Virologic non-suppression and HIV drug resistance among people who inject drugs and their sexual and injecting partners in Kenya.

We evaluated the prevalence and correlates of HIV viral non-suppression and HIV drug resistance (HIV-DR) in a cohort of people who inject drugs living with HIV (PWID-LH) and their sexual and injecting partners living with HIV in Kenya. HIV-DR testing was performed on participants with viral non-suppression. Of 859 PWID-LH and their partners, 623 (72.5%) were on antiretroviral therapy (ART) ≥4 months and 148/623 (23.8%) were not virally suppressed. Viral non-suppression was more common among younger participants and those on ART for a shorter duration. Among 122 (82.4%) successfully sequenced samples, 55 (45.1%) had detectable major HIV-DR mutations, mainly to non-nucleoside and nucleotide reverse transcriptase inhibitors (NNRTI, NRTI). High levels of HIV-DR among those with viral non-suppression suggests need for viral load monitoring, adherence counselling, and timely switching to alternate ART regimens in this key population.