Getting Real on U=U: Human Rights and Gender as Critical Frameworks for Action

U=U, sometimes also called Treatment as Prevention (TasP), has been a critical breakthrough in supporting People Living with HIV, able to access needed medications and technologies, to achieve undetectable viral loads. Everyone, from global organisations to local advocates, bolsters and supports this advance, noting its potential to end much of the stigma that still exists around HIV. Nonetheless, many barriers remain to be addressed for all people who need it to be able to benefit from this new approach. Decades of experience have shown the need to address human rights and gender dynamics in the rollout of any new HIV-related biomedical innovation. The success of U=U/TasP is contingent on an array of factors beyond individual control including protective legal environments, access to acceptable and quality health services including an uninterrupted supply of antiretroviral drugs and regular viral load testing without discrimination, and supportive social and community environments. This chapter seeks to understand how global organisations, non-governmental organisations and advocacy groups address U=U/TasP, in particular the extent to which they focus on gender and rights in their published materials, and ultimately the extent to which this makes a difference for people’s lives.