SUMMIT ISSUE HIGHLIGHT: HAVE YOU HEARD ABOUT U=U?
Can you tell us about the U=U campaign?
The Prevention Access Campaign (PAC), led by Bruce Richman, started the U=U Campaign (or Undetectable equals Untransmittable) in 2016 when he learned about research demonstrating that people with HIV with an undetectable viral load do not transmit HIV to their sexual partners. This groundbreaking research wasn’t reaching the people it was intended to benefit, so over a period of six months, PAC worked on a consensus statement with the leading researchers to confirm U=U, and then sought out pioneering and influential researchers, leaders in the field, and public health officials to support or endorse the statement. Around the same time, PAC began advocacy efforts, working with the U.S. Department of Health and Human Services to jumpstart a review process to update their definition of risk (updated in September of 2017). And so began the Campaign, which included social media outreach and building a network of people living with HIV, disseminating the U=U message as growing numbers of people and organizations began to push this message out around the world.
Today, the U=U Campaign has become a global campaign, supported by 930 organizations in 99 countries. Fifteen state health departments and 28 local jurisdictions in the U.S. are signed onto the Campaign. Six international cities and countries are also officially signed on, with many more supporting the Campaign.
How is this work funded? How has that evolved?
When the Campaign began in 2016, there was no funding to support it. AIDS United provided the first grant to support the U=U Campaign and thereafter Broadway Cares joined as a supporter. Several pharmaceutical companies followed, mostly with project-specific funding. Today, there is a mixture of funding from pharmaceutical companies and foundations. We have also enjoyed a tremendous amount of support, other than funding, from many other agencies, including, for example, Housing Works, NASTAD, and Terrence Higgins Trust, all of whom have been very instrumental in helping to disseminate and support the U=U message.
What does this type of community-led communications and advocacy look like today? Where are the spaces you target?
We have a very broad communications strategy as it’s important to reach people living with HIV, the agencies and people (providers) that serve them, policymakers, and the general public. Our message and communications are obviously tailored, depending on the audience, but it is critical for us to provide clear and accurate information about U=U to all. Our communications efforts are supported and informed by people with HIV through a steering committee and a group of ambassadors who assist us in ensuring we are reaching the populations that need to hear and understand the U=U message.
What would you like private funders to know? What type of funding would help initiatives like U=U?
This message is life-changing for people with HIV and is a true motivator to help them achieve an undetectable viral load. This clearly improves their physical and mental health while dismantling stigma. It’s so powerful, too, because it has the added benefit of preventing new transmissions. So, it’s a message that everyone needs to know and as Dr. Anthony Fauci, director of NIAID at NIH, has said, is the foundation of ending the epidemic.
Unfortunately, far too many people either do not support or understand this message, and many more do not know it. We must change this and in order to change it, Prevention Access Campaign needs funding to build on our success. In particular, funding that supports our communications efforts as well as our technical assistance capacity to support, for instance, jurisdictions that are a part of the Ending the HIV Epidemic Initiative in the U.S.
We also desperately need an informational campaign in the U.S. There are great examples of highly effective campaigns across the world. We have a plethora of campaigns focused on PrEP in the U.S. and these are important, but there are none that focus specifically on U=U or the importance of treatment. Support for such an effort would also be very beneficial.
You will be joining us at the 2019 AIDS Philanthropy Summit in October. What are you planning to talk about, and what do you hope to achieve at this convening?
We will be talking about the U=U movement and how it gives people living with HIV the freedom to live and love without fear of transmitting the virus to their sexual partners. The U=U message is powerful and it helps motivate people with HIV to get on and stay on treatment and then staying engaged in care to regularly monitor their viral load. Clearly, the intersection of media and funders is important to the U=U Campaign and can help us expand this and build on our successes and look forward to talking about this at the Summit next week!
What’s next for you?
We continue to focus on disseminating the U=U message. Far too many people still are not benefiting from this life-changing information. But our message is much bigger than just the basic science of U=U. It includes advocacy focused on increasing access to treatment for everyone. In the U.S., approximately 500,000 people with HIV are not benefiting from treatment are not in care and/or virally suppressed (some do not know their status, some are not in care and/or on treatment for a variety of reasons, and some haven’t achieved viral suppression despite being on treatment) and this must improve in order for us to end the epidemic in the U.S. In the United Kingdom (UK), for example, the picture is much different. More than 90% of people with HIV in the UK are on treatment and 97% of those on treatment have achieved viral suppression. This obviously is an amazing achievement that keeps people healthy and prevents new transmissions. This is greatly improving the trajectory toward ending the epidemic in the U.K. and what we must do in order to achieve this in the U.S. as well.
And as I’ve previously mentioned, we are also focused on improving our communications capacity as well as working on a new opportunity for people with HIV to sign-on to our Campaign and how we can be more supportive of them to help more people access treatment and achieve viral suppression.