The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71373

Matthew R Facer, PhD¹, Juan D. Ruiz, MD, DrPH¹, Richard Donovan, PhD², and Michele Ginsberg, MD³. (1) HIV/AIDS Epidemiology Branch, Office of AIDS, California Department of Health Services, 611 North 7th Street, Suite A, Sacramento, CA 95814, 916-323-7335, mfacer@dhs.ca.gov, (2) Viral and Rickettsial Disease Laboratory, California Department of Health Services, 850 Marina Bay Parkway, Richmond, CA 94804, (3) Division of Community Epidemiology, San Diego County HHSA, 1700 Pacific Highway Room 107, PO Box 85222, San Diego, CA 92186

Objectives: To estimate the prevalence of drug resistant HIV-1 strains in San Diego, California and Tijuana, Mexico, particularly among persons with no reported history of using antiretroviral therapy. Methods: Data from two studies were combined. San Diego was one of ten sites to participate in a national project that conducted sentinel surveillance for variant and drug-resistant strains of HIV-1 among newly infected, antiretroviral-naïve individuals during 1998-2000. The second data source was a target sample of Latino MSM aged 18-29 conducted in the Tijuana-San Diego area during 1999-2001 to assess HIV prevalence. In both studies a plasma sample was collected following the collection of demographic and risk information, and the HIV among those infected was sequenced. Results: For the drug-naïve San Diego sample, 2 out of 39 specimens showed primary mutations associated with resistance to both a protease inhibitor (PI) and reverse transcriptase (RT) inhibitor. Both specimens were from MSM. Of the 38 HIV-infected specimens from the binational young Latino MSM study, 8 showed primary drug mutations (2 with both PI and RT resistance; 5 with only RT resistance; and 1 with only PI resistance), and 2 of these 8 reported never using antiretroviral therapy. Conclusions: MSM in San Diego and Tijuana are infected with drug-resistant strains of HIV-1 and include individuals who have yet to initiate antiretroviral therapy. The public health impact encompasses the entire region, as MSM from each side of the border have reported having sex with both men and women from the other side of the border.

Learning Objectives:

At the end of the session, the participant (learner) in this session will be able to:
• Discuss the presence of drug resistant HIV strains among MSM in the region around San Diego, California and Tijuana, Mexico.
• Recognize the difference between the sampling schemes used in the two studies discussed.
• Describe in general terms why drug resistant strains of HIV are of concern with respect to public health and HIV/AIDS epidemiology, particularly in this geographic region.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.