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Using Latent Class Growth Analysis (LCGA) on a sample of 153 WLWH (1088 observations), three distinct trajectories of detectable VL (\u226550 copies\/ml) were identified: \u2018sustained low probability of detectable VL\u2019, characterized by high probability of long-term VL undetectability (51% of participants); \u2018 high probability of delayed viral undetectability\u2019, characterized by a high probability VL detectability at baseline that decreases over time (43% of participants); and \u2018 high probability of detectable VL\u2019, characterized by a high probability of long-term VL detectability (7% of participants). In multivariable analysis, incarceration (adjusted odds ratio (AOR)\u2009=\u20093.24; 95%CI:1.34\u20137.82), younger age (AOR\u2009=\u20090.96; 95%CI:0.92\u20131.00), and lower CD4 count (AOR\u2009=\u20090.82; 95%CI:0.72\u20130.93) were associated with \u2018 high probability of delayed viral undetectability\u2019 compared to \u2018sustained low probability of detectable VL.\u2019 This study reveals the dynamic and heterogeneous nature of WLWH\u2019s long-term VL patterns, and highlights the need for early engagement in HIV care among young WLWH and programs to mitigate the destabilizing impact of incarceration on WLWH\u2019s HIV treatment outcomes.<\/jats:p>","DOI":"10.1177\/0956462420965847","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T13:24:17Z","timestamp":1607606657000},"page":"322-330","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["HIV viral load trajectories of women living with HIV in Metro Vancouver, Canada"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2027-8862","authenticated-orcid":false,"given":"Putu","family":"Duff","sequence":"first","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"},{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Shannon","sequence":"additional","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"},{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Braschel","sequence":"additional","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flo","family":"Ranville","sequence":"additional","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Kestler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"},{"name":"BC Women\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Elwood Martin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"},{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Kr\u00fcsi","sequence":"additional","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"},{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Deering","sequence":"additional","affiliation":[{"name":"Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada"},{"name":"Faculty of Medicine, University of British Columbia, St. Paul\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"bibr1-0956462420965847","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081355"},{"key":"bibr2-0956462420965847","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67022-5"},{"key":"bibr3-0956462420965847","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60936-1"},{"key":"bibr4-0956462420965847","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b1649"},{"key":"bibr5-0956462420965847","doi-asserted-by":"publisher","DOI":"10.1086\/422601"},{"key":"bibr6-0956462420965847","unstructured":"UNAIDS.\n                      90\u201390\u201390 \u2013 An ambitious treatment target to help end the AIDS epidemic\n                      . 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