Characteristics Associated with HIV Drug Resistance Among Women Screening for an HIV Prevention Trial in KwaZulu-Natal, South Africa.
While the expansion of antiretroviral therapy (ART) in sub-Saharan Africa has reduced morbidity and mortality from HIV/AIDS, it has increased concern about drug resistance. The Microbicide Trials Network 009 study assessed the prevalence of drug-resistance mutations among women at clinical sites in Durban, South Africa who tested seropositive for HIV-1 at screening for the VOICE trial. The objective of this paper was to identify characteristics and behaviors associated with drug resistance. Factors found to be significantly associated with increased resistance were high perceived risk of getting HIV and prior participation in a microbicide trial, a likely proxy for familiarity with the health care system. Two factors were found to be significantly associated with reduced resistance: having a primary sex partner and testing negative for HIV in the past year. Other variables hypothesized to be important in identifying women with resistant virus, including partner or friend on ART who shared with the participant and being given antiretrovirals during pregnancy or labor, or the proxy variable-number of times given birth in a health facility-were not significantly associated. The small number of participants with resistant virus and the probable underreporting of sensitive behaviors likely affected our ability to construct a comprehensive profile of the type of HIV-positive women at greatest risk of developing resistance mutations.
Population Council, One Dag Hammarskjold Plaza, New York, USA. bmensch@popcouncil.org.
Barbara S
BS
Mensch
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
Pamina M
PM
Gorbach
Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Cliff
C
Kelly
HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa.
Photini
P
Kiepiela
FHI 360, Durham, NC, USA.
Kailazarid
K
Gomez
HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa.
Gita
G
Ramjee
HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa.
Shayhana
S
Ganesh
HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa.
Neetha
N
Morar
Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Lydia
L
Soto-Torres
Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Urvi M
UM
Parikh
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology
D019380:Anti-HIV Agents
HIV drug resistance; HIV-positive women screening for a prevention trial; KwaZulu-Natal