High prevalence of undisclosed antiretroviral drug use among individuals initiating HIV treatment in Gaborone, Botswana

This study investigated how many people in Greater Gaborone, Botswana who were newly diagnosed with HIV and about to start treatment were already taking antiretroviral drugs (ARVs) without reporting it to clinicians or researchers. The team tested blood samples from people immediately after diagnosis for traces of four common ARV drugs, including dolutegravir, using a sensitive laboratory method. They found that about 30% of participants had detectable ARV drugs in their blood even though they had reported no prior use of HIV treatment. Most of these individuals had traces of dolutegravir, and a small number had very low or undetectable levels of virus, suggesting they may have been on treatment before and then stopped (defaulted) or were taking medication they didn’t disclose. Undisclosed ARV use was more common among non‑Botswana nationals and was linked with lower levels of HIV in the blood at diagnosis. These findings are important because undisclosed drug use can skew estimates of how many people are newly starting treatment, affect HIV incidence surveillance, and influence assessments of pre‑treatment drug resistance, which are key for planning public health strategies. The authors suggest that incorporating pre‑treatment drug screening into routine care and research could help ensure accurate treatment histories and better monitoring of the HIV epidemic.

Disclaimer: This lay summary was generated by AI and has not been approved by any of the authors yet.