Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia.
Center for Social Research in Health, UNSW Sydney, Sydney, Australia.
AIDS Patient Care STDS. 2020 May;34(5):205-212. doi: 10.1089/apc.2019.0300.
There is effectively no risk of transmission of HIV from an HIV-positive person with consistent undetectable viral load (UDVL) to an HIV-negative person during sex. This has been publicly disseminated by an international health campaign called "undetectable = untransmittable" (U = U). This study extends previous research by examining confidence in the U = U message and potential covariates of confidence in U = U, as well as by assessing the perceived personal risk and sexual outcomes in a sample of people living with HIV (PLWH) in Australia. Between October 2017 and June 2018, 139 adult PLWH were recruited through clinics or community-based strategies. They completed an online questionnaire assessing participant characteristics, general agreement with the U = U message, confidence in U = U as an effective HIV prevention strategy, perceived personal risk of onward transmission, and sexual outcomes. While the majority of participants (70.5%) agreed with the general U = U message, only 48.2% were confident in U = U as an effective HIV transmission prevention strategy across sexual situations. Lack of confidence in U = U was more pronounced in the community subsample, minority group participants, and lower educated participants. A minority of PLWH with self-reported UDVL thought they could pass on HIV and indicated poor sexual outcomes, including sexual inactivity, reduced frequency of sex, and reduced sexual satisfaction. General agreement with the U = U message among PLWH may mask lack of confidence in U = U. Community-based information and education tailored to culturally diverse groups and people with low health literacy are required to promote accurate perception of risk of transmission of HIV with consistent UDVL.
从艾滋病毒阳性且病毒载量持续不可检测（UDVL）的人向艾滋病毒阴性的人传播艾滋病毒，实际上不存在风险。这是一个名为“检测不到即无法传播”（U=U）的国际健康运动公开宣传的内容。本研究通过检查对 U=U 信息的信任度和信任度的潜在协变量，以及评估澳大利亚艾滋病毒感染者（PLWH）样本中的感知个人风险和性结果，扩展了之前的研究。2017 年 10 月至 2018 年 6 月，通过诊所或社区策略招募了 139 名成年 PLWH。他们完成了一份在线问卷，评估了参与者的特征、对 U=U 信息的总体认同、对 U=U 作为一种有效艾滋病毒预防策略的信心、对继续传播的个人风险的感知以及性结果。虽然大多数参与者（70.5%）同意一般的 U=U 信息，但只有 48.2%的人对 U=U 在所有性情况下作为有效的艾滋病毒传播预防策略有信心。在社区亚组、少数群体参与者和受教育程度较低的参与者中，对 U=U 的缺乏信心更为明显。少数报告 UDVL 的 PLWH 认为他们可能会传播 HIV，并表示性结果较差，包括性行为不活跃、性频率降低和性满意度降低。PLWH 对 U=U 信息的普遍认同可能掩盖了对 U=U 的缺乏信心。需要针对文化多元化群体和健康素养较低的人群开展基于社区的信息和教育，以促进对持续 UDVL 时 HIV 传播风险的准确感知。
