Leaving No One Behind: Human Rights and Gender as Critical Frameworks for U=U

Experience has shown the need to explicitly address human rights and gender-related barriers in the rollout of HIV-related biomedical innovations, including "undetectable equals untransmittable" (U=U). This paper brings to light rights and gender considerations relevant to supporting U=U, recognizing a range of barriers that remain to be addressed for all people to benefit equally from U=U. We conducted a literature review to ascertain how human rights and gender were addressed in relevant publications, including peer-reviewed articles published between 2006 and 2020, relevant nongovernmental and global organizations' publications, and abstracts presented at the 2019 International AIDS Conference, that explicitly addressed U=U or "treatment as prevention." Despite evidence to illustrate the importance of attention to human rights and gender within U=U policies and interventions, there remains a lack of explicit attention to human rights and gender considerations in research and programming, particularly with regard to the rights principles of participation and accountability. Explicitly engaging all of these dimensions is key to informing interventions and improving people's lives, health, and well-being.