In vitro data suggests paclitaxel has inducing properties and therefore has the potential to lower the exposure of integrase inhibitors due to CYP3A4 and UGT1A1 induction. However, the clinical relevance has not been evaluated. This study evaluated retrospectively the virological outcomes in 25 people living with HIV on integrase inhibitors-based combination antiretroviral therapy and receiving paclitaxel as second line treatment for Kaposi Sarcoma. Therapeutic drug monitoring (TDM) was performed for two subjects. Viral loads were analyzed at baseline, 6 and 12 months pre- and post-paclitaxel treatment. Participants were on dolutegravir (n=8), raltegravir (n=9), bictegravir (n=6) and long-acting injectable cabotegravir (n=2) based antiretroviral treatments. Virological suppression was observed at baseline in 88% of the participants (non-suppression was mainly due to adherence issues). At 6 months, 88% of participants had an undetectable viral load. TDM was performed in two participants on raltegravir 1200 mg once daily with emtricitabine/tenofovir disoproxil and bictegravir with emtricitabine/tenofovir alafenamide. Trough concentrations were measured on the day prior, 2 days post-, and 14 days post-paclitaxel administration. Raltegravir trough levels before (199 ng/mL) and after (210 ng/mL) paclitaxel administration were similar. The trough level 14 days post-paclitaxel dose was lower (55 ng/mL) but still within the range of concentrations reported in the literature. Bictegravir trough level after paclitaxel (2728 ng/mL) was almost half of that before the dose administration (5083 ng/mL). However, 14 days post-paclitaxel trough level (5527 ng/mL) was comparable to the pre-dose level. All levels were higher than the observed trough of 2610 ng/mL. Both participants remained virologically suppressed. The TDM data suggest that paclitaxel has a transient inducing effect explained by paclitaxel’s short half-life and intermittent dosing (paclitaxel is generally administered every three weeks). Importantly, all measured trough concentrations remained above the protein adjusted IC90 of raltegravir and bictegravir. Overall, paclitaxel did not compromise integrase inhibitors efficacy with failures attributable to non-pharmacological reasons. The authors conclude that these findings support co-administration of paclitaxel with standard dose of oral integrase inhibitors triple based regimens. More data are needed for long acting injectable cabotegravir/rilpivirine and oral integrase based two drug regimens where resistance may differ.