In Malawi, the U=U campaign was launched was officially launched at the 2018 PEPFAR Regional Planning Meeting (RPM), after four large studies conducted from 2007 to 2016 among thousands of sero-discordant couples did not show a single case of sexual HIV transmission from a virally suppressed partner[1]. This is a tool of empowerment to young people especially young women living with HIV because it can help in reducing HIV related stigma.
The message of U=U can bring in social change as young people living with HIV will not be living in denial after they disclose their HIV status because one cannot pass the HIV to another when they are on treatment and virally suppressed. Regardless of the campaign being launched, little advocacy and awareness of the campaign has been done in Malawi as well as other places in the world. This is denying people access to information on the developments towards ending HIV related stigma. Successful implementation of this campaign is dependent on the idea that someone living with HIV, who is both on treatment and virally suppressed, cannot transmit the virus to a sexual partner is revolutionary. U=U messaging has the potential to reduce stigma toward people living with HIV, including self-stigma; increase demand for HIV testing and antiretroviral therapy (ART), including early initiation of treatment; and improve adherence[2].
I remember asking a health personnel end last year to give me some space and talk about U=U with young people living with HIV and I was cautioned not to because it is restricted to share such information. Is this not denying young people access to comprehensive information they need?
Communities at large do not have information about U=U and this is why most young people living with HIV in Malawi are facing unnecessary exclusion from their peers, and relationships. Withholding such information are we not advancing so much HIV related stigma in our society? U=U scientifically proved negligible is zero risk of HIV transmission but it cannot be embraced all in the name of fear. Until when will we shun away from development because of fear?
HIV has been in existence for decades. So long that one might think stigma is not there these days while in actual sense it has just changed its coat to underground. U=U can ably deal with this only when we all have one voice towards information dissemination. Only if U=U was looked at as a form of empowerment to young people if comprehensive information about it is disseminated other than looking at it as a threat.
Apart from reducing stigma and discrimination among young people including self-stigma, U=U increases demand for HIV testing services and demand for early treatment initiation, it improves treatment adherence and increases understanding that a suppressed viral load is important to maintain the long-term health of people living with HIV[3]. With all these benefits, U=U cannot be embraced because of fear of unknown.
The time is now to embrace strides if we are to truly fight HIV successfully and make this world a better place for young people living with HIV.
[1] Malawi COMPASS case study, June 2020 [2] www.i-base.info/u-equals-u [3] www.i-base.info/u-equals-u
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