{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:19:43Z","timestamp":1781932783028,"version":"3.54.5"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI136058"],"award-info":[{"award-number":["R01AI136058"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AI134359"],"award-info":[{"award-number":["K24AI134359"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30AI042853"],"award-info":[{"award-number":["P30AI042853"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Human immunodeficiency virus type 1 (HIV-1) acquired drug resistance (ADR) compromises antiretroviral therapy (ART).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We aggregated all HIV-1 protease\u2013reverse transcriptase\u2013integrase sequences over 2004\u20132021 at the largest HIV center in Rhode Island and evaluated ADR extent, trends, and impact using Stanford Database tools. Trends were measured with Mann-Kendall statistic, and multivariable regressions evaluated resistance predictors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sequences were available for 914 ART-experienced persons. Overall ADR to any drug decreased from 77% to 49% (\u22120.66 Mann-Kendall statistic); nucleoside reverse transcriptase inhibitors 65% to 32%, nonnucleoside reverse transcriptase inhibitors 53% to 43%, and protease inhibitors 28% to 7% (2004\u20132021), and integrase strand transfer inhibitors 16% to 13% (2017\u20132021). Multiclass resistance decreased from 44% to 12% (2-class) and 12% to 6% (3-class). In 2021, 94% had at least one 3-drug or 2-drug one-pill-once-daily (OPOD) option. Males and those exposed to more ART regimens were more likely to have \u22652-class resistance, and higher regimen exposure was also associated with fewer OPOD options.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Comprehensive analyses within a densely-sampled HIV epidemic over 2004\u20132021 demonstrated decreasing ADR. Continued ADR monitoring is important to maintain ART success, particularly with rising INSTI use in all lines of therapy and 2-drug and long-acting formulations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiae344","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T05:12:18Z","timestamp":1721452338000},"page":"1422-1433","source":"Crossref","is-referenced-by-count":4,"title":["Acquired Human Immunodeficiency Virus Type 1 Drug Resistance in Rhode Island, USA, 2004\u20132021"],"prefix":"10.1093","volume":"230","author":[{"given":"Su","family":"Aung","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Novitsky","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brown 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