scholarly journals Increasing Capacity to Detect Clusters of Rapid HIV Transmission in Varied Populations—United States

Viruses ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 577
Author(s):  
Alexandra M. Oster ◽  
Nivedha Panneer ◽  
Sheryl B. Lyss ◽  
R. Paul McClung ◽  
Meg Watson ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Scale Up ◽  
Molecular Clusters ◽  
Transmission Risk ◽  
Molecular Cluster ◽  
Hiv Surveillance ◽  
Care Services ◽  
Rapid Transmission ◽  
Sex With Men ◽  
Racial Ethnic

Molecular cluster detection analyzes HIV sequences to identify rapid HIV transmission and inform public health responses. We describe changes in the capability to detect molecular clusters and in geographic variation in transmission dynamics. We examined the reporting completeness of HIV-1 polymerase sequences in quarterly National HIV Surveillance System datasets from December 2015 to December 2019. Priority clusters were identified quarterly. To understand populations recently affected by rapid transmission, we described the transmission risk and race/ethnicity of people in clusters first detected in 2018–2019. During December 2015 to December 2019, national sequence completeness increased from 26% to 45%. Of the 1212 people in the 136 clusters first detected in 2018–2019, 69% were men who have sex with men (MSM) and 11% were people who inject drugs (PWID). State-by-state analysis showed substantial variation in transmission risk and racial/ethnic groups in clusters of rapid transmission. HIV sequence reporting has increased nationwide. Molecular cluster analysis identifies rapid transmission in varied populations and identifies emerging patterns of rapid transmission in specific population groups, such as PWID, who, in 2015–2016, comprised only 1% of people in such molecular clusters. These data can guide efforts to focus, tailor, and scale up prevention and care services for these populations.

scholarly journals Enhanced use of phylogenetic data to inform public health approaches to HIV among men who have sex with men

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 89 ◽  
Author(s):  
Danielle German ◽  
Mary Kate Grabowski ◽  
Chris Beyrer
Keyword(s):  
Public Health ◽  
Hiv Transmission ◽  
Transmission Risk ◽  
Structural Factors ◽  
Ethical Considerations ◽  
Hiv Surveillance ◽  
Phylogenetic Data ◽  
Sex With Men ◽  
The Individual ◽  
Scientific Questions

The multidimensional nature and continued evolution of HIV epidemics among men who have sex with men (MSM) requires innovative intervention approaches. Strategies are needed that recognise the individual, social and structural factors driving HIV transmission; that can pinpoint networks with heightened transmission risk; and that can help target intervention in real time. HIV phylogenetics is a rapidly evolving field with strong promise for informing innovative responses to the HIV epidemic among MSM. Currently, HIV phylogenetic insights are providing new understandings of characteristics of HIV epidemics involving MSM, social networks influencing transmission, characteristics of HIV transmission clusters involving MSM, targets for antiretroviral and other prevention strategies and dynamics of emergent epidemics. Maximising the potential of HIV phylogenetics for HIV responses among MSM will require attention to key methodological challenges and ethical considerations, as well as resolving key implementation and scientific questions. Enhanced and integrated use of HIV surveillance, sociobehavioural and phylogenetic data resources are becoming increasingly critical for informing public health approaches to HIV among MSM.

Superimposing incident sexually transmitted infections on HIV phylogram to investigate possible misclassification of men who have sex with men as heterosexuals in a cohort in Antwerp, Belgium

2019 ◽  
Vol 30 (5) ◽  
pp. 486-495
Author(s):  
Kara K Osbak ◽  
Conor J Meehan ◽  
Sergio G Ribas ◽  
Leo Heyndrickx ◽  
Kevin K Ariën ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviour ◽  
Hiv Transmission ◽  
Phylogenetic Analyses ◽  
Laboratory Data ◽  
Risk Groups ◽  
Transmission Risk ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Transmission Risk

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.

scholarly journals Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China

2019 ◽  
Vol 96 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Weizi Wu ◽  
Xiaochen Yan ◽  
Xiaoxia Zhang ◽  
Lloyd Goldsamt ◽  
Yuanyuan Chi ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Multivariate Logistic Regression Analysis ◽  
Transmission Risk ◽  
Cross Sectional Survey ◽  
Sexual Behaviours ◽  
Route Of Transmission ◽  
Related Stigma ◽  
Male Sex ◽  
Sex With Men ◽  
Hiv Transmission Risk

ObjectiveThe HIV epidemic in China is shifting from the high-risk groups of men who have sex with men (MSM), injection drug users and sex workers to the general population, and sexual contact among spouses is assumed to be one route of transmission. Our objective was to determine the intention to marry and the expected extramarital male-to-male sex among single Chinese MSM, in order to estimate the potential HIV transmission risk among MSM living with HIV and their female spouses.MethodsWe conducted a web-based, cross-sectional survey between May 2016 and May 2017. A questionnaire covering sociodemographic characteristics, sexual behaviours, HIV-related and homosexuality-related stigma, marriage intention, and expected extramarital sexual behaviours was completed by 556 single MSM in Hunan, China. Descriptive statistics, χ2 test, two-sample t-test and multivariate logistic regression analysis were performed.ResultsCurrently 48.9% of the participants intended to marry a woman in their lifetime, and 91% of them reported that they would continue to have sex with men after getting married. Those who were living with parents (OR=2.26), self-identified as bisexual (OR=2.57), had at least one heterosexual partner in the previous 6 months (OR=0.33) and perceived a higher level of self-homosexual stigma (OR=1.78) had greater intention to marry a woman.ConclusionNearly half of Chinese MSM intend to marry women, which has significantly dropped from the estimated percentage more than 10 years ago for Chinese MSM. However, the expectation of extramarital homosexual behaviours was common in these men. Sexual and gender minority stresses especially from family members, homosexual identity assertiveness and related stigma were the main factors for marriage intention, which should be addressed in future studies and practices.

A multi-state Markov model using notification data to estimate HIV incidence, number of undiagnosed individuals living with HIV, and delay between infection and diagnosis: Illustration in France, 2008–2018

2021 ◽  
pp. 096228022110326
Author(s):  
Charlotte Castel ◽  
Cecile Sommen ◽  
Yann Le Strat ◽  
Ahmadou Alioum
Keyword(s):  
Markov Model ◽  
Hiv Transmission ◽  
Hiv Incidence ◽  
Infected People ◽  
Hiv Surveillance ◽  
Hiv Prevention Strategies ◽  
Penalized Likelihood Approach ◽  
Sex With Men ◽  
Living With Hiv ◽  
Notification Data

Thirty-five years since the discovery of the human immunodeficiency virus (HIV), the epidemic is still ongoing in France. To guide HIV prevention strategies and monitor their impact, it is essential to understand the dynamics of the HIV epidemic. The indicator for reporting the progress of new infections is the HIV incidence. Given that HIV is mainly transmitted by undiagnosed individuals and that earlier treatment leads to less HIV transmission, it is essential to know the number of infected people unaware of their HIV-positive status as well as the time between infection and diagnosis. Our approach is based on a non-homogeneous multi-state Markov model describing the progression of the HIV disease. We propose a penalized likelihood approach to estimate the HIV incidence curve as well as the diagnosis rates. The HIV incidence curve was approximated using cubic M-splines, while an approximation of the cross-validation criterion was used to estimate the smoothing parameter. In a simulation study, we evaluate the performance of the model for reconstructing the HIV incidence curve and diagnosis rates. The method is illustrated in the population of men who have sex with men using HIV surveillance data collected by the French Institute for Public Health Surveillance since 2004.

scholarly journals Characterization of Molecular Cluster Detection and Evaluation of Cluster Investigation Criteria Using Machine Learning Methods and Statewide Surveillance Data in Washington State

Viruses ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 142 ◽  
Author(s):  
Steven J. Erly ◽  
Joshua T. Herbeck ◽  
Roxanne P. Kerani ◽  
Jennifer R. Reuer
Keyword(s):  
Machine Learning ◽  
Random Forest ◽  
Hiv Transmission ◽  
White Male ◽  
Washington State ◽  
Cluster Detection ◽  
Random Forest Model ◽  
Molecular Cluster ◽  
Forest Model ◽  
Sex With Men

Molecular cluster detection can be used to interrupt HIV transmission but is dependent on identifying clusters where transmission is likely. We characterized molecular cluster detection in Washington State, evaluated the current cluster investigation criteria, and developed a criterion using machine learning. The population living with HIV (PLWH) in Washington State, those with an analyzable genotype sequences, and those in clusters were described across demographic characteristics from 2015 to2018. The relationship between 3- and 12-month cluster growth and demographic, clinical, and temporal predictors were described, and a random forest model was fit using data from 2016 to 2017. The ability of this model to identify clusters with future transmission was compared to Centers for Disease Control and Prevention (CDC) and the Washington state criteria in 2018. The population with a genotype was similar to all PLWH, but people in a cluster were disproportionately white, male, and men who have sex with men. The clusters selected for investigation by the random forest model grew on average 2.3 cases (95% CI 1.1–1.4) in 3 months, which was not significantly larger than the CDC criteria (2.0 cases, 95% CI 0.5–3.4). Disparities in the cases analyzed suggest that molecular cluster detection may not benefit all populations. Jurisdictions should use auxiliary data sources for prediction or continue using established investigation criteria.

Preliminary evidence of HIV seroconversion among HIV-negative men who have sex with men taking non-prescribed antiretroviral medication for HIV prevention in Miami, Florida, USA

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 193 ◽  
Author(s):  
Mance E. Buttram ◽  
Steven P. Kurtz
Keyword(s):  
Hiv Prevention ◽  
Hiv Transmission ◽  
Qualitative Interviews ◽  
Transmission Risk ◽  
Accurate Information ◽  
Limited Information ◽  
Antiretroviral Medication ◽  
Hiv Seroconversion ◽  
Sex With Men ◽  
Hiv Negative

Background Limited information suggests that men who have sex with men (MSM) are informally obtaining antiretroviral medication (ARVs) and using them for HIV pre-exposure prophylaxis (PrEP). Methods: Data are drawn from an on-going study examining the use of non-prescribed ARVs for PrEP. To date, 24 qualitative interviews have been conducted with HIV-negative, substance-using MSM living in Miami, Florida, USA. Data are presented from two participants who reported HIV seroconversion while using non-prescribed ARVs for PrEP. Results: Preliminary data indicate that some young MSM: (i) lack awareness of and accurate information about the efficacious use of PrEP; (ii) obtain non-prescribed ARVs from HIV-positive sex partners and use these medications for PrEP in a way that does not provide adequate protection against HIV infection or cohere with established guidelines; and (iii) engage in multiple HIV transmission risk behaviours, including condomless anal sex and injection drug use. Conclusions: The informal, non-prescribed and non-medically supervised use of ARVs for HIV prevention has the potential to undermine the protective benefits of PrEP and leave men unprotected against HIV transmission and at risk for ARV resistance.

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