Facts + Insights

HIV: The End of the Danger of Transmission

November 6, 2020
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This post originally appeared in French on Je suis séropo on July 10, 2019.

How do we live with HIV in an era where danger is a thing of the past?

For people living with HIV, Undetectable = Untransmittible puts an end to the danger of transmission—that sword of Damocles long hung over our heads. We are certainly right to welcome this statement, now supported by nearly 900 organizations around the world.

But how do we integrate "U = U" into our lives? How do we accept the fact that today, if we take treatment as prescribed, we no longer have to fear transmitting HIV to our partners? How do we mourn our fear of infecting others? How do we tear down the strongly held image of us as vectors for transmitting death?

In the spring 2019 edition of Remaides Québec, a collective of people living with HIV signed a powerful editorial on this paradigm shift. This editorial, Mourning for Dangerousness, is reprinted in full below.

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Mourning for Dangerousness                                                

For so long, we felt eaten away by a virus that devoured us day after day. For so long, we felt rejected, and there was nothing we could do about it.

Our hearts shattered with a piece of great science news. For years, we saw ourselves as transmitters of AIDS and tried to learn to live with the fear of infecting others. But then, science told us that a person living with HIV who maintains an undetectable viral load (less than 200 copies/ml of blood) does not transmit HIV!

We still, at times, resist integrating this discovery into our lives. The fear of spreading HIV still lurks in our minds sometimes. This horrifying idea has been part of us for so long that we have had to find our bearings again. However, we know how to react to sudden changes. When we were diagnosed, we had no choice but to suffer the loss of our future. With the advent of antiretroviral treatment, we mourned imminent death, and today, we have to mourn dangerousness.

New information takes time to come into a community. To help us accept it, we test our beliefs by informing ourselves. We refuse to allow others to resist the facts, and at night we dream of all people living with HIV having access to treatment.

Prior to these many upheavals, we were considered multiply bereaved. Since the latest chapter, we have become grief specialists, experts in change. Our resilience is being studied. We have learned to say yes to life and to give ourselves permission to love. Now we have assurance that we will not transmit HIV... to anyone! And we are determined to transmit (from now on) the good news.

We are aware that the virus is still in our bodies and that we currently have the upper hand. But we can't pretend that the goal of maintaining an undetectable viral load is a simple task. For some of us, it has been a long road, and in some cases, impossible. To these people, we salute their courage and effort.

An update to scientific knowledge is before us, one that can improve transparency, support prevention, fight stigmatization and break isolation. Who would dare say that this discovery is not good for our mental health and for public health?

We invite the world to join us in this other paradigm shift.

We are people living with HIV who contribute to l’Institut de développement du leadership positif (The Positive Leadership Development Institute, PLDI). We inspire each other.

We are Les Indétectables (The Undetectables).

What does U=U mean for you?

Have you heard the terminology before? Are people in your community using it to encourage further discussions about HIV, HIV prevention and stigma?

Tell us your thoughts in the comment section below.

Still looking to hear further conversations on the U=U message? Check out this Pozcast episode with Laurie, the Executive Director of CATIE, and Adrian, a HIV-positive activist & Executive Director of an AIDS service organization in Ontario.

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