Abstract
This study evaluates the level of knowledge and the influencing factors related to the U = U (undetectable = untransmittable) concept among residents of Henan Province, China, using an online questionnaire. Among 700 participants whose responses met the inclusion criteria-namely, completion time between 90 and 600 s, consistent answers, and IP addresses located in Henan Province-only 29.86% had a basic understanding of U = U. Many participants held misconceptions, such as believing that individuals who achieve U = U status can discontinue medication or are completely cured of HIV. Descriptive statistics and multivariate logistic regression were used to analyze the data. Multivariate analysis revealed that knowledge of U = U was significantly associated with age, education level, medical background, and sexual orientation. Younger participants, those with higher education, and those with medical training exhibited a better understanding of U = U. These findings highlight the urgent need for targeted health education initiatives, especially for older and less-educated populations, to improve awareness and reduce misinformation.