DISCUSSION
HIV infection, infections
HIV INFECTION, INFECTIONS
To our knowledge, this report presents the first large‐scale, multisite, population‐level study evaluating the prevalence of viraemic control and associated factors in Africa. The study was conducted in a generalized epidemic setting in two sub‐Saharan African countries and included men and women from urban and peri‐urban communities. Using the controller definition described in this report, we identified 126 viraemic controllers and 766 non‐controllers who were not on ART. An advantage of this study was that a biomedical assessment was used to assess ARV drug use. This assay detects 22 drugs in five classes, including those recommended for ART in the study countries at the time the trial was performed. Previous studies have demonstrated that self‐report of ART can be unreliable, as some participants in clinical trials and research studies may not accurately report their ART status [The prevalence of viraemic controllers identified in this report (3.1%) is similar to results from population‐level studies conducted in the United Kingdom (2.7%) [In the Department of Defense study noted above, viraemic control was not associated with biological sex [In the HPTN 071 cohort, viraemic control was more common in South Africa than in Zambia, although these findings were not statistically significant. Previous studies found above‐average rates of HIV control in South Africa, ranging from 5.6% in a cohort of young women [This study had several limitations. First, high rates of ARV drug use limited our ability to identify controllers. This study used VL and ARV drug data that were obtained in a prior study 2 years after the start of the study intervention. More participants may have met the criteria for viraemic control if testing had been performed at the study entry. For this reason, our estimated prevalence of 3.1% should be considered a minimum estimate. Second, HPTN 071 included a disproportionate number of women and was conducted in Zambia and South Africa, where almost all infections are caused by HIV subtype C. In a prior study, we performed HIV genotyping and subtyping for a subset of 758 participants in HPTN 071; 95.9% of those participants had subtype C HIV infection [