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Can we bring the U=U organisation began a virtual support VL, all of them know what VL means and
messaging to South Africa? group which now has over 200 members the importance of treatment adherence
across the country. When the group first in preventing HIV transmission.
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Despite U=U having proven to improve started, members knew nothing about
personal health, sexual safety, intimacy U=U nor the role of ARVs in preventing The question is, does South Africa have the
and self-image; reduce social stigma; viral transmission, less than 60% of the
and promote adherence and viral members knew their VL, and 45% of political will to scale up such U=U programs?
suppression, the U=U message has not members had a detectable VL. Since Only then will the scientific knowledge
13
been formally endorsed in South Africa joining this virtual support group, more that viral load suppression prevents HIV
and the U=U message has not been than 90% of members have a suppressed transmission translate in to reality.
spread sufficiently to those who need to
hear it the most - PLHIV, especially those
newly diagnosed and those struggling U=U in action
with adherence. South African ARV
guidelines do not incorporate the U=U The founder of this U=U project has been in a serodiscordant relationship
8
messaging, clinicians are not trained in for eighteen years and the couple spent thousands of rands on wanting to
it, and the message is not shared in the safely conceive their first-born daughter in 2009. In 2013, when wanting to
media. Currently the message is only conceive their second-born, the husband came across U=U studies and the
shared by individual advocates and a couple decided to conceive naturally with no condom and no pre-exposure
few organisations on social media. prophylaxis (PreP), which they successfully did.

Organisations facilitating adherence Their two daughters are both HIV-free and healthy, the husband remains HIV
clubs and support groups, with discussion negative and the couple has since been relying on U=U completely. This
topics centred around ARV adherence shows us that U=U can give women living with HIV an opportunity to practise
do not have adequate knowledge about their sexual and reproductive health rights freely, with no fear of infecting
U=U and it would be beneficial if group their partner/s. Many serodiscordant couples are unaware of how to plan a
facilitators could be empowered to healthy pregnancy, but the U=U message can help in reducing this anxiety
share the U=U message thus promoting and providing couples with the confidence to conceive safely.
ARV adherence and viral suppression.
Clinicians conducting Provider Initiated
Counselling and Testing (PICT) at
health facilities and Community Health
Workers conducting HIV testing (HTS) References
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U=U awareness campaign is a 5. JC2743_Understanding_FastTrack_en.pdf at: https://www. Social Benefits of Undetectable= Untransmittable Messaging
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An organisation led by South African co.za/2020/11/18/hiv-death-rate-in-sa-men-much-higher-than-
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HIV Nursing Matters | June 2021 | page 26