# Integrating U=U into HIV counseling in South Africa (INTUIT-SA)

> **NIH NIH R34** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2022 · $121,704

## Abstract

Project Summary
The near-elimination of HIV transmission with antiretroviral therapy (ART) has provided the world with a clear
path to end the HIV epidemic through the mass provision of ART at diagnosis, i.e. test-and-treat. Despite the
very large prevention benefits of ART, we found very limited knowledge of treatment-as-prevention (TasP)
in two population-based surveys we recently conducted in South Africa (Bor K01). Indeed, current public health
messaging and clinical HIV counseling in South Africa do not emphasize the prevention benefits of ART.
In 2016, U=U Campaign was launched to disseminate the scientific evidence that people with HIV
cannot transmit the virus if their viral load is undetectable. U=U has been endorsed by NIH and by
organizations in nearly 100 countries. Anecdotal evidence suggests providing information on U=U may reduce
stigma and improve wellbeing of PLWH, and may lead to increased ART uptake and adherence by appealing
to the desire of PLWH to avoid transmission to others. Although the science on U=U is clear, there is currently
a critical evidence gap on (a) how best to integrate information on U=U into HIV counseling services,
and (b) what impact U=U messaging has on wellbeing of PLWH and on treatment-seeking behaviors.
We propose a formative research study (R34) to develop an app-based educational video intervention that
will provide information on U=U that is locally-appropriate and can be integrated into routine HIV counselling.
We will pilot the intervention in a clinical trial of patients receiving HIV post-test and adherence counseling
services, in order to determine feasibility and acceptability, impact on U=U knowledge and attitudes, impact on
stigma and psychological wellbeing, and preliminary evidence for ART uptake, adherence, and viral monitoring
and suppression. The study builds on a longstanding collaboration between Boston University and the Health
Economics and Epidemiology Research Office (HE2RO) at the University of Witwatersrand in South Africa.
This study is highly innovative because we take a novel approach – disseminating information on the
prevention benefits of ART – to improve wellbeing of PLWH and motivate early uptake of ART in South Africa.
Study results will inform an R01 proposal to evaluate the impact of this intervention on viral suppression in a
cluster-randomized efficacy trial. The research will have significant public health impact as the findings have
potential to shape HIV counseling guidelines and practice in the country with the world’s largest HIV epidemic.
We hypothesize that selling treatment-as-prevention on its merits could substantially improve wellbeing
of PLWH and increase demand for ART, enabling countries to maximize the impact of test-and-treat.

## Key facts

- **NIH application ID:** 10455495
- **Project number:** 5R34MH122323-03
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Jacob Bor
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $121,704
- **Award type:** 5
- **Project period:** 2020-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10455495

## Citation

> US National Institutes of Health, RePORTER application 10455495, Integrating U=U into HIV counseling in South Africa (INTUIT-SA) (5R34MH122323-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10455495. Licensed CC0.

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