“The First Thing I Must do is Become Undetectable”: Examining U=U Awareness and the HIV Care Continuum Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV in Lima, Peru

Forer R.; Brisson J.; Sanchez H.; Veneros D.; Lankowski A.; Duerr A. · Journal of the International Association of Providers of AIDS Care (2026) · DOI: 10.1177/23259582261471983

Resumen

Objectives: Awareness of “Undetectable = Untransmittable” (U=U) may strengthen HIV care engagement, yet its influence remains underexamined, particularly in Latin America. Among gay and bisexual men living with HIV in Lima, Peru, we examined (1) sociostructural correlates of U=U awareness; (2) U=U educational experiences and trust; (3) associations between U=U awareness and self-reported ART use; and (4) associations between U=U awareness and viral load. Methods: We conducted a sequential explanatory mixed-methods study including a survey (N=310) and individual interviews (N=30). Results: Most participants (86%) were aware of U=U. Awareness was less common among those diagnosed more recently, those without income in the past month, and non-binary participants. Participants aware of U=U were more likely to report linkage to care, current ART use, and viral suppression. Qualitative findings highlighted U=U as a motivator for ART adherence and viral suppression. Conclusions: Together, these findings underscore the importance of integrating clear, consistent U=U counseling into HIV services in Peru and globally. © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).