Time Spent with HIV Viral Load > 1500 Copies/mL Among Persons Engaged in Continuity HIV Care in an Urban Clinic in the United States, 2010–2015
Persons with HIV who have entered care but have viral load > 1500 copies/mL may be the source of the majority of new HIV infections in the United States. We followed patients engaged in continuity care in the Johns Hopkins HIV Clinical Cohort between January 2010 and August 2015. We estimated person-time spent with viral load > 1500 copies/mL while in care after antiretroviral therapy (ART) initiation, while in care, and while alive. Person-time was classified according to the most recent viral load measurement. Of 11,283.1 person-years in care on after ART initiation, 11,954.7 person-years in care and 13,990.0 total person-years of follow-up spent alive, 12.5, 14.8%, and between 12.6 and 27.2%, respectively (depending on assumptions about the viral load of persons lost to clinic) were spent with viral load > 1500 copies/mL. Patients with lower baseline CD4 cell count, younger age, black race, history of injection drug use, or baseline hazardous alcohol use spent more time with viral load > 1500 copies/mL after ART initiation.
KeywordsAdherence Antiretroviral therapy Prevention of sexual transmission Risk factors Viral load
This work was supported by the National Institutes of Health (U01 DA036935, U01 AA020793 and P30 AI094189).
Compliance with Ethical Standards
Conflicts of interest
The authors have no conflicts of interest to declare.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 25.90-90-90: an ambitious target to help end the AIDS epidemic. In: Joint United Nations Programme on HIV/AIDS (UNAIDS), editor. 2017.Google Scholar
- 27.Buchacz K, Mendoza M, Armon C, Palella FJ, Rose C, Tedaldi E et al. editors. Time spent with HIV viral load > 1500 copies/mL among patients in HIV care, 2000–2014. In: Conference on Retroviruses and Opportunistic Infections; 2017 February 13–16, Seattle; 2017.Google Scholar
- 40.Rothman KJ, Greenland S, Lash TL. Modern epidemiology. 3rd ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.Google Scholar