{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:09:55Z","timestamp":1791850195981,"version":"4.3.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T00:00:00Z","timestamp":1605484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Providence\/Boston Center for AIDS Research","award":["P30AI42853"],"award-info":[{"award-number":["P30AI42853"]}]},{"name":"Emerging Infectious Diseases Scholars Program","award":["R25AI140490"],"award-info":[{"award-number":["R25AI140490"]}]},{"name":"HIV Medicine Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Studies have demonstrated that persons with HIV (PWH) maintaining viral suppression do not transmit HIV to HIV-negative partners through condomless sex, leading to the \u201cUndetectable\u2005=\u2005Untransmittable (U\u2005=\u2005U)\u201d prevention campaign. However, few studies have examined the durability of suppression in the era of U\u2005=\u2005U.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study was conducted in Providence, Rhode Island. PWH aged \u226518 years with documented viral suppression (defined as at least 1 viral load [VL]\u2005&amp;lt;200 copies\/mL and no VL\u2005\u2265200 copies\/mL) in 2015 were included in the baseline cohort. Primary outcomes were viral suppression, viral rebound (at least 1 VL\u2005\u2265200 copies\/mL), or gap in VL monitoring assessed annually from 2016 to 2019. Those with viral rebound were assessed for resuppression within 6 months. Demographic and clinical characteristics associated with viral rebound or gaps in VL monitoring were investigated by bivariate analysis and logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1242 patients with viral suppression were included in the baseline cohort. In each follow-up year, 85%\u201390% maintained viral suppression, 2%\u20135% experienced viral rebound, and 8%\u201310% had a gap in VL monitoring. Among those with viral rebound, approximately one-half were suppressed again within 6 months. In the logistic regression models, retention in care was significantly associated with viral suppression, while younger age, black race, high school or equivalent education, non\u2013men who have sex with men, and history of incarceration were significantly associated with viral rebound.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In the U\u2005=\u2005U era, most patients with viral suppression who are retained in care are likely to maintain viral suppression over time. Some patients require additional support for regular VL monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa529","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T17:52:34Z","timestamp":1605549154000},"source":"Crossref","is-referenced-by-count":18,"title":["Evaluating HIV Viral Rebound Among Persons on Suppressive Antiretroviral Treatment in the Era of \u201cUndetectable Equals Untransmittable (U\u2005=\u2005U)\u201d"],"prefix":"10.1093","volume":"7","author":[{"given":"Sugi","family":"Min","sequence":"first","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fizza S","family":"Gillani","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"The Miriam Hospital, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Aung","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"The Miriam Hospital, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M","family":"Garland","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"The Miriam Hospital, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curt G","family":"Beckwith","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"The Miriam Hospital, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"2020122901402010600_CIT0001","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/jama.2016.5148","article-title":"Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy","volume":"316","author":"Rodger","year":"2016","journal-title":"JAMA"},{"key":"2020122901402010600_CIT0002","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1016\/S0140-6736(19)30418-0","article-title":"Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study","volume":"393","author":"Rodger","year":"2019","journal-title":"Lancet"},{"key":"2020122901402010600_CIT0003","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1016\/S2352-3018(18)30132-2","article-title":"Viral suppression and HIV transmission in serodiscordant male couples: an international, prospective, observational, cohort study","volume":"5","author":"Bavinton","year":"2018","journal-title":"Lancet HIV"},{"key":"2020122901402010600_CIT0004","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral therapy for the prevention of HIV-1 transmission","volume":"375","author":"Cohen","year":"2016","journal-title":"N Engl J Med"},{"key":"2020122901402010600_CIT0005","author":"Prevention Access Campaign"},{"key":"2020122901402010600_CIT0006","author":"Centers for Disease Control and Prevention"},{"key":"2020122901402010600_CIT0007","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1001\/jama.2018.21167","article-title":"HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable","volume":"321","author":"Eisinger","year":"2019","journal-title":"JAMA"},{"key":"2020122901402010600_CIT0008","author":"International AIDS Society","year":"2020"},{"key":"2020122901402010600_CIT0009","author":"UNAIDS","year":"2018"},{"key":"2020122901402010600_CIT0010","doi-asserted-by":"crossref","first-page":"376","DOI":"10.7326\/M17-2242","article-title":"HIV viral suppression trends over time among HIV-infected patients receiving care in the United States, 1997 to 2015: a cohort study","volume":"169","author":"Nance","year":"2018","journal-title":"Ann Intern Med"},{"key":"2020122901402010600_CIT0011","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/S2352-3018(17)30053-X","article-title":"Durability of viral suppression with first-line antiretroviral therapy in patients with HIV in the UK: an observational cohort study","volume":"4","author":"O\u2019Connor","year":"2017","journal-title":"Lancet HIV"},{"key":"2020122901402010600_CIT0012","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1001\/archpedi.159.8.764","article-title":"Longitudinal antiretroviral adherence among adolescents infected with human immunodeficiency virus","volume":"159","author":"Murphy","year":"2005","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2020122901402010600_CIT0013","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/QAI.0B013E31822D7564","article-title":"Clinical outcomes of adolescents and young adults in adult HIV care","volume":"58","author":"Ryscavage","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0014","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1097\/QAI.0000000000002308","article-title":"The HIV continuum of care for adolescents and young adults attending 13 urban US HIV care centers of the NICHD-ATN-CDC-HRSA SMILE Collaborative","volume":"84","author":"Kapogiannis","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0015","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/QAI.0b013e3181b98537","article-title":"Virologic response differences between African Americans and European Americans initiating highly active antiretroviral therapy with equal access to care","volume":"52","author":"Weintrob","year":"2009","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0016","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1093\/cid\/cit595","article-title":"Racial differences in response to antiretroviral therapy for HIV infection: an AIDS Clinical Trials Group (ACTG) study analysis","volume":"57","author":"Ribaudo","year":"2013","journal-title":"Clin Infect Dis"},{"key":"2020122901402010600_CIT0017","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1093\/cid\/cir491","article-title":"Incarceration predicts virologic failure for HIV-infected injection drug users receiving antiretroviral therapy","volume":"53","author":"Westergaard","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2020122901402010600_CIT0018","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/003335490512000114","article-title":"Effect of release from prison and re-incarceration on the viral loads of HIV-infected individuals","volume":"120","author":"Stephenson","year":"2005","journal-title":"Public Health Rep"},{"key":"2020122901402010600_CIT0019","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1001\/jama.2009.202","article-title":"Accessing antiretroviral therapy following release from prison","volume":"301","author":"Baillargeon","year":"2009","journal-title":"JAMA"},{"key":"2020122901402010600_CIT0020","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1007\/s10461-014-0917-6","article-title":"True durability: HIV virologic suppression in an urban clinic and implications for timing of intensive adherence efforts and viral load monitoring","volume":"19","author":"Benator","year":"2015","journal-title":"AIDS Behav"},{"key":"2020122901402010600_CIT0021","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/2325957416678929","article-title":"Retention in continuous care and sustained viral suppression","volume":"16","author":"Crawford","year":"2017","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"2020122901402010600_CIT0022","author":"Health Resources and Services Administration","year":"2013"},{"key":"2020122901402010600_CIT0023","author":"Dean","year":"2013"},{"key":"2020122901402010600_CIT0024","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1097\/00002030-200308150-00003","article-title":"Virological rebound after suppression on highly active antiretroviral therapy","volume":"17","author":"Mocroft","year":"2003","journal-title":"AIDS"},{"key":"2020122901402010600_CIT0025","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1097\/QAD.0b013e3281532ca7","article-title":"Increased duration of viral suppression is associated with lower viral rebound rates in patients with previous treatment failures","volume":"21","author":"Benzie","year":"2007","journal-title":"AIDS"},{"key":"2020122901402010600_CIT0026","author":"Department of Health and Human Services","year":"2019"},{"key":"2020122901402010600_CIT0027","doi-asserted-by":"crossref","first-page":"e25415","DOI":"10.1002\/jia2.25415","article-title":"HIV viral resuppression following an elevated viral load: a systematic review and meta-analysis","volume":"22","author":"Ford","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"2020122901402010600_CIT0028","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/tmi.12237","article-title":"Durable HIV RNA resuppression after virologic failure while remaining on a first-line regimen: a cohort study","volume":"19","author":"Hoffmann","year":"2014","journal-title":"Trop Med Int Health"},{"key":"2020122901402010600_CIT0029","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1093\/cid\/civ941","article-title":"Continuous retention and viral suppression provide further insights into the HIV care continuum compared to the cross-sectional HIV care cascade","volume":"62","author":"Colasanti","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2020122901402010600_CIT0030","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/QAI.0000000000000023","article-title":"Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts","volume":"65","author":"Yehia","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0031","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1089\/aid.2010.0268","article-title":"The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study","volume":"27","author":"Tripathi","year":"2011","journal-title":"AIDS Res Hum Retroviruses"},{"key":"2020122901402010600_CIT0032","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"2020122901402010600_CIT0033","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1001\/jamainternmed.2014.8180","article-title":"Human immunodeficiency virus transmission at each step of the care continuum in the United States","volume":"175","author":"Skarbinski","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2020122901402010600_CIT0034","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/QAI.0000000000000489","article-title":"Impact of age on retention in care and viral suppression","volume":"68","author":"Yehia","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0035","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1093\/infdis\/jir032","article-title":"Dose-response effect of incarceration events on nonadherence to HIV antiretroviral therapy among injection drug users","volume":"203","author":"Milloy","year":"2011","journal-title":"J Infect Dis"},{"key":"2020122901402010600_CIT0036","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/QAI.0000000000002240","article-title":"Brief report: accuracy in self-report of viral suppression among HIV-positive men with HIV-negative male partners","volume":"83","author":"Stephenson","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020122901402010600_CIT0037","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1007\/s10461-018-2112-7","article-title":"Discordance of self-report and laboratory measures of HIV viral load among young men who have sex with men and transgender women in Chicago: implications for epidemiology, care, and prevention","volume":"22","author":"Mustanski","year":"2018","journal-title":"AIDS Behav"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofaa529\/34324497\/ofaa529.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/7\/12\/ofaa529\/35224751\/ofaa529.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/7\/12\/ofaa529\/35224751\/ofaa529.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T06:40:59Z","timestamp":1609224059000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaa529\/5983412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,16]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaa529","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,11,16]]},"article-number":"ofaa529"}}