In the era of dolutegravir, viral non-suppression should be rare; yet in South Africa it remains common, with rising levels of dolutegravir drug resistance among individuals with persistent viraemia. While clinicians have become better at identifying whether viraemia is due to adherence challenges or resistance, we remain far less effective at addressing why the person reaches this point. For many patients, persistent viraemia reflects not only biological failure, but also the cumulative impact of fragmented care, missed opportunities, and the realities of lifelong treatment.



This Friday’s talk will present real clinical cases to explore how a more person-centred approach to persistent viraemia could be helpful, examining how clinicians might move beyond guideline-based, algorithm-driven care to improve adherence, prevent resistance, and achieve more durable outcomes in routine practice.