Socio-behavioural and community predictors of unsuppressed viral load: multi-level results from a hyper-endemic rural South African population.

Extensive anti-retroviral therapy scale-up is expected to prevent onward transmission of HIV by reducing the overall community viral load (VL). Despite countless studies about predictors of VL derived from clinical settings, to date, no study has established them in sub-Saharan Africa hyperendemic community settings that can inform population-based interventions designed to halt HIV transmission. We used one of Africa's largest population-based prospective cohorts in rural KwaZulu-Natal Province, South Africa, to establish for the first time the socio-demographic, behavioral and community predictors of unsuppressed VL.