Drug Resistance Is Unlikely to Increase Substantially from Use of ART Prevention Strategies

The same antiretroviral drugs are used for both HIV prevention and treatment, raising concerns about drug resistance. Using a mathematical model to simulate outcomes for antiretroviral therapy (ART) alone, preexposure prophylaxis (PrEP) alone, and combined ART and PrEP, researchers assessed the potential effects of these strategies on HIV transmission and drug resistance in South Africa.

During 10 years, ART alone (implemented at CD4 counts <200 cells/mm³) was projected to prevent 920,000 HIV infections (20% reduction), with a resistance prevalence of 6.6% (4.2% acquired resistance and 2.4% transmitted resistance). PrEP alone was projected to prevent 960,000 HIV infections (21% reduction), with a resistance prevalence of about 0.5%. Combined…