Abstract:
Objective: To analyze antiretroviral drug use and HIV drug resistance among HIVinfected MSM and transgender women who were screened for participation in the HIV
Prevention Trials Network 075 study.
Methods: A qualitative assay was used to detect 20 antiretroviral drugs in five drug
classes; this assay is based on liquid chromatography coupled with high-resolution
accurate-mass mass spectrometry. HIV viral load testing was performed using the
RealTime HIV-1 Viral Load Assay. HIV drug resistance testing was performed using the
ViroSeq HIV-1 Genotyping System. Logistic regression was used to evaluate factors
associated with study outcomes.
Results: Antiretroviral drugs were detected in 63 (34.4%) of 183 participants who had
confirmed HIV infection at screening; 11 (17.5%) of the 63 participants were not virally
suppressed. Six (54.5%) of the 11 participants had drug-resistant HIV, including four
who had multiclass resistance. Seven (63.6%) of the 11 were at risk of acquiring
resistance to additional antiretroviral drugs. In multivariate model, antiretroviral drugs
were more frequently detected in older participants, those recruited from Kisumu, Kenya,
and those who reported ever having been in HIV care or on antiretroviral therapy (ART).
Conclusion: Most of HIV-infected persons screened for participation in HIV Prevention
Trials Network 075 were not on ART, and many of those who were on ART were not
virally suppressed. Many of those participants had drug-resistant HIV. These findings
highlight the need for improved HIV care for African MSM and transgender women.