U=U position statement

Introduction

2 Spirit, gay, bisexual, queer, and other transgender and cisgender men who have sex with men (2SGBMSM) have been intensely affected by the HIV epidemic going back to a time before there was even a name for the virus. Before the term AIDS was coined, the condition was named GRID (gay related immune deficiency). Thus, gay men living with and affected by HIV have been at the forefront of advocacy and activism for equal, affordable, and dignified access to treatment and care, access to relevant and timely information, and accessible HIV prevention options including HIV testing and biomedical advancements like pre-exposure prophylaxis (PrEP). The message of U=U (Undetectable = Untransmittable), developed by the Prevention Access Campaign, gives an opportunity for gay men to embrace a new era in the HIV epidemic. U=U provides the gay community with the opportunity to reflect upon and celebrate the successes in the fight to end HIV, and to focus on the best opportunities we have to end this epidemic. Key to ending the epidemic is ending HIV stigma. HIV stigma, mixed with homophobia, transphobia, misogyny, racism, and HIV criminalization have taken an immeasurable toll on the gay community in the 35 plus years of the epidemic. HIV stigma specifically has had detrimental effects on the wellbeing and quality of life for gay men living with HIV. Much of that stigma has been reproduced and perpetuated within social/sexual realms of the gay community itself. U=U is a dramatic, scientifically proven, and transformational milestone in the HIV epidemic and an important tool for eliminating HIV stigma once and for all. Community-based organizations are uniquely placed to bridge the gap between science and community engagement on U=U. As individuals who are directly supporting people living with, and affected by HIV, we must nurture and guide conversations. U=U is a new reality that comes with complexities. Its our job to communicate and facilitate engagement in this new landscape. Therefore, we must embrace the science of U=U and celebrate the message it sends: people who are undetectable cannot transmit HIV to their sexual partners.