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已发表论文
在中国湖南省，艾滋病病毒携带者/艾滋病患者中“检测不到等于不具传染性”的认知及其与性风险行为的关系以及潜在的身体和心理益处
Authors Duan Y, Li Y, Qin Z, Wang P, Liu T, Wang H , Xiao X
Received 3 June 2025
Accepted for publication 19 September 2025
Published 30 September 2025 Volume 2025:19 Pages 3057—3068
DOI https://doi.org/10.2147/PPA.S544362
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Yuqiong Duan, Yixuan Li, Ziqi Qin, Pingwu Wang, Tao Liu, Honghong Wang, Xueling Xiao
Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
Correspondence: Xueling Xiao, Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China, Email xuelingxiao93@hotmail.com
Purpose: Undetectable = Untransmittable (U=U) is the scientific consensus that people living with HIV (PLWH) who maintain an undetectable viral load cannot sexually transmit HIV to others. This study aimed to explore the status of PLWH’s perception of U=U (including knowledge, attitude, and acceptance) and the relationships with their sexual behaviors and potential physical and psychological benefits (satisfaction of health, depression, self-stigma, quality of life, ART adherence, viral load and CD4+ cell level).
Patients and Methods: We analyzed data from 730 PLWH aged 18 years or older from the outpatient clinic at the Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, between October 2021 and January 2022. Data were collected using a structured, anonymous, paper-based questionnaire. It gathered information on U=U perception, sexual risk behaviors, potential physical and psychological benefits and socio-demographic and clinical characteristics. To examine associations between U=U perception and sexual risk behaviors and potential physical and psychological benefits, for categorical outcome variable, multiple logistic regression was adopted for the CD4+ cells and HIV viral load level; for count outcome variable, generalized linear model (GLM) with Poisson regressor was used for sexual risk behaviors; and since all the other response variables were skewed, GLM with Gamma regressor was used.
Results: The mean age of the participants was 33.6 years (SD = 10.8). Majority (95.1%) of the participants were male and initiated ART (97%). Nearly half had bachelor’s degree or higher (45.6%) and were identified as homosexuality (48.5%). More than half heard U=U (63.8%) and perceived U=U accurate (57.4%), however only 13.6% had a comprehensive understanding of U=U and 19.9% accepted U=U as a strategy for HIV prevention. The acceptance level of U=U was positively correlated with increased unprotected sexual behaviors [β(95% CI)=0.21(0.045,0.365); P< 0.05)]. The U=U perception was not related to depression, antiretroviral therapy adherence, self-stigma and perceived quality of life. We only found that less U=U knowledge was associated with the detectable [β(95% CI)=0.69(0.503,0.903); P< 0.05)] or unavailable viral load [β(95% CI)=0.68(0.0528,0.884); P< 0.01)], and unavailable CD4+ cell counts was more like to less U=U knowledge [β(95% CI)=0.62(0.395,0.959); P< 0.05)]. Furthermore, those with unavailable viral data exhibited a more negative attitude towards U=U [β(95% CI)=0.79(0.635,0.977); P< 0.05)]. In addition, lower level of U=U acceptance was related to the unavailable CD4 cell counts [β(95% CI)=0.67(0.474,0.940); P< 0.05)].
Conclusion: This study suggests that PLWH have not fully reaped the benefits of U=U. Further research is necessary to explore strategies for promoting clear and accurate information about U=U and for effectively communicating the personal and societal benefits of U=U to PLWH.
Keywords: undetectable = untransmittable, knowledge, attitude, acceptance, sexual behaviour, potential physical and psychological benefits
Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
Correspondence: Xueling Xiao, Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China, Email xuelingxiao93@hotmail.com
Purpose: Undetectable = Untransmittable (U=U) is the scientific consensus that people living with HIV (PLWH) who maintain an undetectable viral load cannot sexually transmit HIV to others. This study aimed to explore the status of PLWH’s perception of U=U (including knowledge, attitude, and acceptance) and the relationships with their sexual behaviors and potential physical and psychological benefits (satisfaction of health, depression, self-stigma, quality of life, ART adherence, viral load and CD4+ cell level).
Patients and Methods: We analyzed data from 730 PLWH aged 18 years or older from the outpatient clinic at the Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, between October 2021 and January 2022. Data were collected using a structured, anonymous, paper-based questionnaire. It gathered information on U=U perception, sexual risk behaviors, potential physical and psychological benefits and socio-demographic and clinical characteristics. To examine associations between U=U perception and sexual risk behaviors and potential physical and psychological benefits, for categorical outcome variable, multiple logistic regression was adopted for the CD4+ cells and HIV viral load level; for count outcome variable, generalized linear model (GLM) with Poisson regressor was used for sexual risk behaviors; and since all the other response variables were skewed, GLM with Gamma regressor was used.
Results: The mean age of the participants was 33.6 years (SD = 10.8). Majority (95.1%) of the participants were male and initiated ART (97%). Nearly half had bachelor’s degree or higher (45.6%) and were identified as homosexuality (48.5%). More than half heard U=U (63.8%) and perceived U=U accurate (57.4%), however only 13.6% had a comprehensive understanding of U=U and 19.9% accepted U=U as a strategy for HIV prevention. The acceptance level of U=U was positively correlated with increased unprotected sexual behaviors [β(95% CI)=0.21(0.045,0.365); P< 0.05)]. The U=U perception was not related to depression, antiretroviral therapy adherence, self-stigma and perceived quality of life. We only found that less U=U knowledge was associated with the detectable [β(95% CI)=0.69(0.503,0.903); P< 0.05)] or unavailable viral load [β(95% CI)=0.68(0.0528,0.884); P< 0.01)], and unavailable CD4+ cell counts was more like to less U=U knowledge [β(95% CI)=0.62(0.395,0.959); P< 0.05)]. Furthermore, those with unavailable viral data exhibited a more negative attitude towards U=U [β(95% CI)=0.79(0.635,0.977); P< 0.05)]. In addition, lower level of U=U acceptance was related to the unavailable CD4 cell counts [β(95% CI)=0.67(0.474,0.940); P< 0.05)].
Conclusion: This study suggests that PLWH have not fully reaped the benefits of U=U. Further research is necessary to explore strategies for promoting clear and accurate information about U=U and for effectively communicating the personal and societal benefits of U=U to PLWH.
Keywords: undetectable = untransmittable, knowledge, attitude, acceptance, sexual behaviour, potential physical and psychological benefits