Comparison of indicators measuring the proportion of human immunodeficiency virus-infected persons with a suppressed viral load.
OBJECTIVE
The Centers for Disease Control and Prevention uses the last viral load to estimate the proportion of human immunodeficiency virus (HIV)-infected persons with a suppressed viral load. Several recent studies report that it may overestimate viral suppression in the population and have suggested using sustained viral suppression. The objective of this analysis is to compare these indicators.


METHODS
Using New York City HIV surveillance data, two indicators were compared with a new one, weighted viral suppression, which accounts for both the status and duration of viral suppression.


RESULTS
Among 72,315 HIV-infected persons with at least one viral load measurement in New York City in 2013, 62,829 had at least one suppressed viral load, 58,041 had a suppressed last viral load, and 47,948 had sustained viral suppression. Compared with the weighted proportion (77.5%), the proportion based on last viral load suppression (80.3%) was slightly higher, and the proportion based on sustained viral suppression (66.3%) was substantially lower.


CONCLUSIONS
The indicator based on last viral load suppression is the most straightforward to calculate and understand and also approximates the weighted indicator, which measures viral suppression for the entire analysis period. Therefore, we support using the indicator based on last viral load suppression to monitor the National HIV/AIDS Strategy.
The New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, Long Island City, NY. Electronic address: qxia@health.nyc.gov.
Qiang
Q
Xia
The New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, Long Island City, NY.
Ellen W
EW
Wiewel
The New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, Long Island City, NY.
Sarah L
SL
Braunstein
The New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, Long Island City, NY.
Laura S
LS
Kersanske
The New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, Long Island City, NY.
Lucia V
LV
Torian
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D019562:Viral Load / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
Evaluation; HIV; Surveillance; Viral load