Perceived Barriers and Facilitators to Providing “Undetectable Equals Untransmittable” Information to HIV/AIDS Patients: A Qualitative Study From the Perspective of Chinese Health Care Providers

Health care providers (HCPs) report a low willingness to discuss "undetectable equals untransmittable" (U=U) with patients, despite its recognized importance for both public health and the well-being of persons with HIV (PWH). To better understand the barriers and facilitators associated with providing the U=U message, we conducted 16 face-to-face in-depth interviews with HCPs working with PWH in Hunan, China, from October 2021 to May 2022. Data collection was guided by a social-ecological framework. Participants reported reluctance to provide clear U=U information to PWH. The barriers included inaccurate knowledge, doubt about the reliability, ethical concerns, population-related informing biases and lack of a guideline or consensus, and so on. However, some facilitators were also noted, such as confirmed clinical benefits, individuals' desires to have children, and the effect of the international U=U campaign. These findings provide valuable insights into designing and developing targeted training and policy to promote U=U implementation in China.