This survey aimed to understand how far the Italian infectious diseases (ID) specialists are confident in the “Undetectable = Untransmittable” (U = U) message and translate this concept into clinical practice. An anonymous survey was distributed by e-mail to 286 clinicians to collect their opinions regarding six situations potentially at risk of HIV transmission between virologically suppressed patients and seronegative individuals who possibly require postexposure prophylaxis (PEP). Overall, 51% of ID specialists deemed zero risk of HIV transmission through condomless sex for undetectable patients. This answer was more frequent among HIV specialists (30% vs. 21%, p = .01) and clinicians working in teaching hospitals (35% vs. 16%, p = .03). Remarkably, 61% of participants would advise taking PEP for the HIV-negative partner in case of sexual intercourse with a seropositive person with a recent blip occurrence or absence of an HIV RNA test performed within the last 6 months (63%). Seventy-three percent of respondents deemed it essential to know patients' history of adherence to interpreting an HIV RNA test, regardless of its timing. When applying the U = U concept to daily clinical decisions, we observed an overall cautious attitude among physicians. Concerns mainly regarded the timing of the last HIV RNA test to the exposure event, especially in the absence of details on the patient's adherence. Wider diffusion and application of the U = U message are needed.

中文翻译：

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意大利传染病专家对 U = U 的看法：一项关于提供者对病毒学抑制患者 HIV 传播风险态度的全国调查

这项调查旨在了解意大利传染病 (ID) 专家对“无法检测 = 不可传播”(U = U) 信息的信心程度，并将这一概念转化为临床实践。通过电子邮件向 286 名临床医生分发了一份匿名调查，以收集他们对 HIV 在病毒学抑制患者和可能需要暴露后预防 (PEP) 的血清反应阴性个体之间可能存在 HIV 传播风险的六种情况的意见。总体而言，51% 的 ID 专家认为，对于无法检测到的患者，通过无安全套性行为传播 HIV 的风险为零。这个答案在 HIV 专家（30% 对 21%，p  = .01）和在教学医院工作的临床医生（35% 对 16%，p =.03）。值得注意的是，61% 的参与者会建议 HIV 阴性的伴侣在与近期出现异常或在过去 6 个月内未进行 HIV RNA 检测的血清阳性者发生性关系时进行 PEP (63%)。73% 的受访者认为了解患者坚持解读 HIV RNA 检测的历史非常重要，无论检测时间如何。在将 U = U 概念应用于日常临床决策时，我们观察到医生总体上持谨慎态度。主要关注的是最后一次 HIV RNA 检测到暴露事件的时间，尤其是在缺乏患者依从性的详细信息的情况下。需要更广泛地传播和应用 U = U 信息。