ArticleAIDS (London, England)2019
Sociobehavioral and community predictors of unsuppressed HIV viral load: multilevel results from a hyperendemic rural South African population.
Article in AIDS (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence and factors associated with viral non-suppression in people living with HIV receiving antiretroviral therapy in sub-Saharan Africa: A systematic review and meta-analysis.Reviews in medical virology · 2024Pooled it
- Leveraging Smartphone Mobility Data to Understand HIV Risk Among Rural South African Young Adults: Feasibility Study.JMIR mHealth and uHealth · 2025Article
- Association between population viral load surrogate indicator and HIV transmission potential: a prospective cohort study in Xinjiang, China.BMC public health · 2025Article
- Viral load dynamics among adults receiving HIV care in rural North-Eastern South Africa, 2015-2020: insights from a population-based record linkage study.Frontiers in public health · 2025Article
- Article
- Viral load non-suppression among adolescents and youth living with HIV in South Africa.Southern African journal of infectious diseases · 2024Article
- The predictors of unsuppressed viremia among PLHIV: a cross-sectional study in Ghana.BMC public health · 2023Article
- From 'no problem' to 'a lot of difficulties': barriers to health service utilization among migrants in Rakai, Uganda.Health policy and planning · 2023Article
- Virological non-suppression among adult males attending HIV care services in the fishing communities in Bulisa district, Uganda.PloS one · 2023Article
- Syndemics of intimate partner violence among women in HIV endemic South Africa: geospatial analysis of nationally representative data.Scientific reports · 2022Article
- Spatiotemporal Variation and Predictors of Unsuppressed Viral Load among HIV-Positive Men and Women in Rural and Peri-Urban KwaZulu-Natal, South Africa.Tropical medicine and infectious disease · 2022Article
- Identifying Potential Factors Associated with High HIV viral load in KwaZulu-Natal, South Africa using Multiple Correspondence Analysis and Random Forest Analysis.BMC medical research methodology · 2022Article
- HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo.Southern African journal of HIV medicine · 2022Article
- Beyond HIV prevalence: identifying people living with HIV within underserved areas in South Africa.BMJ global health · 2021Article
- HIV incidence declines in a rural South African population: a G-imputation approach for inference.BMC public health · 2020Article
- Young people's experiences of sexual and reproductive health interventions in rural KwaZulu-Natal, South Africa.International journal of adolescence and youth · 2020Article
- Recording of HIV viral loads and viral suppression in South African patients receiving antiretroviral treatment: a multicentre cohort study.Antiviral therapy · 2020Article
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7 authors.
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Abstract
objectiveExtensive antiretroviral therapy scale-up is expected to prevent onward transmission of HIV by reducing the overall community viral load. Despite multiple studies about predictors of detectable viral load derived from clinical setting, to date, no study has established such predictors using a population-based viral load survey in a sub-Saharan African hyperendemic setting to inform interventions designed to halt HIV transmission. We used one of Africa's largest prospective cohorts in rural KwaZulu-Natal Province, South Africa, to establish the key sociodemographic, behavioral and community predictors of unsuppressed viral load at the population level.
methodsWe collected 5454 viral load measurements from a population-based viral load survey of 3892 women living with HIV from a rural population during 2011, 2013 and 2014. Multilevel logistic regression models were fitted to examine the risk predictors of unsuppressed viral load.
resultsAmong women living with HIV in this population, the prevalence of unsuppressed viral load was 69% in 2011, 58% in 2013 and 53% in 2014. Although time since HIV infection was associated with lower risk for virologic detection [adjusted odds ratio (aOR) = 0.91,0.87-0.94], young women (aOR = 2.59,1.47-4.55) with extensive external migration history (aOR = 1.25,1.02-1.54), greater number of sexual partners (aOR = 1.30,1.02-1.67), and longer history of residing in an HIV incidence hotspot community were more likely to experience unsuppressed viral load (aOR = 1.12,1.06-1.19).
conclusionYoung women, number of sexual partners, transiency and longer residence in an HIV hotspot community are important determinants of unsuppressed viral load in a hyperendemic rural African setting. To substantially reduce the persistently high transmission potential in these settings, targeted interventions to address these risk factors will be essential for both individual and population health gains.
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