How the U=U Message Transformed My Life with HIV

Early on in my diagnosis, I did what I ask so many of the patients I work with not to do. I searched the internet for answers to all of the millions of questions I had. Somewhere in the deep space of the internet, I found a video of a man who was passionately talking about a fact that few inside the HIV community were even aware of.

That video changed my life. That man was Bruce Richman and that fact was U=U.

How the U=U message offers freedom from fear

Patients often tell me they feel like sex is off-limits. This isn’t surprising. Sex education in the United States is rarely comprehensive. This leads to heavy stigma. Because sex is a common mode of transmission, many people living with HIV feel like intimacy is no longer an option for them. This creates a massive burden on our HIV sexual health.

And for those of us who genuinely would never wish to cause another sentient being harm, abstinence could feel like some holy mission to protect others.

Why PrEP messaging felt alienating

Then in came PrEP in 2012, offering additional protection to those who were HIV negative.

Now don’t get me wrong: it’s a wonderful tool in our prevention toolbox. But its marketing, as seen so often with prevention messaging, created another level of hierarchy in an already Grand Canyon-sized divide. Those who didn’t have access or the privilege to afford it were often those who needed it most, creating further otherness for already marginalized people.

For those of us who didn’t have access or the privilege and who acquired HIV, that is a lot of heaviness to walk around with.

Reclaiming my HIV sexual health through U=U

Then along came Bruce on a mission after learning he couldn’t transmit HIV to his sexual partners. That mission became a movement that brought hope and a reclaiming of our sexuality to millions of people living with HIV, including a 28-year-old me.

I’ll never forget watching that video of Bruce talking about how once I was undetectable and maintained it for more than 6 months, there was ZERO chance I could pass HIV on to anyone else. I also learned that the foundation of U=U is consistent treatment adherence. This is the most vital part of managing HIV sexual health. I also learned that the foundation of U=U is treatment adherence. To stay undetectable, I had to commit to my health by taking my medication every single day without fail. The "science" only works if the medicine is in your system.

By committing to treatment adherence, I could finally address the internal stigma I had carried for years. It sounded complicated at first, but modern medicine has made it so simple. Taking just one pill a day became my daily act of liberation. It was like the door to connecting with the outside world I had closed was opened in a whole new way. No longer did I live in fear that I would harm someone. I was free to love and have sex without fear.

The impact of sharing the U=U message

It became my personal mission to spread the word. When I went to work at an AIDS Service Organization in 2017, I wanted every patient I came in contact with to know.

Empowering the community through advocacy

I worked with our wonderful HIV services team to make sure that every patient who came into our health center knew the truth about U=U. I wanted them to understand how this knowledge improves HIV sexual health and dismantles the stigma that holds so many back. I was also able to work with our local AIDS service foundation to bring Bruce here as an HIV advocate to share the incredible news on a much larger scale.

I got lucky to hear this message so early on in my journey. I’m so grateful to Bruce and the team at Prevention Access Campaign for their unwavering commitment to the truth.

In this case, the truth truly sets you free.