Population HIV viral load metrics for community health.

Abstract

Evidence linking HIV-1 RNA viral load and downstream HIV incidence is strong on both an individual and population level. The risk of HIV acquisition is higher from people with HIV who have high viral load levels compared with low viral load levels. In North American settings, rates of HIV incidence have tracked with viral suppression levels in people who have been diagnosed with HIV (ie, community viral load).1 Universal HIV test-and-treat trials done in sub-Saharan Africa between 2012 and 2018 show that expanding universal HIV testing and antiretroviral therapy (ART) delivery can substantially reduce population viral load, with concomitant reductions in HIV incidence.