Human Immunodeficiency Virus (HIV)-1 Transmission among Persons with Acute HIV-1 Infection in Malawi: Demographic, Behavioral, and Phylogenetic Relationships
| Autor: | Dominic Nsona, Myron S. Cohen, Sarah E. Rutstein, Ann M Dennis, Cecilia Massa, Irving F. Hoffman, Mina C. Hosseinipour, Audrey Pettifor, Sam Phiri, Kimberly A. Powers, William C. Miller, Dana K. Pasquale, Gift Kamanga, Katherine B. Rucinski |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Malawi Referral Demographics Sexual Behavior 030106 microbiology Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause 03 medical and health sciences Young Adult 0302 clinical medicine Epidemiology medicine Humans 030212 general & internal medicine Articles and Commentaries Phylogeny Demography Phylogenetic tree business.industry Transmission (medicine) Partner notification Clinical trial Infectious Diseases Sexual Partners Acute Disease HIV-1 Female Contact Tracing business |
| DOI: | 10.17615/ecd3-vz19 |
| Popis: | BackgroundUnderstanding sexual networks involving acute human immunodeficiency virus (HIV)-1 infections (AHI) may lead to prevention opportunities to mitigate high rates of onward transmission. We evaluated HIV-1 phylogenetic and behavioral characteristics among persons with AHI and their referred partners.MethodsBetween 2012 and 2014, 46 persons with AHI in Malawi participated in a combined behavioral and biomedical intervention. Participants referred sexual partners by passive referral. Demographics and sexual behaviors were collected through interviews and HIV-1 genetic relationships were assessed with phylogenetics.ResultsAmong 45 AHI participants with HIV-1 sequences, none was phylogenetically-linked with another AHI index. There were 19 (42%) AHI participants who referred a single partner that returned for testing. Most partners (n = 17) were HIV-infected, with 15 (88%) presenting with an established infection. There were 14 index-partner pairs that had sequences available; 13 (93%) pairs were phylogenetically-linked dyads. The AHI index was female in 7/13 (54%) dyads. Age-disparate relationships among dyads were common (≥5-year age difference in 67% of dyads), including 3/6 dyads involving a male index and a younger woman. Index participants with a referred partner were more likely to report no casual partners and to be living with their current partner than participants not in dyads.ConclusionsPassive-partner referral successfully identified partners with genetically-similar HIV infections—the likely source of infection—but only 40% of index cases referred partners who presented for HIV-1 testing. Future work evaluating assisted partner notification may help reach susceptible partners or more people with untreated HIV-1 infections connected to acute transmission.Clinical Trials RegistrationNCT01450189 |
| Databáze: | OpenAIRE |
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