Beyond Awareness: Perceived Psychological Impact of the Undetectable = Untransmittable (U=U) Message and Mental Health Among People Living with HIV in Turkey


Atasoy Tahtasakal C., Gerdan G., Demirbas N. D., Yıldız Sevgi D.

International Journal of Sexual Health, cilt.38, sa.3, ss.1300-1315, 2026 (SSCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 3
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1080/19317611.2026.2716277
  • Dergi Adı: International Journal of Sexual Health
  • Derginin Tarandığı İndeksler: Social Sciences Citation Index (SSCI), Scopus, IBZ Online, CINAHL, Psycinfo, Public Affairs Index, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest), Sociology Source Ultimate (EBSCO)
  • Sayfa Sayıları: ss.1300-1315
  • Anahtar Kelimeler: HIV, Undetectable = Untransmittable (U=U), mental health
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objectives: This study examined associations between awareness of the Undetectable = Untransmittable (U=U) message, U=U-related perceptions, mental health symptoms, and expectations regarding sexual protection among people living with HIV (PLWH). Methods: This cross-sectional study was conducted in Istanbul, Turkey, between 2023 and 2024 and included 210 PLWH aged 18–65 years. Participants completed the Hospital Anxiety and Depression Scale (HADS) along with self-report measures assessing U=U awareness and perceptions. Descriptive analyses and multivariable linear regression models were used. Results: Overall, 73.8% of participants reported being aware of the U=U message. U=U awareness was associated with relationship status, HIV status disclosure, and stronger beliefs regarding the psychological benefits of U=U dissemination but was not associated with expectations of discontinuing condom use. In unadjusted analyses, participants who were aware of U=U reported lower anxiety and depressive symptoms. However, in multivariable analyses, U=U awareness was no longer independently associated with mental health outcomes once U=U-related perceptions were included. In contrast, greater perceived psychological impact of U=U dissemination was independently associated with lower levels of both anxiety and depressive symptoms. Conclusions: These findings suggest that perceived psychological impact of the U=U message was more consistently associated with anxiety and depressive symptoms than U=U awareness after adjustment for relevant sociodemographic and relational factors. The potential value of integrating U=U into psychosocial counseling frameworks, rather than presenting it solely as biomedical information, warrants further examination in longitudinal and intervention studies. Given the cross-sectional design, the direction of these associations cannot be determined.