Using Molecular HIV Surveillance Data to Understand Transmission between Subpopulations in the United States
Published Date:Dec 1 2015
Source:J Acquir Immune Defic Syndr. 70(4):444-451.
Disease Transmission, Infectious
Intravenous Drug Users
Men Who Have Sex With Men
Pol Gene Products, Human Immunodeficiency Virus
Sequence Analysis, DNA
Pubmed Central ID:PMC4878401
Funding:CC999999/Intramural CDC HHS/United States
K01 AI110181/AI/NIAID NIH HHS/United States
K01AI110181/AI/NIAID NIH HHS/United States
Studying HIV transmission networks provides insight into the spread of HIV and opportunities for intervention. We identified transmission dynamics among risk groups and racial/ethnic groups in the United States.
For HIV-1 pol sequences reported to the U.S. National HIV Surveillance System during 2001–2012, we calculated pairwise genetic distance, identified linked pairs of sequences (those with distance ≤1.5%), and examined transmission category and race/ethnicity of these potential transmission partners.
Of 40,950 sequences, 12,910 (32%) linked to ≥1 other sequence. Of men who have sex with men (MSM) who linked to ≥1 sequence, 88% were linked to other MSM and only 4% were linked to heterosexual women. Of heterosexual women for whom we identified potential transmission partners, 29% linked to MSM, 21% to heterosexual men, and 12% to persons who inject drugs. Older and black MSM were more likely to be linked to heterosexual women. Assortative mixing was present for all racial/ethnic groups; 81% of blacks/African Americans linked to other blacks.
This analysis is the first use of U.S. surveillance data to infer an HIV transmission network. Our data suggest that HIV infections among heterosexual women predominantly originate from MSM, followed by heterosexual men. Although few MSM were linked to women, suggesting that a minority of MSM are involved in transmission with heterosexual women, these transmissions represent a substantial proportion of HIV acquisitions by heterosexual women. Interventions that reduce transmissions involving MSM are likely to also reduce HIV acquisition among other risk groups.
application/vnd.openxmlformats-officedocument.wordprocessingml.document application/octet-stream image/gif image/jpeg image/gif image/jpeg image/gif image/jpeg
You May Also Like: