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. 2016 Jun 16;3(3):ofw125. doi: 10.1093/ofid/ofw125

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© The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.

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Figure 4. — Prevalent drug-resistant cases after 10 years of pre-exposure prophylaxis (PrEP) scale-up. Panels show results of (A) optimistic and (B) conservative base-case scenarios. Optimistic (conservative) scenario assumptions were as follows: 90% (70%) PrEP efficacy, 80% (70%) PrEP reliability vs wild-type human immunodeficiency virus (HIV), 0%–50% relative efficacy vs rilpivirine-resistant HIV, 40% (70%) cross-resistance between antiretroviral treatment (ART) and PrEP, and successful (all) PrEP injections select drug-resistant HIV after breakthrough infection. In primary analysis, PrEP drug levels cleared when PrEP efficacy disappeared after 2 months (“Clear”); in secondary analysis, drug levels persisted for 3 (optimistic) or 6 (conservative) months, whereas efficacy disappeared after 2 months (“Persist”). Data are shown for 15% unprioritized and age-prioritized PrEP coverage. Abbreviations: ADR, acquired drug resistance; TDR, transmitted drug resistance.