The introduction of antiretroviral therapy in Trinidad and Tobago in the 1980s has resulted in a decrease in mortality of HIV-infected persons. Poor adherence to antiretroviral therapy (ART) has resulted in the development of multidrug resistant HIV. Resistance testing done on 40 samples showed that 64.8% of patients had K103 mutation, 75.6% of patients had M184 mutations and 62% of patients showed resistance to tenofovir suggesting that the K65R mutation was highly likely to be present. There was reduced activity to the protease inhibitors; no resistance was found to the protease inhibitor, darunavir. Thus, there is a need for salvage therapy to be introduced which will result in virologic suppression and potentially stop the spread of multidrug resistant HIV. Darunavir, a new generation protease inhibitor, is an essential part of salvage therapy and needs to be introduced into the national formulary.