By Sharon Atieno
Undetectable equals Untransmittable (U=U) campaign is set to be a game changer in the fight against HIV and stigma associated with HIV in Kenya, expert says.
Dr. Lazarus Momanyi, Care and Treatment Manager, National AIDS and Sexually Transmitted Infections (STI) Control Programme (NASCOP) said during a Media for Environment, Science, Health and Agriculture (MESHA) café.
The campaign, according to Dr. Momanyi is driven by science after four large studies carried out between 2007 and 2016 proved that “people who are virally suppressed do not transmit HIV through sex.”
The studies (HPTN, PARTNER, PARTNER 2 and OPPOSITES ATTRACT) involved HIV-discordant (where one partner has HIV) heterosexual partners and men who have sex with men (MSM) couples who were engaging in condom less sex and not using pre-exposure prophylaxis (PrEP).
“The goal is to empower people living with HIV to achieve viral suppression and maintain viral suppression,” he said.
Viral suppression, according to Dr. Momanyi is achieved when the viral load is lower than 1000 copies. But we want our patients to be undetectable, this is a level whereby the virus cannot be detected by the machine, usually anything below 400 copies, he adds.
Key outcomes of the U=U campaign, Dr. Momanyi mentioned include: diminishing stigma associated with HIV, reducing barriers to HIV testing and treatment, increasing interest in starting and staying on ART, improving self-esteem by removing the fear of being contagious, supporting healthy sexuality regardless of HIV and reducing sex partners’ concerns.
However, Dr. Momanyi said that U=U is one of the bullets and not a magic bullet in the fight against HIV. “As a National Programme, we still recommend the use of combination-prevention strategies such as PrEP and condoms,” he said, noting that U=U does not protect from pregnancy and STIs.
Since the national launch in September, 2021, Kenya has developed targeted messages for key populations such as MSM, sex workers, adolescents and youths, and women among others on the campaign.
Also, they have identified champions, people who are living with HIV who are virally suppressed, who talk on U=U to other people, Dr. Momanyi said.
However, he admits that there is no research that has shown that U=U will work on people who inject drugs or on mother to child transmissions.
In Kenya, the HIV burden remains high with 1.5 million people living with HIV. Of these, 1.4 million are adults and about 105,000 are children 14 years and below.
Uptake of anti-retroviral therapy is at 83.1% with more than 1.1 million people on treatment and about 94% of them being virally suppressed.