WHO recommends assessing whether antiretroviral therapy (ART) programmes are delivering services at the quality required, in order to minimize the emergence of HIV drug resistance. This assessment is achieved through the use of a set of standard quality-of-care indicators known as “early warning indicators” of HIV drug resistance. 

The early warning indicators use standardized definitions, which have evolved over time as programmes mature and public health actions are refined. The most up-to-date set of early warning indicators for HIV drug resistance are included in the WHO “Consolidated HIV strategic information guidelines” and the HIV drug resistance strategy, 2021 update:

1. Total attrition from ART
2. People living with HIV who have suppressed viral load
3. Viral load testing coverage 
4. Timely second viral load test
5. ARV medicine stock-out
6. ART adherence proxy (ARV refills)
7. Timely switch to second-line ART

WHO regularly produce a global report on HIV drug resistance threats, prevalence and trends, including early warning indicators of HIV drug resistance. Click here to see the reports.