Optimizing HIV Treatment Initiation in the Context of Resistance in Mexico

Link to abstract here

In Mexico, resistance to first-line antiretroviral therapy (ART) is estimated to be 11%. The WHO recommends that countries initiate HIV patients on alternate ART regiments when resistance to standard first-line ART exceeds 10%. However, in Mexico, these alternate regimens are much more expensive. Routine resistance testing prior to initiating ART is an alternate approach. We evaluated the costs and benefits of different ART initiation strategies in light of drug resistance using a simulation model of HIV care and treatment in Mexico. We identify the optimal policy under current epidemiological conditions, as well as how the optimal policy changes as first-line ART resistance increases.