Undetectable HIV Equals Untransmittable HIV (U = U) Statement in Women. Are we there Yet?
Justyna D Kowalska1,2, Dagny C Krankowska3*, Agnieszka Wróblewska2 and Ewa Firląg-Burkacka2
1Department of Adults’ Infectious Diseases, Medical University of Warsaw, Poland
2HIV Out-Patient Clinic, Hospital for Infectious Diseases, Warsaw, Poland
3Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Hospital for Infectious Diseases, Warsaw, Poland
*Corresponding Author: Dagny C Krankowska, Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Hospital for Infectious Diseases, Warsaw, Poland.
April 08, 2022; Published: May 17, 2022
Introduction: The “undetectable equals untransmittable” (U = U) statement confirms that a HIV positive person on effective antiretroviral therapy is not transmitting HIV to his/her sexual partner. Poor adherence to treatment can jeopardize this benefit. Women living with HIV (WLWH) are more at risk of having suboptimal adherence than men.
Objectives: To compare the characteristics of women on effective cART with those who have a detectable HIV viral load (VL), in order to understand the differences in behavioral patterns and to better address the U = U statement among women.
Methods: Women with HIV using gynecological services in the Out-Patient Clinic in Warsaw participated in a survey about sexual behavioral patterns and history of sexually transmitted infections (STIs). The data about HIV VL, status of HCV, HPV and other STIs was exported from the medical database. Characteristics of women with HIV RNA>50 copies/ml and women with HIV RNA<50 copies/ml were compared using non-parametric tests as appropriate.
Results: The study included 97 WLWH with median age 39 years and 82 (84.5%) with undetectable HIV VL. The median number of sexual partners in both groups was five (IQR: 3.5-8.5 and 3-10 for those with VL<50 and VL>50 respectively). Most characteristics were comparable between study groups except that more women with detectable VL did not use condoms (66.7% vs. 39%, p = 0.0244).
Conclusions: More attention should be drawn to reasons of poor adherence to cART in WLWH. Same efforts in educating about safe sex and U = U should be made in WLWH as for other key populations.
Keywords: HIV; cART; Undetectable; Untransmittable; Adherence; Women
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