Amit Dhir, MBA, MSN, CRNP, is a nurse practitioner with Chase Brexton Health Care’s Infectious Diseases team, and a proponent of the U=U message.
How did you first hear about U=U? What was your impression of it at the time?
I first heard about the U=U campaign in early 2017 from national community organizations involved in HIV research. I am signed up with quite a few organizations where I get newsletters about what’s “new” and this was quite the talk back then. My first impression of U=U was “relief” and “joy” as being in the medical community and in the forefront of treating HIV, I have always wondered how someone could transmit when they are undetectable? We knew this from treatment as prevention (TasP), the term we used before U=U campaign started, and TaSP is actually the foundation of U=U. And the research finally confirmed it. By relief and joy, I am talking about breaking barriers in the community, people and the entire world.
How aware are your patients about U=U, and what is their reaction when they learn about it?
Well, now a LOT of my patients are aware of it because we talk about it. We talk about sex and healthy living and this almost always comes up because people still carry the fear from “ages” ago. I get a mixed bag of reaction from my patients. Some say “finally”, a large number say “what, wow, I never heard about it and didn’t know this was such a thing” and some just take it like any other news and are happy that people can love each other, live healthy and have intimate relationships with each other without having to worry.
What impacts can the U=U message have on a patient’s life?
U=U has a HUGE impact on a patient’s life. Imagine the amount of stress, fear, and stigma HIV-positive patients experienced over the years–especially people who were diagnosed 30 to 40 years ago or even just a decade ago. This uplifts our community, gives confidence, removes the stigma and barriers and sends them a strong message that we are all equal, we don’t have to–or rather we shouldn’t–discriminate based on someone’s “status.” I sometimes get a question from my patients: “can we have ‘normal’ kids?” My answer is absolutely yes! if someone is taking their HIV medications daily and is undetectable, their virus is undetectable (cannot be seen by the blood test) and cannot be transmitted–period! An undetectable/low viral load also means that their immune system is healthy. People now are aging and living with HIV; they are living longer and healthier.
In your opinion, what is needed to help spread the U=U message even farther?
In my opinion, we need clinics/organizations like Chase Brexton to spread the message widely through social media, by talking to our patients and partnering with local community organizations to hold public events, where this message is clear, to the point and gets across as it is: U=U. There are no ifs, ands, or buts.
U=U has the potential to address all kinds of HIV stigma — including institutional stigma occurring in healthcare settings, workplaces, and broadly across society; interpersonal (between people) stigma that can be so damaging among family and friends; and internalized stigma, the negative beliefs about HIV held by people living with HIV themselves, which many people don’t even realize they hold.
While researchers must continue to examine the promise and the impact of treatment as prevention, the science that is currently available strongly supports U=U. That alone is a reason to make sure that all people living with HIV or vulnerable to acquiring HIV have access to this information so that they can make the most informed decisions possible about their own sexual health and lives.
We all have to shift our attitudes, behaviors and beliefs to get this message to the world.