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U=U Educational Initiative for Youth

June 22, 2020
Author: University of North Carolina Infectious Disease Clinic

Center for Quality Improvement and Innovation (CQII)


Implemented U = U educational initiative with young clients, both new and existing, via education during clinic visits, educational materials, and social media. 

Change Ideas

  • Developed social media communication policy.
  • Disseminated ‘Undetectables’ comics to new and returning patients.
  • iPads with HIV educational videos were distributed to patients in clinic.
  • Flyers with U = U message were hung in clinic.
  • Reports of unsuppressed patients were reviewed monthly.


Undetectable = Untransmittable (U = U) means that people with HIV who have a viral load that is undetectable cannot sexually transmit HIV,1 which is included in the Federal HIV Treatment Guidelines.2 The U = U educational initiative was implemented to educate youth ages 18-24 years on the U = U message. This initiative started in January 2018 and involved all clinic providers to educate new and existing patients on U = U regularly during clinic visits. A social media communication policy was developed, which was approved by the University of North Carolina (UNC) Privacy Office and rolled out in June 2019. Education on U = U was delivered through the Undetectables comics given to new and returning patients. In July 2019, iPads with HIV educational videos were distributed to patients. Flyers were also posted in the clinic with the U = U message. Monthly reports of unsuppressed patients were reviewed to monitor progress. One-hundred percent of new diagnoses since October 2018 became undetectable within 3 months. For their youth subpopulation, viral suppression steadily increased from 80% (40/50) in June 2018 to 84.8% (39/46) in June 2019.

1 Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet. 2019. 393: 2428–38.

2 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Available at Clinical Accessed May 19, 2020.

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