Changing Knowledge and Attitudes Towards HIV Treatment‑as‑Prevention and “Undetectable=Untransmittable”: A Systematic Review
Date
2021-04-30
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Abstract
People on HIV treatment with undetectable virus cannot transmit HIV sexually (Undetectable=Untransmittable, U=U).
However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who
could beneft from this information. We systematically reviewed the global literature on knowledge and attitudes related to
TasP and interventions providing TasP or U=U information. We included studies of providers, patients, and communities
from all regions of the world, published 2008–2020. We screened 885 papers and abstracts and identifed 72 for inclusion.
Studies in high-income settings reported high awareness of TasP but gaps in knowledge about the likelihood of transmission
with undetectable HIV. Greater knowledge was associated with more positive attitudes towards TasP. Extant literature shows
low awareness of TasP in Africa where 2 in 3 people with HIV live. The emerging evidence on interventions delivering
information on TasP suggests benefcial impacts on knowledge, stigma, HIV testing, and viral suppression.
Review was pre-registered at PROSPERO: CRD42020153725
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Keywords
Systematic review · Treatment-as-Prevention · Undetectable=Untransmittable