The science behind U=U has been liberating people with HIV for years

Science over stigma: the evolution of U=U

The U=U movement has been evolving alongside the HIV epidemic for decades. “Undetectable equals untransmittable,” more popularly known as U=U, is the globally-accepted scientific consensus that continues to change the lives of people living with HIV — and has also become one of our most vital tools in the fight to eliminate the virus. U=U simply means that an HIV-positive person who is on treatment and has achieved an undetectable viral load also has a zero chance of transmitting the virus to a sexual partner, even without the use of a condom.

Here’s a look back on how science and radical activism have worked together through the years to harness the power of U=U...

​1980s—early ’90s: The Reagan/Bush years

During what is now often referred to as the “AIDS era,” early medications available to treat HIV were largely ineffective and came with toxicity levels that often did more harm than good to the bodies of those prescribed it. Tragically, many diagnosed during this time ultimately did not survive, and many of those who did suffered from debilitating drug side effects and other complications, not to mention PTSD (post-traumatic stress disorder) from losing so many friends and lovers. It was a dark and difficult time, and one we still bear the scars of.

And while tens of thousands were sick and dying from the virus at the time, the government (primarily, the right-wing Reagan and Bush administrations) largely ignored the epidemic, most likely because HIV only seemed to largely affect queer communities. This lack of federal response would end up birthing a powerful rise in activism, with the formation of groups like ACT UP, which staged radical demonstrations and protests in order to bring national awareness to the issue of HIV and AIDS.

1996—2006: Activism and science unite

By the mid-1990s, major scientific advancements in HIV treatment had changed everything. Antiretroviral treatment (ART) drugs were finally made available to the public and proved to be highly effective in stopping the spread of HIV within the body — and researchers would soon discover that, once on treatment, people living with HIV could quickly achieve an undetectable viral load.

In 2006, Dr. Julio Montaner, a pioneering physician and HIV researcher, first introduced the concept of “Treatment as Prevention,” also known as TasP. Montaner was one of the first experts to hone in on the idea that getting people on treatment was a key factor in preventing the transmission of HIV, and ultimately ending the epidemic. The introduction of TasP marked the true beginnings of the U=U movement.

2016: U=U goes global

A group of HIV activists formed the Prevention Access Campaign (PAC) and first coined the term “U=U.”

“U=U is my calling,” Bruce Richman, a lawyer-turned-activist and founder of PAC, told Plus in 2020. “I knew that undetectable equals untransmittable, but millions of people were suffering because they were not being told, and people in positions of great influence to alleviate that suffering were sitting on their hands. I had no choice.”

PAC continues to grow as an organization and be one of the world’s most powerful voices in spreading the U=U message on a global scale.

2022: U=U makes it to the White House

Deondre Moore is a public health advocate living with HIV since the age of 19. His moving speech at the 2022 Presidential Advisory Council on HIV/AIDS (PACHA) meeting was instrumental in getting the White House to recognize U=U.

“With your leadership and support, we can measure, optimize, and scale up the impact U=U has on improving the health, wellbeing, and emotional wellness of people living with HIV,” Moore said at the PACHA meeting. “This will also prevent new transmissions. Embracing U=U is a win-win.”

In December of that year, the Biden-Harris administration announced its official endorsement of U=U to further its “efforts to end HIV/AIDS at home and abroad.”

2024: Oprah speaks on U=U

At the GLAAD Awards ceremony in March in Beverly Hills, California, Oprah Winfrey was honored for her years of allyship to the LGBTQ+ community. While accepting the Vanguard Award, Winfrey spent much of her time onstage speaking about HIV and the AIDS crisis. She became emotional after sharing that her brother Lee died from HIV-related complications 35 years ago at age 29.

Winfrey also mentioned late activist Hydiea Broadbent, who the media icon interviewed when Broadbent was 11 years old, noting she “used her life empowering others and she showed us that people living with HIV today, when on effective treatment, can live healthy lives and do not transmit HIV.”