Shen M, et al. - The target of reserchers was to evaluate the costs and benefits of initiating antiretroviral treatment (ART) earlier while expanding pre-exposure prophylaxis (PrEP) coverage among men who have sex with men (MSM) in San Francisco, taking into consideration the risk of drug resistance and high cost of second-line drugs. It was reported that high PrEP coverage with earlier ART yielded the greatest benefit but also entailed the highest costs among the strategies considered. This strategy appeared to be cost-effective for the San Francisco MSM population, even considering the acquisition and transmission of ART-mediated drug resistance. Without a notable rise in the San Francisco’s annual HIV budget, however, early initiation of ART could serve as the most advisable strategy, while maintaining current strategies of PrEP enrollment.