This study examined 51 patients who underwent bariatric surgery between 2004 and 2022 in the Netherlands.  Median age at surgery was 46 years and 55% were women; 76% underwent gastric bypass and 24% had sleeve gastrectomy.  Median weight and BMI pre-procedure were 121kg and 39.8kg/m².  43/51 (84%) had VL < 40 at baseline.  49% were on a INSTI + 2 NRTI combination, with 29% using DTG as their anchor.  Of these 43 people, only one person (who was receiving a three-class regimen) developed virologic failure eight months post-surgery; this was attributed to non-adherence.  Three people with undetectable VL at baseline developed blips after 6-7 months.  The three people on dual therapy remained suppressed over the 18-month follow-up period.  89% achieved >20% loss of baseline weight, and lipid profiles improved significantly.  There were 24 ART modifications among 21 patients, mostly for routine reasons (e.g., desire for treatment simplification, pregnancy, other).  One person modified therapy due to persistent low-level viremia.  Twelve people stopped all their non-HIV medications and approximately half stopped their antihypertensive or antihyperlipidemic medications; 75% stopped their antidiabetic medications.  Plasma concentration testing found adequate/therapeutic exposure for elvitegravir, dolutegravir, emtricitabine, and tenofovir (TDF and TAF); darunavir/ritonavir results were mixed.  There was no significant difference in weight reduction among people who continuously took INSTI without TAF, or INSTI plus TAF vs. non-INSTI/non-TAF regimens.