19 February 2020
We represent APCOM Foundation and Prevention Access Campaign, international NGOs working in partnership to bring a regional discussion on U=U to Asia. We are saddened by the recent hostilities in Thailand toward HIV advocates and doctors who communicated the most important fact since the beginning of antiretroviral therapy: A person with HIV who is on treatment and has an undetectable viral load cannot pass on HIV to partners. In other word, Undetectable = Untransmittable (U=U).
There should be no doubt about the U=U science which is backed by an overwhelming evidence base building over the past twenty years. The research proving U=U has been published in the top three journals (JAMA, The Lancet, NEJM) and validated by the world’s leading medical, research, and public health institutions including the WHO, UNAIDS, U.S. National Institutes of Health, U.S. Centers for Disease Control and Prevention, Public Health England, China Center for Disease Control and Prevention, and federal health ministries on every continent.
The Thailand medical and scientific community should communicate the U=U message clearly and consistently to improve the lives of people living with HIV and to propel Thailand toward ending the epidemic. It is an unprecedented opportunity to transform the lives of millions of people with and affected by HIV and to change the field.
The benefits of sharing this game-changing message are widespread:
- Well-being of people with HIV: Transforms the social, sexual, and reproductive lives of people with HIV by freeing them from the shame and fear of sexual transmission to their partners.
- HIV stigma: Dismantles the HIV stigma that has been destroying lives and impeding progress in the field since the beginning of the epidemic.
- Treatment goals: Reduces the anxiety associated with testing, and encourages people living with HIV to start and stay on treatment to stay healthy and prevent transmission.
- Universal access: Offers a public health argument to increase access and remove barriers to treatment, care, and diagnostics to save lives and prevent new transmissions.
Neary 1,000 organizations from 100 countries have signed on to the international U=U campaign to incorporate the science into their public health communications, clinical practice and advocacy work. U=U public health campaigns, visible in cities throughout the world, are decreasing stigma and changing the definition of what it means to live with HIV.
Asian countries are leading the world in sharing the message. The Vietnamese Health Ministry in cooperation with research institutions and community launched the first countrywide U=U (K=K) campaign last year building upon regional efforts that began in 2017. Leading Japanese HIV organizations have created inclusive and sex positive U=U campaigns over the past two years that are among the best in the world. Taiwanese medical professionals and NGOs are routinely sharing the U=U message countrywide. China’s leading HIV prevention authority has also validated the science of U=U.
It is important for Thailand’s medical providers to communicate accurate information about the prevention benefits of viral suppression or an undetectable viral load. It is unethical to provide guidance that is counter to the established science about HIV transmission. Denying the U=U science will promote HIV stigma, which is harmful to people with HIV, and is a persistent barrier to HIV testing, treatment uptake and engagement in care. Efforts to undermine the validity of the U=U science or to assign negative judgments to sex will waste opportunities to improve personal and public health.
It is important that providers understand and communicate up to date information to their patients about U=U along with appropriate guidance on other forms of HIV and STI prevention, including condoms, so that people can make fully informed choices about their sexual and reproductive health. U=U provides an added incentive to start and stay on treatment and remain in care. New developments in treatment are making it increasingly easier for people living with HIV to adhere to medications to improve personal and public health.
Thailand must join global medical, scientific and public health leaders. We support the statement
Outrage over U=U messaging in Thailand: An example of pervasive stigma and discrimination in 2020 and its call-to-action items of PREVENTION (a special Task Force research unit of the Thai Red Cross AIDS Research Centre):
– Doctors need to be formally educated on U=U and how to apply it in clinical practice.
– In Thailand, medical authorities such as The Ministry of Public Health, Thai AIDS Society, and Thai Medical Council, as well as Thai People Living with HIV Network, must publicly endorse U=U.
– International HIV communities, researchers, clinicians, people living with HIV, and policy makers should seriously strategize dissemination of this evidence-based U=U message to educate wider global communities.
– In Thailand and worldwide, the existence of condomless sex must be seen and accepted regardless of HIV status. Other preventive methods must be accessible to people who choose to practice condomless sex with no judgement.
For Media contact:
APCOM Foundation [email protected]
Prevention Access Campaign [email protected]