HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya.

Autor: Cholette F; National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at J.C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada. cholettf@myumanitoba.ca.; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada. cholettf@myumanitoba.ca., Lazarus L; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Macharia P; Health Options for Young Men On HIV/AIDS and STIs, Nairobi, Kenya., Walimbwa J; G10 Research Advisory Committee, Nairobi, Kenya., Kuria S; Mamboleo Peer Empowerment Group, Kiambu, Kenya., Bhattacharjee P; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada.; Partners for Health and Development in Africa, Nairobi, Kenya., Musyoki H; National AIDS and STI Control Programme, Ministry of Health, Nairobi, Kenya., Mugambi M; National AIDS and STI Control Programme, Ministry of Health, Nairobi, Kenya., Ongaro MK; HIV and AIDS People's Alliance of Kenya, Mombasa, Kenya., Olango K; Men Against AIDS Youth Group, Kisumu, Kenya., Musimbi J; Partners for Health and Development in Africa, Nairobi, Kenya., Emmanuel F; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Isac S; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada.; India Health Action Trust, New Delhi, India., Pickles M; Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK., Becker ML; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Mishra S; MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.; Department of Medicine, University of Toronto, Toronto, Canada.; Institute of Medical Sciences, University of Toronto, Toronto, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada., McKinnon LR; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.; Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.; Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya., Blanchard J; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Ho J; National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at J.C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada., Henry O; National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at J.C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada., Fabia R; National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at J.C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada., Sandstrom P; National Sexually Transmitted and Blood Borne Infection Laboratory, National Microbiology Laboratory at J.C. Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Canada.; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada., Lorway R; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada., Shaw SY; Institute for Global Public Health, University of Manitoba, Winnipeg, Canada.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2024 Nov 20; Vol. 24 (1), pp. 1323. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1186/s12879-024-10052-5
Abstrakt: Background: The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.
Methods: Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.
Results: Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).
Conclusions: Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.
Competing Interests: Declarations. Ethics approval and consent to participate: The study obtained approval from the Institutional Review Boards of the Kenyatta National Hospital – University of Nairobi, Kenya (P557/08/2018) and the University of Manitoba Health Research Ethics Board, Canada (HS22205). All participants provided written informed consent and were ≥ 18 years of age. Consent for publication Not applicable. Competing interests: The authors declare that they have no competing interests.
(© 2024. Crown.)
Databáze: MEDLINE
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