Objective To explore whether HIV-1 provirus DNA in peripheral blood of patients with HIV-1 low viral load (LVL) carries dominant drug-resistant mutations (DRMs), and the potential clinical significance of HIV-1 provirus DNA resistance detection. Methods The whole blood specimens of HIV-1 infected persons who received antiviral treatment in the outpatient department of a hospital for more than 6 months and plasma viral load (VL) of HIV-1 RNA was 50-1 000 copies/mL in two consecutive DNA genotype resistance detection between May 2020 and May 2021 were collected, HIV-1 pol gene was amplified by nested polymerase chain reaction (PCR) and Sanger sequencing, the sequence information was analyzed by Stanford University HIV resistance database. Results The dominant DRMs of HIV-1 provirus DNA in 26 LVL specimens with known pol region sequence were analyzed. It was found that 7 cases of HIV-1 provirus DNA carried dominant DRMs, including 1 case (3.85%) with nucleoside reverse transcriptase inhibitor (NRTIs) dominant DRMs, 4 cases (15.38%) with non-nucleoside reverse transcriptase inhibitor (NNRTIs) dominant DRMs, 1 case (3.85%) with protease inhibitor (PIs) dominant DRMs and 1 case with integrase inhibitor dominant DRMs. A total of 3 cases showed low to moderate drug resistance, 1 of which had low resistance to drugs in the current antiviral treatment scheme, and the rest were potentially drug-resistant. Conclusion There are dominant DRMs in peripheral blood HIV-1 provirus DNA of patients with HIV-1 LVL, suggesting that the detection of DNA resistance of HIV-1 provirus can provide certain reference for the formulation and adjustment of AIDS treatment scheme.