{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T17:00:27Z","timestamp":1770570027911,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,21]],"date-time":"2024-07-21T00:00:00Z","timestamp":1721520000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>New South Wales (NSW) has one of the world's highest uptake rates of HIV pre\u2010exposure prophylaxis (PrEP). This uptake has been credited with sharp declines in HIV transmission, particularly among Australian\u2010born gay and bisexual men. Concerns have been raised around the potential for the emergence of tenofovir (TFV) and XTC (lamivudine\/emtricitabine) resistance in settings of high PrEP use. Such an emergence could also increase treatment failure and associated clinical outcomes among people living with HIV (PLHIV). Despite low levels of nucleoside reverse\u2010transcriptase inhibitor (NRTI) resistance relating to PrEP use in clinical settings, there are few published studies describing the prevalence of NRTI resistance among people newly diagnosed with HIV in a setting of high PrEP use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using HIV antiretroviral drug resistance data linked to NSW HIV notifications records of people diagnosed from 1 January 2015 to 31 December 2021 and with HIV attributed to male\u2010to\u2010male sex, we described trends in TFV and XTC resistance. Resistance was identified using the Stanford HIV Drug Resistance genotypic resistance interpretation system. To focus on transmitted drug resistance, resistance prevalence estimates were generated using sequences taken less than 3 months post\u2010HIV diagnosis. These estimates were stratified by timing of sequencing relative to the date of diagnosis, year of sequencing, birthplace, likely place of HIV acquisition, and stage of HIV at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1119 diagnoses linked to HIV genomes sequenced less than 3 months following diagnosis, overall XTC resistance prevalence was 1.3%. Between 2015 and 2021, XTC resistance fluctuated between 0.5% to 2.9% and was 1.0% in 2021. No TFV resistance was found over the study period in any of the sequences analysed. Higher XTC resistance prevalence was observed among people with newly acquired HIV (evidence of HIV acquisition in the 12 months prior to diagnosis; 2.9%, <jats:italic>p<\/jats:italic> = 0.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this Australian setting, TFV and XTC resistance prevalence in new HIV diagnoses remained low. Our findings offer further evidence for the safe scale\u2010up of PrEP in high\u2010income settings, without jeopardizing the treatment of those living with HIV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26308","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T05:34:15Z","timestamp":1721626455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Low HIV drug resistance prevalence among recently diagnosed HIV\u2010positive men who have sex with men in a setting of high PrEP use"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9086-5929","authenticated-orcid":false,"given":"Jonathan M","family":"King","sequence":"first","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-4095","authenticated-orcid":false,"given":"Francesca Di","family":"Giallonardo","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ansari","family":"Shaik","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Skye","family":"McGregor","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie Yuek Kee","family":"Yeung","sequence":"additional","affiliation":[{"name":"New South Wales State Reference Laboratory \u2010 HIV\/AIDS St Vincent's Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tharshini","family":"Sivaruban","sequence":"additional","affiliation":[{"name":"New South Wales Health Pathology\u2010ICPMR Westmead Hospital  Westmead Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick J","family":"Lee","sequence":"additional","affiliation":[{"name":"New South Wales Health Pathology\u2010RPA, Royal Prince Alfred Hospital  Camperdown Australia"},{"name":"Department of Clinical Immunology and Allergy Royal Prince Alfred Hospital  Camperdown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Cunningham","sequence":"additional","affiliation":[{"name":"New South Wales State Reference Laboratory \u2010 HIV\/AIDS St Vincent's Hospital  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic E","family":"Dwyer","sequence":"additional","affiliation":[{"name":"New South Wales Health Pathology\u2010ICPMR Westmead Hospital  Westmead Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J","family":"Nigro","sequence":"additional","affiliation":[{"name":"Health Protection NSW NSW Ministry of Health Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew E","family":"Grulich","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony D","family":"Kelleher","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,21]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"KingJ McManusH KwonA GrayR McGregorS.HIV viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2023 [Internet]. The Kirby Institute UNSW Sydney Sydney Australia;2023. Accessed 9 March 2024. Available from:http:\/\/handle.unsw.edu.au\/1959.4\/unsworks_81131"},{"key":"e_1_2_10_3_1","unstructured":"UNAIDS.Fast\u2010track ending the AIDS Epidemic by 2030 UNAIDS World AIDS Day report 2014.2014. Accessed 9 March 2024. Available from:https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/JC2686_WAD2014report_en.pdf"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00112-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002797"},{"key":"e_1_2_10_6_1","unstructured":"BroadyT CarnaE RanceJ LaffertyL BrenerL TreloarC et\u00a0al.Annual report of trends in behaviour 2023: HIV\/STIs and sexual health in Australia. Centre for Social Research in Health UNSW Sydney;2023. 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