AI Article Synopsis
- Understanding geographic patterns of HIV transmission is essential for creating targeted interventions, focusing on transmission risk and urban-rural characteristics among people with closely related HIV strains.
- The study used US National HIV Surveillance data from 2010-2016 to analyze genetic linkages between individuals diagnosed with HIV, revealing that over half of linked individuals lived in different counties, with the median distance between them being 11 km/7 miles.
- Results indicated that men who have sex with men (MSM) and MSM who inject drugs experienced the largest median distances, suggesting that transmission networks in rural areas and among key populations are more dispersed, emphasizing the need for coordinated health department efforts for effective follow-up and care.
Article Abstract
Background: Understanding geographic patterns of HIV transmission is critical to designing effective interventions. We characterized geographic proximity by transmission risk and urban-rural characteristics among people with closely related HIV strains suggestive of potential transmission relationships.
Methods: We analyzed US National HIV Surveillance System data of people diagnosed between 2010 and 2016 with a reported HIV-1 partial polymerase nucleotide sequence. We used HIV TRAnsmission Cluster Engine (HIV-TRACE) to identify sequences linked at a genetic distance of ≤0.5%. For each linked person, we assessed median distances between counties of residence at diagnosis by transmission category and urban-rural classification, weighting observations to account for persons with multiple linked sequences.
Results: There were 24,743 persons with viral sequence linkages to at least one other person included in this analysis. Overall, half (50.9%) of persons with linked viral sequences resided in different counties, and the median distance from persons with linked viruses was 11 km/7 miles [interquartile range (IQR), 0-145 km/90 miles]. Median distances were highest for men who have sex with men (MSM: 14 km/9 miles; IQR, 0-179 km/111 miles) and MSM who inject drugs, and median distances increased with increasing rurality (large central metro: 0 km/miles; IQR, 0-83 km/52 miles; nonmetro: 103 km/64 miles; IQR, 40 km/25 miles-316 km/196 miles).
Conclusion: Transmission networks in the United States involving MSM, MSM who inject drugs, or persons living in small metro and nonmetro counties may be more geographically dispersed, highlighting the importance of coordinated health department efforts for comprehensive follow-up and linkage to care.
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| http://dx.doi.org/10.1097/QAI.0000000000002448 | DOI Listing |
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