HIV seroconversions and genotypic viral resistance profiles in the PrEP impact trial

Here we describe HIV seroconversion events in participants of the PrEP Impact trial.

Of 24 268 participants, we reviewed data for the 54 who were diagnosed with HIV during the trial; 11 at baseline.

Incidence was low for those diagnosed pre-pandemic at 0.13 per 100 person-years, and mainly linked to low self-reported adherence. The emergence of drug resistance in participants reporting recent oral PrEP (tenofovir disoproxil maleate with emtricitabine (TDF/FTC)) exposure was low (where analysis results are available, 21% of participants who seroconverted during trial participation showed drug resistance).

Oral PrEP TDF/FTC is an effective HIV prevention intervention. Further data are needed to assess the prevalence and impact of increasing oral PrEP TDF/FTC use on HIV resistance.