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Abstract
We established a statewide surveillance system in Oregon to monitor transmitted antiretroviral resistance using laboratory-reported HIV sequence data collected for clinical purposes. From 2007–2011, laboratories reported 49% of expected tests, increasing to 73% in 2011. Among newly diagnosed cases, 24.5% had resistance testing within three months of diagnosis. Overall, 17.3% had at least one resistance mutation, comparable to U.S. estimates, though nucleoside reverse transcriptase inhibitor resistance was significantly higher. This approach provides accurate estimates of transmitted resistance and offers a replicable, cost-efficient model for statewide HIV surveillance.