Case 29. U=U: Living a New Normal
Download MP3A 48-year-old man with HIV that is well-controlled on dolutegravir/lamivudine has met someone and they are starting to date. His partner is HIV-seronegative, and they have not yet been sexually active. Listen as Eileen Scully and Chris Hoffmann of Johns Hopkins discuss the importance of normalizing sexuality in patients with HIV and strategies for counseling patients that “undetectable=untransmittable (U=U).”
References:
References:
- Bavinton BR, Pinto AN, Phanuphak N, et al. Opposites Attract Study Group. Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV 2018 Aug;5(8):e438-e447. [PMID: 30025681]
- Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016;375(9):830-39. [PMID: 27424812]
- Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 2000 Mar 30;342(13):921-9. [PMID: 10738050]
- Rodger AJ, Cambiano V, Bruun T, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393(10189):2428-38. [PMID: 31056293]
- Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016;316(2):171-81. [PMID: 27404185]
- Vernazza P, Hirschelb B, Bernasconic E, Fleppd M. HIV positive individuals not suffering from any other STD and adhering to an effective antiretroviral treatment do not transmit HIV sexually. (Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle). Bulletin des médecins suisses 2008; 89 (5). [Link to the English translation and original French publication]
Related Guidelines and Resources:
- NYSDOH AI Clinical Guidelines Program: U=U Guidance for Implementation in Clinical Settings
