Director General of the Ghana AIDS Commission, Dr. Prosper Kharmacelle Akanbong, has explained the science behind why people living with HIV who consistently take their medication cannot transmit the virus, using the discussion to challenge the societal stigma that continues to surround the disease.
Dr. Akanbong explained that modern HIV treatment medications are so effective that consistent use can bring a patient to a stage where the virus becomes undetectable in their blood system, a significant shift from earlier stages of infection where viral levels may have been considerably higher.
Dr. Akanbong explained the scientific principle behind the phrase “U equals U,” describing how patients who reach undetectable viral levels through consistent medication become unable to transmit the disease to others.
“So you have gone from a stage where you may have high levels of virus, and with the regular taking of the medications, you get to a point where the virus cannot be detected in your blood at all.”
Director General of the Ghana AIDS Commission, Dr. Atuahene Prosper Kharmacelle Akanbong
He clarified that reaching undetectable status does not necessarily mean the virus has completely left the body, explaining that certain sequestered sites within the body, including the lymph nodes, bone marrow, ovaries, testicles, and even some brain cells, may still harbour the virus in a controlled and managed state.
He explained that because the virus remains encapsulated within these sites and does not enter the general bloodstream, transmission through blood, blood products, or semen becomes effectively impossible.
The 95-95-95 Targets Explained
Dr. Akanbong explained that as more people living with HIV reach undetectable and untransmittable status, new infections are expected to decline significantly, moving countries closer to what is described as epidemic control.
He referenced the World Health Organisation and UNAIDS targets, known as the 95-95-95 framework, which call for 95 percent of people with HIV to know their status, 95 percent of those diagnosed to be on treatment, and 95 percent of those on treatment to achieve undetectable viral levels.
He explained that sustained achievement of these targets over time would signal meaningful progress toward controlling the epidemic at a national level, positioning the framework as the guiding benchmark against which countries, including Ghana, measure their progress in the fight against HIV.
Stigma Rooted In Societal Perception, Not Science
Addressing why stigma persists despite the scientific reality that treated individuals cannot transmit the virus, Dr. Kharmacelle explained that the stigma surrounding HIV is fundamentally a societal issue rooted in misconceptions about how the disease is contracted.
“It is society’s perception of how HIV is contracted that makes people begin to look at you as promiscuous, and it is that kind of societal perception that you must be a bad person to have HIV.”
Director General of the Ghana AIDS Commission, Dr. Atuahene Prosper Kharmacelle
He pushed back firmly against the assumption that all individuals living with HIV must be promiscuous, explaining that the virus can be contracted through a single sexual encounter, even among individuals who are not promiscuous by nature, since sex remains a normal and universal part of human life.
Transmission Beyond Sexual Contact
Dr. Kharmacelle broadened the conversation beyond sexual transmission, noting that individuals can also contract HIV through blood-related exposures, including sharing needles during drug injection or other blood-to-blood contact.
He questioned why such individuals continue to face discrimination, arguing that the method of transmission should not determine how society treats a person living with the virus.
He was emphatic that this pervasive discrimination has driven many people to conceal their HIV status altogether, discouraging them from coming forward for testing, treatment, or support, largely out of fear of how they might be judged once their status becomes known.
Dr. Akanbong’s remarks collectively point to a broader appeal for the public to separate the science of HIV transmission and treatment from the moral judgments frequently attached to how the virus is contracted.
By emphasising that modern treatment renders the virus untransmittable when properly managed, he sought to reinforce the message that continued stigma against people living with HIV is both scientifically unfounded and socially harmful, discouraging open testing and treatment uptake that remains essential to achieving the 95-95-95 targets and Ghana’s broader public health goals around HIV epidemic control.
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