UCT School of Economics Seminar

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September 30, 2024 at 13:00


Speaker: Jacob Bor and Dorina Onoya (Boston University & University of Witwatersrand) 

Title: Integrating “Undetectable = Untransmittable” into HIV counselling: a randomized trial in South Africa 

Abstract: People living with HIV (PLHIV) who are virally suppressed cannot transmit the virus sexually: “Undetectable = Untransmittable (U=U)”. However, in many settings, PLHIV do not receive information on U=U as part of routine HIV counselling. We developed a video-based App, called “Undetectable & You”, to deliver information on U=U through testimonials of PLHIV and their partners as part of HIV counseling in South Africa. We piloted the App in a parallel, two-arm randomized trial (n=135) at primary health facilities in Johannesburg. The intervention increased U=U knowledge, i.e. the percentage believing there was zero risk of transmission if virally suppressed, from 42% (control) to 76% (intervention) (p<0.01). Viral suppression (<200 copies at 3-10 months) was 33% in the control arm and in 52% in the treatment arm (risk difference: 19%; p=0.028). Effects were largest among men and those with previous care interruptions. The gap in clinical retention between intervention and control participants widened over time, suggesting changes in underlying treatment motivations.  

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