Example:
Lopez, Michelle MD
Spanish
Try to delete the anchor element first and then insert the new one. It does not matter if it is there or not for the delete statement. I also provided a better way to build your new anchor element. It takes care of creating entities for characters like &.
-- Delete the anchor node from the XML
set @xml.modify('delete /root/StartOne/Value6/a');
-- Build the XML for the new anchor node
set @a = (
select @locTitle as 'a/@title',
@locUrl as 'a/@href',
'_blank' as 'a/@target',
@locTitle as 'a'
for xml path(''), type
);
-- Insert the new anchor node
set @xml.modify('insert sql:variable("@a") into (/root/StartOne/Value6)[1]');