Estimating the prevalence and characterizing the HIV-1 transmitted drug resistance (TDR) are crucial for the prevention and control of HIV/AIDS. However, there are limited data currently on TDR among men who have sex with men (MSM) in Zhenjiang, Jiangsu, a high-risk population for drug resistance. We conducted a retrospective analysis among the newly diagnosed and antiretroviral therapy (ART)-naive HIV-1-infected MSM in Zhenjiang, 2012–2018. We analyzed the HIV-1 subtypes, TDR prevalence, TDR-associated mutations, and predicted drug sensitivity. Among these 192 participants, CRF01_AE (50.0%) and CRF07_BC (34.9%) were the predominant HIV-1 strains, with an increasing diversity of circulating subtypes (p < .05). A total of nine patients infected with CRF01_AE exhibited one or more TDR mutations, including 3.6% for Protease Inhibitor (PI)-related mutations, 1.0% for NRTI-related mutations and 1.0% for NNRTI-related mutations. The most common mutation was M46L/I for PIs. Notably, TDR prevalence showed an upward trend from 2012 to 2018, with an average of 4.7%. The gradually diversified subtypes, the increased TDR prevalence, and the potential risk of transmitting drug-resistant strains to the general population highlight the necessity of TDR monitoring in MSM. This will be beneficial for the prevention and control of HIV/AIDS in Zhenjiang.
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