hirshcel B, Bernasconi E, et al. HIV‐infizierte Menschen ohne andere STD sind unter wirksamer antiretroviraler Therapie sexuell nicht infektiös. [HIV‐infected people without other STDs are not sexually infectious during effective antiretroviral therapy]. Schweizerische Ärztezeitung 2008; 89: 165–169.
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  • 9. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. Undetectable = Untransmittable: a guide for clinicians to discuss 2020. https://www.ashm.org.au/HIV/UequalsU/ (viewed Sept 2020).
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  • 11. Power J, Amir S, Brown G, et al. HIV Futures 9: quality of life among people living with HIV in Australia, monograph series number 116. Melbourne: La Trobe University, 2019. https://www.latrobe.edu.au/__data/assets/pdf_file/0007/1058614/HIV‐Futures‐9.pdf (viewed July 2021).
  • 12. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. Updated Australian guidance for clinicians and other health care providers discussing undetectable = untransmittable (U = U) with people living with HIV 2018. https://ashm.org.au/news/updated‐australian‐guidance‐for‐health‐care‐providers‐and‐UU/ (viewed July 2021).
  • 13. Grace D, Nath R, Parry R, et al. “.. if U equals U what does the second U mean?”: sexual minority men’s accounts of HIV undetectability and untransmittable scepticism. Cult Health Sex 2020; https://doi.org/10.1080/13691058.2020.1776397 [Epub ahead of print].

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