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Undetectable = Untransmittable: A Cross-Population Systematic Review and Meta-Analysis on Awareness and Acceptance.
Nikolaos Georgiadis1, Andreas Katsimpris2, Perry N Halkitis3
1Department of Public Health Policy, School of Public Health, University of West Attica, Alexandras Avenue 196, 11521 Athens, Greece.
Pathogens (Basel, Switzerland)
|July 30, 2025
Summary
Awareness and acceptance of the Undetectable = Untransmittable (U=U) HIV message vary globally. Targeted education is needed, especially for populations with lower U=U understanding and acceptance to reduce stigma.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- The Undetectable = Untransmittable (U=U) message is crucial for HIV public health communication.
- Global awareness and acceptance of U=U across key populations are not well understood.
- HIV stigma remains a significant global health challenge.
Purpose of the Study:
- To assess the global prevalence of awareness and acceptance of the U=U message.
- To analyze U=U awareness and acceptance among men who have sex with men (MSM), people living with HIV (PLWH), healthcare professionals, and the general population.
Main Methods:
- Systematic review and meta-analysis of studies from PubMed, Embase, and Google Scholar.
- Included prospective cohort studies, randomized clinical trials, and cross-sectional studies.
- Data analyzed using a random effects model.
Main Results:
- U=U awareness was high in PLWH, moderate in MSM and healthcare professionals, and low in the general population.
- Complete U=U acceptance was low in MSM and the general population, moderate in PLWH and healthcare professionals.
- Any U=U acceptance was moderate in MSM and the general population, and high in PLWH and healthcare professionals.
Conclusions:
- Significant variations in U=U awareness and acceptance exist across different populations.
- Targeted educational strategies are essential to improve U=U understanding.
- Enhancing U=U knowledge can help reduce HIV-related stigma.
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