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We examined clinical factors and their associations with KS rates among MWH in North America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among MWH in the North American AIDS Cohort Collaboration on Research and Design, we estimated annual KS rates (per 100 000 person-years [PY]) by viral suppression (&amp;lt;200\u2005copies\/mL), CD4 count (&amp;lt;500 vs \u2265500\u2005cells\/mm3), and time since ART initiation (&amp;lt;1 year\/naive vs \u22651 year) from 2009\u20132019. We quantified associations between clinical factors and KS rates using negative binomial regression, estimating incidence rate ratios (IRRs) with 95% CIs. Among MWH with KS, we estimated average annual percentage changes (AAPCs) in clinical factor distribution using joinpoint regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 61 155 MWH (370 624 PY) contributing 262 KS diagnoses. KS decreased from 132 to 43 cases per 100 000 PY between 2009 and 2019. Viral suppression (IRR2009: .09 [95% CI: .04\u2013.20]; IRR2019: .69 [.31\u20131.54]), recent\/no ART initiation (IRR2009: .14 [.07\u2013.30]; IRR2019: 1.16 [.53, 2.56]), and CD4 count \u2265500\u2005cells\/mm3 (IRR2009: .13 [.05\u2013.31]; IRR2019: .44 [.18\u20131.10]) were associated with reduced KS rates, attenuating over time. Unsuppressed viral load at KS diagnosis decreased by 10.6% (\u221215.8%, \u22124.8%) as did those on ART \u22641 year\/naive (70%\u201340%; AAPC: \u20136.3% [\u221213.8%, 2.1%]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings underscore the importance of early HIV diagnosis\/treatment in reducing KS burden. Attenuating associations with HIV factors indicate that those successfully managing HIV increasingly represent KS patients. KS drivers are evolving, requiring patient\/population-level monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf446","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T11:59:27Z","timestamp":1755172767000},"page":"e68-e77","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Predictors and Incidence of Kaposi Sarcoma Among Males With HIV in the Treat-All Era in the United States and Canada"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6423-1137","authenticated-orcid":false,"given":"Sally B","family":"Coburn","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9322-1395","authenticated-orcid":false,"given":"Michael 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