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Detectable viremia was defined as viral load (VL) &amp;gt;50 copies\/mL and further classified into low-level viremia (LLV; VL from 51 to 999 copies\/mL) and virologic failure (VF; VL \u22651000 copies\/mL). The rates of detectable viremia, LLV, and VF were stratified by year from 2017 to 2022 and mapped by districts in Botswana. Generalized estimating equation (GEE) models were utilized to evaluate odds of detectable viremia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was an overall trend of increasing detectable viremia, with rates of 6.7% (2017), 5.6% (2018), 4.7% (2019), 7.1% (2020), 13.5% (2021), and 11.2% (2022) (P &amp;lt; .001). The linear annual trend showed that each additional year from 2017 was associated with 23% increased odds of detectable viremia and 50% increase in the odds of LLV, while odds of VF decreased by 6% per year. Repeated-measures GEE models showed that male sex (adjusted odds ratio [aOR], 1.36 [95% confidence interval {CI}, 1.30\u20131.43]) and rural residence (aOR, 1.10 [95% CI, 1.05\u20131.16]) were consistently associated with higher odds of detectable viremia, LLV, and VF over follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While VF is declining, LLV is increasing. We observed spatial heterogeneity in detectable viremia, and higher odds in males, those with rural residence, and young individuals (18\u201335 years). Targeted interventions are necessary for high-risk groups and regions to further suppress viremia and achieve sustained epidemic control beyond the UNAIDS 95-95-95 targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag364","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:21:37Z","timestamp":1786360897000},"page":"373-384","source":"Crossref","is-referenced-by-count":0,"title":["Low-Level Viremia and Spatial Heterogeneity Among Individuals on Dolutegravir-Based Antiretroviral Therapy in Botswana: A Nationwide Study (2016\u20132022)"],"prefix":"10.1093","volume":"234","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8147-2193","authenticated-orcid":false,"given":"Ontlametse T","family":"Choga","sequence":"first","affiliation":[{"name":"Botswana Harvard Health Partnership Research Laboratory, , Gaborone ,","place":["Botswana"]},{"name":"Department of Medical Sciences, Faculty of Allied Health Professions, University of Botswana , Gaborone ,","place":["Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvifadzo","family":"Matsena-Zingoni","sequence":"additional","affiliation":[{"name":"Center for Biomedical Modeling, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7606-0569","authenticated-orcid":false,"given":"Wonderful T","family":"Choga","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership Research Laboratory, , Gaborone ,","place":["Botswana"]},{"name":"Department of Medical Sciences, Faculty of Allied Health Professions, University of Botswana , Gaborone ,","place":["Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5891-0461","authenticated-orcid":false,"given":"Goitseone M","family":"Lemogang","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership Research Laboratory, , Gaborone ,","place":["Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine K","family":"Koofhethile","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership Research Laboratory, , Gaborone ,","place":["Botswana"]},{"name":"Department of Immunology and Infectious Diseases, Harvard T.H. 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