Socially marginalized sexual and gender minority men (SGMM) are less likely to know about U=U than their more mainstream peers, a Canadian survey published in AIDS Care found.
Researchers recruited 2,681 men at Pride festivals and asked them whether they knew that PLWH on antiretroviral treatment (ART) whose viral load is undetectable cannot transmit the virus to their sexual partner. They then correlated the response to a Social Positionality Index Score based on a number of factors that may lead to marginalization, such as being transgender, not being out about one’s sexuality or gender, being a person of color or indigenous person, or having little money or education.
Overall, 73% of participants said they knew about U=U. U=U awareness was more common among men who were not monogamous than men in a committed relationship with one person.
That said, most respondents who identified their HIV status as negative or unknown reported that they had not had anal sex with a person they knew to be living with HIV.
Meanwhile, every single-point increase in a respondent’s social position score was correlated with 21% lower odds of knowing about U=U. However, most participants were not socially marginalized: 91% were cisgender, 76% white, 81% financially secure, and 54% college educated. These demographics show the need for making health education and spaces for SGMM more inclusive beyond white, gay middle-class men, study authors commented.
The social position score also did not address the potential interplay of specific marginalization characteristics. Future research should explore that intersectionality and its effect on HIV-related knowledge, study authors recommended.
Other fields of inquiry yet to be explored include the relationship between U=U knowledge and PrEP uptake, the validation of this novel scoring method, and the addition of other traits such as older age to the score.