New York State Department of Health, Albany, NY, USA.
United States Public Health Service, Washington, USA.
AIDS Behav. 2021 Jul;25(7):2259-2265. doi: 10.1007/s10461-020-03154-z. Epub 2021 Jan 13.
The "Undetectable = Untransmittable" campaign indicates that persons living with Human Immunodeficiency Virus (HIV) who maintain a suppressed viral load cannot sexually transmit the virus. However, there is little knowledge of the percent of individuals at a population level who sustain viral suppression long term. The aims of this study were to: (1) establish a baseline of persons living with diagnosed HIV who resided in New York and had consecutive suppressed viral load tests; (2) describe the risk of virologic failure among those who were consecutively suppressed; and (3) gain an understanding of the length of time between consecutive viral suppression to virologic failure. A total of 102,339 New Yorkers aged 13-90 years were living with diagnosed HIV at the beginning of 2012; 47.9% were consecutively suppressed (last two HIV viral load test results from 2010-2011 that were < 420 days apart and < 200 copies/mL). Of consecutively suppressed individuals, 54.3% maintained viral suppression for the entire study period and 33.6% experienced virologic failure during the study period. Among persons who experienced virologic failure, 82.6% did so six or more months after being consecutively suppressed. Our findings support the need for ongoing viral load monitoring, adherence support, and ongoing risk reduction messaging to prevent forward HIV transmission.
“检测不到=不传播”运动表明，病毒载量受到抑制的艾滋病毒感染者不会通过性行为传播病毒。然而，对于在人群水平上有多少个体能够长期维持病毒抑制知之甚少。本研究的目的是：（1）确定居住在纽约且连续两次病毒载量检测受到抑制的艾滋病毒感染者的基线人数；（2）描述那些连续抑制的人发生病毒学失败的风险；（3）了解连续抑制与病毒学失败之间的时间间隔。在 2012 年初，共有 102339 名年龄在 13-90 岁的纽约人被诊断为艾滋病毒感染者；其中 47.9%的人连续受到抑制（最后两次 HIV 病毒载量检测结果来自 2010-2011 年，间隔时间不到 420 天，且病毒载量低于 200 拷贝/mL）。在连续受到抑制的人群中，54.3%的人在整个研究期间维持病毒抑制，33.6%的人在研究期间发生病毒学失败。在发生病毒学失败的人群中，82.6%的人在连续受到抑制后 6 个月或更长时间出现病毒学失败。我们的研究结果支持需要进行持续的病毒载量监测、依从性支持和持续的风险降低信息传递，以防止艾滋病毒的进一步传播。
