TransmissionBehavior in Partnerships of Newly HIV Infected Southern Californians

描述(申请人提供)：最近感染艾滋病毒的人通常病毒载量很高，可能具有很高的传染性。因此，感染后不久的危险性行为极有可能将艾滋病毒传播给其他人。在意识到最近感染艾滋病毒后，一些人(但不是所有人)会改变行为，以降低他们传播艾滋病毒的风险。这种行为变化的可能中介因素包括药物使用和伙伴关系的动态。随着时间的推移跟踪最近感染艾滋病毒的个人及其伴侣，可以提供对二级预防至关重要的信息，说明在高传染性时期与伴侣承担的风险如何变化，并能够估计艾滋病毒的传播如何最有效。这项拟议的研究将扩展NIAID资助的急性感染和早期疾病研究计划(AIEDRP)中进行的行为研究，该计划被称为南加州初级感染计划，并衡量最近感染艾滋病毒的个人及其伴侣之间的传播风险和伙伴关系动态如何随着时间的推移而变化。我们将比较最近感染艾滋病毒的人与慢性感染艾滋病毒的人和没有感染艾滋病毒的人的行为模式。它将通过积极招募性伴侣来进行伙伴关系水平分析。特别关注的将是药物使用，特别是甲基苯丙胺，随着时间的推移在影响行为方面的作用，以及伙伴关系动态如何与药物使用相互作用，以允许艾滋病毒传播。这项拟议的研究将招募150名最近感染艾滋病毒的人，并对他们进行为期一年的跟踪调查。我们还将为每个最近感染艾滋病毒的人招募最多6个性伴侣，并在一个“网络队列”中跟踪这些伴侣。一些性伴将是HIV阴性的，一些HIV阳性的，允许通过队列中的HIV状态来比较随着时间的推移个人行为，以及血清不一致和血清一致的伴侣之间的关系。这些结果将被送入数学模型，该模型将量化最近感染艾滋病毒的个人行为变化对人口水平和伙伴关系水平的影响，使用微观模拟将我们的结果与当前对时间传染性模式的估计相结合。了解这些关联对于以血清不一致伙伴关系中最近感染艾滋病毒的个人降低风险为目标的干预措施至关重要。研究他们的伙伴关系和在其中的传播可能会阐明一些男男性行为者(MSM)，特别是少数MSM，如何跨越网络连接艾滋病毒，并最终进入普通人群。

DESCRIPTION (provided by applicant): Individuals recently HIV infected often have high viral loads and may be highly infectious. Risky sexual behavior soon after infection therefore carries high potential for HIV transmission to others. Upon awareness of recent HIV infection, some but not all individuals change behaviors to reduce their risks of transmitting HIV. Possible mediators of such behavior change include drug use and dynamics of partnerships. Following individuals with recent HIV infection and their partners over time can provide information critical to secondary prevention on how risks taken with partners vary during a time of high infectiousness and allow for estimates of how the spread of HIV is most efficient. The proposed study will extend the behavioral research conducted in the NIAID funded Acute Infection and Early Disease Research Program (AIEDRP) known as The Southern California Primary Infections Program and measure how transmission risks and partnership dynamics change overtime among recently HIV-infected individuals and their partners. We will compare behavioral patterns of recently HIV infected individuals with those with chronic HIV infection and no HIV infection. It will allow for partnership level analyses by actively recruiting sexual partners. Of special focus will be the role of drug use, especially methamphetamine, in affecting behaviors over time and how partnership dynamics interact with drug use to allow for HIV transmission. The proposed study will enroll 150 recently HIV-infected individuals and follow them for one year. We will also recruit at up to 6 sexual partners for each recently HIV infected individual and follow these partners in a "cyber-cohort". Some sexual partners will be HIV negative and some HIV positive allowing for comparisons of individual behaviors over time by HIV status in the cohort and between serodiscordant and seroconcordant partnerships. The results will feed into mathematical models that will quantify population-level and partnership-level impacts of behavior change by recently HIV infected individuals, using microsimulation to integrate our results with current estimates of temporal infectiousness patterns. Understanding these associations will be critical for interventions that target risk reduction for recently HIV-infected individuals in serodiscordant partnerships. Studying partnerships and transmission within them may elucidate how some men who have sex with men (MSM), especially minority MSM, may bridge HIV across networks and ultimately into the general population.