Bruce Richman Wants You to Know About U = U

"When I was diagnosed with HIV in 2003, I felt like I was a walking infection. I was terrified about passing HIV on to someone that I love," said HIV activist Bruce Richman in an 2017 interview on the HIV-activist site BETA. He refused treatment because he didn't want to be reminded that he was infectious, but when his health deteriorated in 2012, he started the drug regimen. And his doctor gave him some good news: "that because I was undetectable, I couldn't transmit HIV. I couldn't pass it on."

Then he got angry. "Because every HIV treatment site, every media outlet, every ASO, every federal health department, every state health department, everywhere, was saying that I was still a risk. And millions of people with HIV were still a risk.

"To clear up the confusion, a group of us living with HIV collaborated with researchers on a consensus statement and advocacy campaign called Undetectable is Untransmittable."

He then founded and became executive director of the Prevention Access Campaign and Undetectable = Untransmittable, U= U, a global community of HIV advocates, researchers and organizations, uniting disseminate the largely unknown fact that people living with HIV on effective treatment cannot transmit HIV.

Richman, who has a Master's in Administration Planning and Social Policy from Harvard Graduate School of Education and he is J.D. from Harvard Law School, worked in philanthropy for corporations and high-profile clients before starting PAC. EDGE spoke to the hunky Richman (he has his fans) about his activism.

Why the Prevention Access Campaign?

EDGE: Why did you start your work with Prevention Access Campaign & Undetectable = Untransmittable?

Bruce Richman: Before starting this campaign, I had been doing philanthropy work for corporations and high-profile people. After I learned back in 2012, that I couldn't pass it (HIV) on I knew this was a message that needed to be told. My social life, sexual life, and the way I thought about myself all changed. This message was not being told anywhere publicly. Some folks in influence knew about it. It was only being shared on an individual basis. Millions of people's lives were at risk because they and others believed they are infectious. I had to find a way to tell everyone who is living with HIV what U=U meant for us.

EDGE: What does undetectable mean?

Bruce Richman: It means a person living with HIV is on treatment that has suppressed the virus to the point that it's no longer detectable by tests. That keeps us healthy and prevents passing on HIV to sexual partners. Measurements for undetectable vary by test and country, so the number to remain under is 200.

EDGE: Why aren't we hearing more U = U messages in the media?

Bruce Richman: It's the reason I get up every day to spread this message. The stigma of HIV is killing us every day. We need to treat HIV stigma like a public health crisis but we're not hearing enough about U=U, the unprecedented opportunity to dismantle stigma. Part of the reason is frankly that there isn't any PR firm working on getting the message out. All the media coverage we got, like Washington Post, CBS Evening News, China Global TV, has been organic. Also, there is a long history of paternalism and prejudice in the field and even serophobia among journalists. We have lived with fear of HIV and people with HIV for more than 35 years so there is so much that must be unlearned. This is radical change, and many are not comfortable with change.

The impact of condomless sex

EDGE: With this message, do you have concerns that more condomless sex will take place and lead to an increase in other sexually transmitted infections?

Bruce Richman: I have heard a lot of concerns about it. Just because you think there will be more condomless sex when people with HIV learn about U=U doesn't mean you withhold information about U=U. You educate about condoms. This should be part of the ongoing sexual health conversation along with PrEP.

EDGE: How have HIV negative people responded to this news?

Bruce Richman: It is still a mixed reaction. At the highest levels, this message is being accepted. Some of our most important heroes are within the medical field and are negative. However, we expected fewer concerns and more excitement about it among U.S. community organizations and even activists. In the gay community, the news of U=U has been trickling out.

EDGE: Is a cure for HIV still unthinkable?

Bruce Richman: I don't think it is unthinkable. It's possible.

EDGE: It's great that celebrities are disclosing their status, but how does that help?

Bruce Richman: Definitely! It is important for the message to be delivered in an informed and professional way. High profile voices draw attention to the cause. When TV host Karl Schmid talked about his HIV status and stigma on the Today Show, he delivered that message to millions of Megyn Kelly viewers. It was amazing!

Ending the stigma

EDGE: Do you feel like the LGBTQ community should be doing more to end the HIV stigma?

Bruce Richman: Yes. The U.S. gay community is run by HIV negative cisgender men who are very attached to PrEP and generally don't seem to understand the importance of U=U. Those of us who live with HIV in US and within the queer community make up a tiny minority and to many we don't exist, we don't matter as much. There were 14 pride events in Canada featuring U=U floats and themes, and only two in the US. More organizations that serve the gay community need to step up and do more work spreading this message. We need more champions here in the US and more voices.

EDGE: How can people get involved?

Bruce Richman: Currently, our campaign is running in close to 100 countries. Here in the US, it's crickets. We need people to rise up and go to their state public health departments, LGBTQ centers and local gay organizations and press upon them to update their exaggerated risk descriptions and get the facts out. There are extensive resources on our website Uequalsu.org. Hundreds of thousands of people with HIV are suffering because they believe they are infectious to their partners. There's no time to waste!

EDGE: Greatest moments of this campaign for you?

Bruce Richman: There are so many! Wow! This has been the most incredible experience of my life. Every week I have new great moments. One was attending The World AIDS conference in Amsterdam this summer and seeing the message everywhere and accepted by the top researchers and minds in the field. Every day I connect with the activists who are using the U=U message and science to change lives all over the world.

Having the Mayor of D.C. join U=U last summer was huge for us. And when Dr. Anthony S. Fauci, the world's preeminent immunologist, took the stage between two huge screens showing "U=U" at the US Conference on AIDS and stating that "the science really does verify and validate U=U" was a historic moment in the history of the epidemic.

For more information about U=U and the Prevention Access Campaign, visit the organization's website.