Local expert backs ‘U=U’ message to curb HIV stigma

Nations from Africa and the Caribbean should support the evidence-based U=U message and incorporate U=U into efforts to prevent, diagnose and treat HIV, says Institute of HIV Research and Innovation (IHRI) executive director, Nittaya Phanuphak.
The “knowledge” to which she refers is the concept of undetectable = untransmittable, or U=U for short.
Last year the World Health Organization endorsed the principle, stressing that when a patient’s viral load is undetectable, there is zero chance of sexual transmission.
Dr Nittaya was speaking to people from community organisations and governments dealing with HIV at a forum in Bangkok recently.
They were representatives from Botswana, Ghana, Ivory Coast, Jamaica, Mozambique, South Africa and Zambia.
They came to Bangkok as part of a learning exchange coordinated by the Global Partnership for Action to Eliminate all Forms of HIV-related Stigma and Discrimination.
In her remarks to the meeting, Dr Nittaya said she remembered that in 2020, a gay Thai man living with HIV sparked controversy with a Facebook post.
He was on antiretroviral therapy and had taken lab tests to check the level of virus in his blood, she said.
Since his viral load was undetectable, he wrote, he was going to stop using condoms, she said.
The public responded to the post with a mix of contempt and disbelief, resulting in a debate that spilt from social media and made it onto national radio and TV as it gathered steam, she said.
“There was a huge backlash,” Dr Nittaya said, adding that she and her father, Dr Praphan, founder of an Aids research centre, thought it was their duty to contribute to the public discourse.
While the man’s approach might have been unconventional, the science behind his statement was sound, she said.
Dr Praphan diagnosed Thailand’s first HIV case in 1985 and dedicated his life to HIV research, service delivery and advocacy, she said.
He co-founded the Thai Red Cross Aids Research Centre, which in 2014, conducted cutting-edge research as part of the Opposites Attract Study, she said.
Conducted in Australia, Brazil and Thailand, that study tracked couples in which one person was HIV-negative and the other was living with HIV but had achieved an undetectable viral load through successful treatment, Dr Nittaya said.
It confirmed that after two years of unprotected sex, there were no cases of HIV transmission between more than 300 couples, she said.
“It’s a scientific fact,” Dr Nittaya said.
“For me, I felt like we really needed to do something. We can not just wait for the next 50 years for this knowledge to gradually seep into Thai society.”