In June 2025, ASHM and NAPWHA convened a workshop bringing together clinicians and people living with HIV to consider strategies for discussing HIV viral load and U=U in clinical settings.
U=U, or “undetectable equals untransmittable”, refers to the fact that people who take antiretroviral therapy (ART) for HIV as prescribed, and who achieve and maintain a viral load of less than 200 copies/mL (HIV RNA <200 copies/mL), cannot sexually transmit the virus to an HIV-negative partner.
The workshop focused specifically on the challenges of discussing transmissibility in situations where a person living with HIV does not have an undetectable viral load but may still fall below the threshold for U=U of <200 copies/mL, for example, due to low-level viraemia.
This report summarises the discussions and key takeaways from the workshop, detailing considerations and recommendations around challenges in reinforcing the U=U message and supporting clinical conversations about U=U.
