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Healthcare providers are uniquely positioned to disseminate the U\u2009=\u2009U message. Our study explored patient-provider communication about U\u2009=\u2009U and HIV risk from the perspectives of gay, bisexual, and other men living with HIV (MLHIV) and healthcare providers engaged in HIV treatment and prevention service delivery. We conducted 40 semi-structured interviews with key informants recruited through HIV community-based and professional organizations in Australia (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920) and the US (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200920). Key informants included 20 MLHIV and 20 providers. Data were analyzed thematically. MLHIV were cisgender men aged 29\u201367 years (M[SD]\u2009=\u200952[13.1]). Providers were cisgender adults aged 30\u201365 years (M[SD]\u2009=\u200938[9.0]). MLHIV preferred that providers use clear and direct language to explain U\u2009=\u2009U. When prompted to explain U\u2009=\u2009U as they would to patients, 8 of 10 Australian and 4 of 10 US providers used language consistent with those preferences. MLHIV, especially US MLHIV, reported that their providers\u2019 explanation of the U\u2009=\u2009U message was often absent, ambiguous, or inaccurate in practice. Such suboptimal communication aligned with the skepticism about U\u2009=\u2009U and concerns about patient behavior (e.g., adherence) expressed by several providers in the study. Providers relayed multiple reservations regarding new World Health Organization recommendations about informing patients that low-level viremia (detectable viral load\n                    <jats:inline-formula>\n                      <jats:tex-math>$$\\leq$$<\/jats:tex-math>\n                    <\/jats:inline-formula>\n                    1000 copies\/mL) conferred \u201calmost zero\u201d risk. Many Australian and US providers would benefit from training developed in collaboration with people living with HIV to improve patient-provider communication about U\u2009=\u2009U and HIV transmission risk.\n                  <\/jats:p>","DOI":"10.1007\/s10461-025-04783-y","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T10:51:00Z","timestamp":1751539860000},"page":"3367-3386","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Suboptimal Patient-Provider Communication About Undetectable\u2009=\u2009Untransmittable and HIV Transmission Risk in Australia and the US"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-0208","authenticated-orcid":false,"given":"Sarah K.","family":"Calabrese","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Holt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Kalwicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justino J.","family":"Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaosisochukwu C.","family":"Onochie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin R.","family":"Bavinton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Haire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony K. 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Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study. Lancet HIV. 2018 Aug;5(8):e438-e447.","DOI":"10.1016\/S2352-3018(18)30132-2"},{"issue":"9","key":"4783_CR3","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1056\/NEJMoa1600693","volume":"375","author":"MS Cohen","year":"2016","unstructured":"Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med. 2016;375(9):830\u20139.","journal-title":"N Engl J Med"},{"issue":"10189","key":"4783_CR4","doi-asserted-by":"publisher","first-page":"2428","DOI":"10.1016\/S0140-6736(19)30418-0","volume":"393","author":"AJ Rodger","year":"2019","unstructured":"Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O, et al. 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MH is an Associate Editor of AIDS and Behavior. SKC and BR received indirect compensation and support for travel expenses from Gilead Sciences and ViiV Healthcare for coordination of a U\u2009=\u2009U research forum. BRB has received honoraria, support for travel expenses, and unrestricted research grants from Gilead Sciences and ViiV Healthcare. CT has received speaker fees from Gilead Sciences. BR is the founder of the U\u2009=\u2009U movement and Prevention Access Campaign, the website for which is cited in connection to the U\u2009=\u2009U movement and supplemental resources. The authors have no other relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Study procedures were approved by the Human Research Ethics Committee of the University of New South Wales (#HC220734) and the Office of Human Research of the George Washington University (#NCR224429) prior to implementation. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and in later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Verbal informed consent was obtained from all study participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Participants were notified of the authors\u2019 intent to publish study results as part of the consent process.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}]}}