{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:13:50Z","timestamp":1787163230940,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA032106"],"award-info":[{"award-number":["R01DA032106"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI129659"],"award-info":[{"award-number":["K23AI129659"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007813","name":"Center for AIDS Research, University of Washington","doi-asserted-by":"publisher","award":["2P30\u2010AI027757"],"award-info":[{"award-number":["2P30\u2010AI027757"]}],"id":[{"id":"10.13039\/100007813","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001117","name":"amfAR, The Foundation for AIDS Research","doi-asserted-by":"publisher","award":["109071\u201057\u2010HGMM"],"award-info":[{"award-number":["109071\u201057\u2010HGMM"]}],"id":[{"id":"10.13039\/100001117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Transmitted, or any pretreatment drug resistance (TDR, PDR) can compromise efficacy of first\u2010line antiretroviral therapy (ART). In Peru, genotypic resistance testing is not routinely performed before ART initiation, and estimated PDR prevalence prior to 2012 ranged from 1.0% to 4.7%. We aimed to update estimates of PDR prevalence in men who have sex with men (cis\u2010MSM) and transgender women (TW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We obtained HIV sequences from three studies of ART\u2010na\u00efve cisgender\u2010MSM and TW (n\u00a0=\u00a0470) in Lima, Peru from 2013 to 2017, almost two\u2010thirds of whom had acute or recent infections. Sanger sequences of HIV\n                      <jats:italic>pol<\/jats:italic>\n                      were interrogated for surveillance drug resistance mutations (SDRM) using the Stanford Calibrated Population Resistance (CPR) tool and scored for resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non\u2010nucleoside reverse transcriptase inhibitors (NNRTIs) with the HIVdb programme. We calculated binomial proportions and 95% confidence intervals. \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      and exact or trend tests were used to examine predictors of PDR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010seven (16.4%) individuals had PDR (95% CI: 13.2 to 20.0); most resistance was likely TDR since 63% were incident infections. SDRM were present in 9.8% (7.3 to 12.9). Resistance to any NRTI was present in &lt;1% of individuals, while efavirenz resistance was present in 10% (6.9% to 12.4%). TW were not statistically more likely than cis\u2010MSM to have PDR (11.4% vs. 9.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.54). Age, incident versus prevalent infection, or residence district did not predict PDR. Prevalence of SDRM increased from 3% in 2013 to 21% 2017 within incident infections (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04), but not when including prevalent infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prevalence of NNRTI resistance in three studies of ART\u2010na\u00efve MSM and TW in Lima, Peru reaches 10%. Because our study reports PDR in a population in which most acquired HIV recently, the overall prevalence of PDR, including previously treated persons, is likely underestimated. These results underscore the need for a nationally representative survey of PDR in Peru and consideration of non\u2010NNRTI anchored first\u2010line ART options. This study also represents the first evaluation of PDR in cis\u2010MSM versus TW in South America, and demonstrates that, although TW are at higher risk of acquiring HIV, they are at similar risk of acquiring a virus with resistance mutations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25411","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T03:39:56Z","timestamp":1574825996000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["HIV pretreatment drug resistance among cisgender MSM and transgender women from Lima, Peru"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1356-9178","authenticated-orcid":false,"given":"William L","family":"Trebelcock","sequence":"first","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier R","family":"Lama","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Civil Impacta Salud y Educaci\u00f3n Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Duerr","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"},{"name":"Fred Hutchinson Cancer Research Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Epicentro Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robinson","family":"Cabello","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n V\u00eda Libre Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trupti","family":"Gilada","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle WA USA"},{"name":"Unison Medicare and Research Centre Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Segura","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Civil Impacta Salud y Educaci\u00f3n Lima Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-4746","authenticated-orcid":false,"given":"Sari L","family":"Reisner","sequence":"additional","affiliation":[{"name":"Harvard University Boston MA USA"},{"name":"The Fenway Institute Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7460-733X","authenticated-orcid":false,"given":"Kenneth H","family":"Mayer","sequence":"additional","affiliation":[{"name":"Harvard University Boston MA USA"},{"name":"The Fenway Institute Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Mullins","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6167-1447","authenticated-orcid":false,"given":"Rachel A","family":"Bender Ignacio","sequence":"additional","affiliation":[{"name":"University of Washington Seattle WA USA"},{"name":"Fred Hutchinson Cancer Research Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Fact sheet \u2010 Latest global and regional statistics on the status of the AIDS epidemic. 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