Awareness of U = U among Sexual and Gender Minorities in Brazil, Mexico, and Peru: Differences According to Self-reported HIV Status

• DOI: 10.1007/s10461-024-04336-9
• Publication Date: 2024-04-25T15:02:42Z
• Authors: K. A. Konda; J. Qquellon; T. S. Torres; E. H. Vega-Ramirez; O. Elorreaga; C. Guillén-Díaz-B...; D. Diaz-Sosa; B. Hoagland; J. V. Guanira; M. Benedetti; C. Pimenta; H. Vermandere; S. Bautista-Arred...; V. G. Veloso; B. Grinsztejn; C. F. Caceres
• Keywords: Male; Adult; Health Knowledge, Attitudes, Practice; Adolescent; Sociology and Political Science; Epidemiology; Sexual Behavior; Population; Immunology; Social Sciences; HIV Infections; Nursing; FOS: Health sciences; Poisson regression; Sexual and Gender Minorities; Young Adult; Risk-Taking; Sociology; Surveys and Questionnaires; Peru; Health Sciences; Humans; Psychology; Global Epidemiology of HIV and Drug Use; Mexico; Demography; Original Paper; Public health; Prevention and Treatment of HIV/AIDS Infection; FOS: Clinical medicine; HIV; Human immunodeficiency virus (HIV); Middle Aged; Global Impact of Sex Work and Trafficking; FOS: Sociology; Health psychology; FOS: Psychology; Sexual Partners; Infectious Diseases; Medicine; Female; Pre-Exposure Prophylaxis; Self Report; Gerontology; Brazil

AbstractThe slogan Undetectable equals Untransmittable (U = U) communicates that people living with HIV (PLHIV) who are on antiretroviral therapy (ART) will not transmit HIV to their sexual partners. We describe awareness of U = U among sexual and gender minorities (SGM) living in Brazil, Mexico, and Peru by self-reported HIV status (PLHIV, negative, unknown) during 2021 using an online survey. We estimated two models using Poisson regression for each population group: Model A including socio-demographic factors (country, gender, age, race, education, and income), and then Model B including taking ART (for PLHIV) or risk behavior, ever-taking PrEP, and HIV risk perception (for HIV-negative or of unknown HIV status). A total of 21,590 respondents were included (Brazil: 61%, Mexico: 30%, Peru: 9%). Among HIV-negative (74%) and unknown status (12%), 13% ever used PrEP. Among PLHIV (13%), 93% reported current use of ART. Awareness of U = U was 89% in both Brazil and Mexico, which was higher than in Peru 64%. Awareness of U = U was higher among PLHIV (96%) than HIV-negative (88%) and HIV-unknown (70%). In multivariate models, PLHIV with lower education were less aware of U = U, while those taking ART were more aware. Among HIV-negative, non-cisgender, lower income, and those with lower education had lower awareness of U = U, while individuals ever using PrEP had higher awareness. In conclusion, awareness of U = U varied by HIV status, socio-demographic characteristics, and HIV risk behavior. The concept of U = U should be disseminated through educational strategies and include a focus on SGM to combat HIV stigma.