Single Measurement May Underestimate HIV Viral Suppression Interview with:
Dr. Nicole Crepaz PhD
Behavioral Scientist
Division of HIV/AIDS Prevention
CDC What is the background for this study?

Response: The most common measure of viral suppression in clinical and surveillance studies is the most recent viral load in past 12 months. This single-value measure does not capture the viral load dynamics over time. We examined durable viral suppression, never virally suppressed, and cumulative HIV burden (measured in the viremia copy-year) to help us better understand viral suppression and transmission risk potential. What are the main findings? What should readers take away from your report?

Response: Assessing durable viral suppression and never virally suppressed can better inform treatment response and potential for HIV transmission. Clinicians may benefit from close examination of a patient’s historical context of clinic attendance, missed visits, medication adherence and viral load patterns (e.g., instability, wide swings) in order to identify patients who may be at risk of not achieving or not maintaining durable viral suppression. Our finding also shows that some persons who seemed to have received regular care for HIV infection still had viral loads high enough to substantially increase transmission risk – pointing out the need for intensified efforts to ensure that effective care and treatment reach everyone who needs it. What recommendations do you have for future research as a result of this study?

Response: We found viral suppression to be particularly low among African American risk groups compared to other races/ethnicities. There are several possible explanations such differences in access to and use of health care and challenges in adhering to medications due to structural barriers like transportation and homelessness. However, it is not completely clear these factors completely explain the disparities. We do know strategies for these subpopulations may need to be tailored to the population — and even to a geographic area — for improvements in HIV care outcomes to be achieved. Thank you for your contribution to the community.


Viral Suppression Patterns Among Persons in the United States With Diagnosed HIV Infection in 2014
Nicole Crepaz, PhD; Tian Tang, MS; Gary Marks, PhD; H. Irene Hall, PhD
Published: Ann Intern Med. 2017;1-2.
DOI: 10.7326/L17-0278

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on August 9, 2017 by Marie Benz MD FAAD