García-Payá E, et al. - Given the lack of data regarding the protective effect of ART in MSM, researchers characterized the factors associated with persistent HIV-1 RNA rectal shedding in this prospective study including virologically suppressed MSM from an HIV cohort. Virologically suppressed MSM showed a high prevalence of HIV-1 RNA rectal shedding. In addition to ART and the immune system integrity, local factors, including the co-existence of high-grade anal intraepithelial neoplasia and the burden of sexually transmitted infections, may account for the persistence of HIV-1 RNA shedding in rectal mucosa.