In a new paper in Proceedings of the Royal Society B, we investigated under what circumstances earlier initiation of antiretroviral therapy could decrease both the number of total new HIV infections and of new drug-resistant HIV infections amongst men who have sex with men (MSM) in San Francisco. Using a transmission model fit to data from this population, we find that this goal occurs when the second-line drug effectiveness (combination of resistance monitoring, biomedical drug efficacy, and adherence) exceeds 80%. However, these dual decreases in the number of new infections may misleadingly and seemingly paradoxically be accompanied by an increase in the proportion of new infections that are drug resistant. This work was led by Mingwang Shen, a PhD student visiting from Xi’an Jiaotong University, in close collaboration with Steve during Mingwang’s 2 year scholar exchange in Lauren Ancel Meyers’ Lab at The University of Texas at Austin.
Shen M, Xiao Y, Rong L, Meyers LA, and Bellan SE (2017). Early antiretroviral therapy and potent second-line drugs could decrease HIV incidence of drug resistance. Proc R Soc B. (postprint PDF, journal PDF) (Appendix)