We assessed virological outcomes of rilpivirine use in France from 2012 to 2017, in three groups of people living with HIV (PLHIV):(1) antiretroviral (ARV)-naïve PLHIV;(2) ARVexperienced PLHIV switching to rilpivirine while failing therapy; and (3) ARV-experienced PLHIV switching to rilpivirine while virologically controlled. Methods: Virological success (VS) was defined as a plasma HIV-1 viral load (VL)<50 copies/mL and virological failure (VF) as two consecutive VL>50 copies/mL or one VL>50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering rilpivirine discontinuation, loss to follow-up, and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results: Among the 2166 ARV-naïve PLHIV initiating rilpivirine, the four-year cumulative incidence of VS was 91.0% and was associated with baseline VL. Among the 2125 ARVexperienced PLHIV switching to rilpivirine while failing therapy, the four-year cumulative incidence of VS was 82.5% and was associated with lower VL, higher CD4, and less than three prior ARVs. Among the 11828 ARV-experienced PLHIV switching to rilpivirine while virologically controlled, the four-year cumulative incidence of VF was 9.6%. The risk of VF was lower among MSM, for PLHIV with CD4≥500/mm 3 , without a prior AIDS event, or with a longer VL suppression at baseline. Conclusion: Rilpivirine-containing regimens yielded high rates of viral suppression in most participants, while it was ineffective when used outside the marketing authorization in naïve participants.