Empowerment through knowledge: Qualitative perceptions of 'undetectable equals Untransmittable' among people living with HIV and tuberculosis in South Africa.
Alanna J Bergman, Michael V Relf, Kelly Lowensen and 3 others
PMID 39864148WHAT IT FOUND
Most people with HIV and rifampicin-resistant TB did not know what viral suppression or undetectable equals untransmittable meant.
They described gaining understanding and motivation after repeated community health worker education, but wanted results explained at clinic visits.
Key findings
01At baseline, participants generally did not understand viral suppression or undetectable equals untransmittable, and none understood its link to inability to transmit HIV.
02Participants said lab results and education about undetectable equals untransmittable were not routine in clinic visits, and most did not receive viral load results despite monthly visits.
03By the third interview, most participants could accurately explain undetectable equals untransmittable, but some participants said this knowledge would not change stigma in their community.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Qualitative findings are perceptions from 30 participants, with 24 completing all three interviews, and are not meant to be generalizable. The study was conducted at a public district hospital in KwaZulu-Natal with participants who identified as Black African and spoke English or isiZulu. Participants had both HIV and rifampicin-resistant TB, so their experiences may differ from people living with HIV only. Some participants withdrew or transferred care, so longitudinal analysis could not continue for all. Interviewers were also the primary and secondary coders, and the analysis team included a US-based researcher, which may shape interpretation.
Declared interests
No funding source is reported in the supplied text. The authors declared no known competing financial interests or personal relationships. Participants were compensated R100 (USD 5.29) for participation.
The easy way to misread this
Do not conclude that explaining undetectable equals untransmittable to patients improves adherence or reduces stigma. This was a qualitative sub-study of participants' perceptions nested in a trial, and some participants said this knowledge would not change stigma in their community.