Sharing with the press at the event "K=K is a balancing tool in the health sector" within the framework of the 49th Conference of the Global Fund Executive Council recently held in Hanoi, Associate Professor, Dr. Phan Thi Thu Huong, Director of the Department of HIV/AIDS Prevention and Control ( Ministry of Health ) emphasized that K=K (Undetectable = Untransmittable) is an extremely important scientific evidence that fundamentally changes the perspective on HIV treatment.
Reporter (PV) : K=K is a new message about the benefits of antiretroviral (ARV) treatment for people with HIV. Could you please tell us more specifically what K=K is and what scientific evidence it is based on?
Associate Professor, Dr. Phan Thi Thu Huong: Undetectable = Untransmittable (often abbreviated as K=K) means that a person with HIV who takes ARV drugs daily as prescribed, achieves and maintains a viral load below the threshold (conventionally defined as less than 200 copies/1ml of blood) will have absolutely no risk of sexually transmitting HIV to an HIV-negative partner.
The evidence is strong, with at least four different studies of tens of thousands of HIV-negative people, with a total of 128,000 sexual encounters with HIV-positive people on ARV treatment who had undetectable viral loads, showing no cases of HIV infection (no transmission).
The above scientific evidence was published at the Global Conferences on HIV/AIDS Prevention and Control in 2017 in France and 2018 in the Netherlands. The evidence confirms that "if an HIV-infected person is treated with ARV drugs, adheres to treatment and achieves an undetectable viral load, there is no possibility of transmitting HIV to others through sexual contact" which we often call U=U or K=K, meaning Undetectable = Untransmittable.
To date, more than 1,000 international organizations have declared their agreement and confirmation of this finding, including prestigious organizations such as the World Health Organization (WHO); the Joint United Nations Program on HIV/AIDS (UNAIDS), the US Centers for Disease Control and Prevention (US CDC)...
It can be said that this scientific evidence is extremely important and fundamentally changes the view on HIV treatment. Treatment is also prevention. It is extremely important for everyone.
PV: How did Vietnam implement this campaign and what is your assessment of its effectiveness?
Assoc. Prof. Dr. Phan Thi Thu Huong: It can be said that since 2017, when this message was disseminated at the International AIDS Conference in the Netherlands, Vietnam has also supported and organized propaganda for this message.
In September 2019, the Department of HIV/AIDS Prevention and Control officially issued a document guiding localities to deploy the K=K Campaign for all 63 provinces and cities as well as officially launched the national campaign on K=K with a series of activities including communication, training for officials and organizing events...
We coordinated with Bach Mai Hospital to launch the National Campaign on October 22, 2019. Implementing the guidance of the Department of HIV/AIDS Prevention and Control, localities also launched this Campaign in provinces and cities. The event started in the two major cities of Hanoi and Ho Chi Minh City, then spread to other provinces and cities. The central government and provinces organized training courses for health workers and journalists on K=K; K=K messages were also integrated into other training courses for service providers as well as community organizations...
We believe that when this campaign is spread, it will have many meanings depending on each target group:
Specifically, people who do not have HIV will proactively go for early HIV testing or regular testing so that if they have HIV, they will receive early ARV treatment to help achieve an HIV viral load below the detection threshold. Do not discriminate against people with HIV because even though they have HIV, if they receive ARV treatment and achieve an HIV viral load below the detection threshold, they will still live healthy lives and will not transmit HIV to others through sex. Do not fear HIV infection from an HIV-infected partner when they have received ARV treatment and have an HIV viral load below the detection threshold.
People with HIV will have early access to ARV treatment to achieve an HIV viral load below the detection threshold; Comply with treatment as directed by the doctor; Do not self-stigmatize, because people with HIV are still healthy and do not transmit HIV to others through sex; Have regular HIV viral load tests to know if their HIV viral load is "below the detection threshold" and also to know the results of HIV treatment; Participate in health insurance to receive continuous, long-term ARV treatment.
For health workers, there will be no stigma and discrimination against people with HIV; Knowing the effectiveness of ARV treatment of patients; Counseling people with HIV and their partners about the importance of ARV treatment and adherence to treatment.
The most important thing is to educate the community about the benefits of ARV treatment so that there is no stigma and discrimination against people with HIV...
PV: Madam, Vietnam is considered to have one of the highest HIV suppression rates in the world. Could you please tell us why Vietnam has achieved these results?
Assoc. Prof. Dr. Phan Thi Thu Huong : Currently, Vietnam is announced by the US Center for Disease Control as a country with a very high HIV suppression rate in the world, the highest among the countries that the US President's Emergency Plan for AIDS Relief (PEPFAR) is supporting.
To achieve this result, in my opinion, it is because we have done a good job of communication and consultation so that patients understand the benefits of early treatment, maintain and comply with treatment. On the other hand, we continuously update treatment regimens according to the recommendations of world organizations so that patients receive the best drugs and regimens according to WHO recommendations. In addition, we have a wide treatment network in all provinces and most districts, with more than 500 drug distribution points in communes and wards, so patients can easily access and maintain treatment.
Along with that, we have many models and initiatives being implemented such as: Treatment 2.0; Expanding treatment within the day; dispensing medicine for many months... also creating conditions for patients to access and comply with treatment.
PV: So, how to continue to maintain effective K=K in Vietnam, madam?
Assoc. Prof. Dr. Phan Thi Thu Huong : To maintain the quality of HIV/AIDS treatment, K=K, the Ministry of Health has directed to continue communicating about K=K and HIV neutral status, treatment is prevention. Improve HIV testing in a way that is convenient for people with high-risk behaviors with different models such as testing in the community, through the website, self-testing to detect HIV infection early and receive early ARV treatment, support treatment adherence so that patients soon achieve viral load below the detection threshold.
Along with that, apply WHO recommendations in organizing the HIV/AIDS testing and treatment system and monitoring treatment results. Strengthen communication on the effectiveness of HIV/AIDS treatment so that people with high-risk behaviors can access testing and treatment services early; so that health workers, relatives, families and the community do not stigmatize or discriminate against people with HIV; people with HIV and people with high-risk behaviors must also rise up, overcome difficulties and barriers, and not stigmatize themselves...
I think that when an initiative or a message has been confirmed by meaningful scientific evidence like K=K, it needs to be further disseminated so that everyone understands the benefits of treatment as well as reduces stigma and discrimination related to HIV. That is also a solution for us to be able to complete the goal of "Ending the AIDS epidemic by 2030"./.
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