Intersection of Syphilis and Human Immunodeficiency Virus (HIV) Networks to Identify Opportunities to Enhance HIV Prevention.
Intersection of Syphilis and Human Immunodeficiency Virus (HIV) Networks to Identify Opportunities to Enhance HIV Prevention.
复制标题
梅毒和人类免疫缺陷病毒 (HIV) 网络的交叉点，以确定加强艾滋病毒预防的机会。
DOI：
10.1093/cid/ciab431
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Seña,ArleneC
中科院分区：
文献类型：
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作者：
Dennis,AnnM;Cressman,Andrew;Pasquale,Dana;Frost,SimonDW;Kelly,Elizabeth;Guy,Jalila;Mobley,Victoria;Samoff,Erika;Hurt,ChristopherB;Mcneil,Candice;Hightow-Weidman,Lisa;Carry,Monique;Hogben,Matthew;Seña,ArleneC
背景：在美国，人类免疫缺陷病毒（HIV）和梅毒感染在男男性行为（MSM）的少数男性中继续以不成比例的比例存在。将艾滋病毒遗传聚类与合作伙伴服务相结合，可以提供对当地流行病趋势的重要见解，以指导干预和控制工作。方法对2018年至2020年北卡罗来纳州2个地区诊断为早期梅毒和/或HIV感染的少数族裔男性和跨性别女性指标人群的接触网络进行评估。通过全州监测收集的序列构建HIV聚类。一个综合的“艾滋病毒风险”网络，包括与艾滋病毒阳性者有任何联系（遗传或性接触）的人，通过组成规模、人口统计学因素和艾滋病毒抑制来评估。结果共发现1289名指标人群，55%的人被点名1153名接触者。大多数指标对象为黑人（88%）和年轻人（中位年龄30岁）；70%的人患有早期梅毒，43%的人感染艾滋病毒。大多数艾滋病毒感染者（65%）出现在艾滋病毒群集中。联合艾滋病毒风险网络（1590个接触网络和1500个集群成员）包括287个不同的组成部分；然而，1586例（51%）属于单一成分。55%的HIV网络成员没有病毒抑制的迹象。总体而言，在没有病毒抑制的情况下确定1名hiv阳性成员时，需要采访的指标人员较少（1.3对4.0）。结论HIV聚集和病毒载量的整合说明了HIV高流行网络，表明最近和正在进行的传播。加强对这些网络的干预可以有效地接触到艾滋病毒预防和护理人员。
BackgroundHuman immunodeficiency virus (HIV) and syphilis infection continue at disproportionate rates among minority men who have sex with men (MSM) in the United States. The integration of HIV genetic clustering with partner services can provide important insight into local epidemic trends to guide interventions and control efforts.MethodsWe evaluated contact networks of index persons defined as minority men and transgender women diagnosed with early syphilis and/or HIV infection between 2018 and 2020 in 2 North Carolina regions. HIV clusters were constructed frompolsequences collected through statewide surveillance. A combined “HIV-risk” network, which included persons with any links (genetic or sexual contact) to HIV-positive persons, was evaluated by component size, demographic factors, and HIV viral suppression.ResultsIn total, 1289 index persons were identified and 55% named 1153 contacts. Most index persons were Black (88%) and young (median age 30 years); 70% had early syphilis and 43% had prevalent HIV infection. Most people with HIV (65%) appeared in an HIV cluster. The combined HIV-risk network (1590 contact network and 1500 cluster members) included 287 distinct components; however, 1586 (51%) were in a single component. Fifty-five percent of network members with HIV had no evidence of viral suppression. Overall, fewer index persons needed to be interviewed to identify 1 HIV-positive member without viral suppression (1.3 vs 4.0 for contact tracing).ConclusionsIntegration of HIV clusters and viral loads illuminate networks with high HIV prevalence, indicating recent and ongoing transmission. Interventions intensified toward these networks may efficiently reach persons for HIV prevention and care re-engagement.