title: Durable Viral Suppression and Transmission Risk Potential Among Persons With Diagnosed HIV Infection: United States, 2012-2013.
abstract: We examined durable viral suppression, cumulative viral load (VL) burden, and transmission risk potential among human immunodeficiency virus (HIV)-diagnosed persons in care.
  
  
  
  Using data from the National HIV Surveillance System from 17 jurisdictions with complete reporting of VL test results, we determined the percentage of persons in HIV care who achieved durable viral suppression (all VL results <200 copies/mL) and examined viremia copy-years and time spent above VL levels that increase the risk of HIV transmission during 2012-2013.
  
  
  
  Of 265 264 persons in HIV care in 2011, 238 641 had at least 2 VLs in 2012-2013. The median number of VLs per individual during the 2-year period was 5. Approximately 62% had durable viral suppression. The remaining 38% had high VL burden (geometric mean of viremia copy-years, 7261) and spent an average of 438 days, 316 days, and 215 days (60%, 43.2%, and 29.5% of the 2-year period) above 200, 1500, and 10 000 copies/mL. Women, blacks/African Americans, Hispanics/Latinos, persons with HIV infection attributed to transmission other than male-to-male sexual contact, younger age groups, and persons with gaps in care had higher viral burden and transmission risk potential.
  
  
  
  Two-thirds of persons in HIV care had durable viral suppression during a 2-year period. One-third had high VL burden and spent substantial time above VL levels with increased risk of onward transmission. More intervention efforts are needed to improve retention in care and medication adherence so that more persons in HIV care achieve durable viral suppression.
authors.affiliation: Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention.
authors.forename: Nicole
authors.initials: N
authors.lastname: Crepaz
authors.affiliation: ICF International, Atlanta, Georgia.
authors.forename: Tian
authors.initials: T
authors.lastname: Tang
authors.affiliation: Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention.
authors.forename: Gary
authors.initials: G
authors.lastname: Marks
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of Alabama, Birmingham.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.affiliation: Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention.
authors.forename: Lorena
authors.initials: L
authors.lastname: Espinoza
authors.affiliation: Division of HIV/AIDS Prevention, US Centers for Disease Control and Prevention.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D000072230:Sustained Virologic Response; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV transmission risk; HIV-diagnosed persons; disparity; durable viral suppression; viral burden