New York State: U=U Guidance for Implementation in Clinical Settings

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People who achieve and maintain an undetectable HIV viral load do not sexually transmit HIV.

This scientific finding, called “Undetectable = Untransmittable,” or “U=U,” has been promoted as a health equity initiative by the Prevention Access Campaign since 2016 and has been endorsed by the U.S. Centers for Disease Control and Prevention, the New York City Health Department, the New York State Department of Health (NYSDOH), and many other health departments and experts. U=U asserts that individuals who keep their viral load below the level of assay detection (typically HIV RNA <20 copies/mL) do not pass HIV through sex. Leading scientists recently lent their support to U=U, assessing the evidence base as “scientifically sound” [Eisinger, et al. 2019].

As emphasized in the NYSDOH U=U Policy Statement and detailed in the accompanying FAQ, the U=U concept is a “driving force to accelerate the achievement of New York State’s Ending the Epidemic goals.” Specifically, U=U aligns with numerous efforts to dismantle HIV-related stigma and improve the health, well-being, and self-esteem of all people living with HIV, particularly by removing fear from their sexual and romantic relationships and combating the isolation they may experience. The statement further elaborates: “Endorsing U=U opens a new and hopeful chapter in New York State’s HIV epidemic, creating unprecedented opportunities for New Yorkers living with HIV and the institutions that serve them.”



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