HIV Transmission Cluster Analysis to Inform Prevention

HIV 传播聚类分析为预防提供信息

• 批准号: 9102264
• 负责人: HONG-HA M TRUONG
• 金额: $ 34.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9102264
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acute; Affect; Alcohol or Other Drugs use; Antiretroviral resistance; Behavior; Behavioral; Biological; Caring; Categories; Chemoprophylaxis; Clinical; Cluster Analysis; Communication; Complement; DNA Sequence; Data; Databases; Development; Epidemic; Epidemiology; Genetic; Guidelines; HIV; HIV Infections; HIV risk; Hand; Heterogeneity; Heterosexuals; Hot Spot; Infection; Injecting drug user; Intervention; Interview; Laboratories; Link; Methodology; Modeling; Molecular; Outcome; Pattern; Persons; Phylogenetic Analysis; Population; Prevention; Prevention strategy; Registries; Reporting; Research; Resistance; Risk Reduction; Sexual Partners; Sexually Transmitted Diseases; Source; Specificity; Techniques; Testing; Time; Viral; Virus; Woman; disease diagnosis; disease transmission; high risk; innovation; insight; men; men who have sex with men; population based; prevent; psychosocial; response; seroconversion; sex; social; stem; therapy development; tool; transmission process; urban area; viral resistance; viral transmission

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) are disproportionately affected by the HIV/AIDS epidemic. They are often referred to collectively as a high-risk group, but this generalization belies the fact that there is a high degree of heterogeneity of HIV risk within the population. Certain socio-ecological factors place some MSM at higher risk for HIV. There are a number of potential drivers of the HIV epidemic, including substance use, undiagnosed infections and high number of sexual partners. However, these broad categories need refinement in order to identify transmission patterns, as it remains unclear which drivers are contributing to the epidemic with HIV transmission as the biological outcome. Real-time identification of epidemiological hot spots, pinpointing the chains of viral transmission and biologically linking drivers of the epidemic are needed to effectively target prevention strategies and interrupt these chains of HIV transmission. Increasing use of antiretroviral (ARV) resistance testing in response to revised clinical guidelines has enriched the availability of viral sequences to study HIV transmission epidemiology. DNA sequencing can be used to establish epidemiological linkages between infected persons. Such linkages are referred to as HIV transmission clusters, comprised of cases whose viruses share sufficient phylogenetic similarities to suggest a recent common source of infection or participation in linked chains of transmission. Identifying clusters that account for the largest proportion of onward transmissions and characterizing the structural, behavioral and biological correlates that predict transmissibility would inform the development of targeted interventions. The proposed study will use a combination of biological, epidemiological, behavioral and psychosocial research tools to obtain an innovative perspective on the HIV epidemic among MSM. The specific aims are: 1) to characterize HIV transmission clusters and correlates associated with transmission; 2) to evaluate the relative impact of acute, recent and long-term HIV infections on transmission clusters; and 3) to assess HIV transmission cluster patterns in relation to attempted risk reduction strategies. We are poised to analyze viral sequences to elucidate the key patterns of HIV transmission. We will enhance the utility of existing data by creating a population-based, analytical database that will harmonize an urban area's HIV/AIDS case registry with viral resistance and sexually transmitted diseases databases. Qualitative interviews will be conducted to describe the psychosocial and behavioral contexts at the level of the transmission cluster to complement the phylogenetic data. Using an adapted Social Ecological model as a conceptual framework, the interviews will elicit seroconversion narratives and obtain detailed data on any specific strategies attempted to prevent HIV transmission. Real-time analysis of HIV transmission cluster data will place us on the leading edge of the epidemic and enable assessment of how high-risk clusters and current prevention strategies affect transmission patterns.

描述（由申请人提供）：男男性行为者（MSM）受到艾滋病毒/艾滋病流行病的影响不成比例。他们经常被统称为高风险群体，但这一概括掩盖了人口中艾滋病毒风险高度异质性的事实。某些社会生态因素使一些男男性行为者感染艾滋病毒的风险更高。艾滋病毒流行病有一些潜在的驱动因素，包括药物使用、未确诊的感染和大量的性伴侣。然而，这些广泛的类别需要完善，以确定传播模式，因为目前仍不清楚哪些驱动因素助长了艾滋病毒传播作为生物结果的流行病。需要实时查明流行病热点，查明病毒传播链，并将流行病的驱动因素与生物学联系起来，以有效地制定预防战略，阻断这些艾滋病毒传播链。为响应修订后的临床指南，越来越多地使用抗逆转录病毒（ARV）耐药性检测， 研究HIV传播流行病学的病毒序列的可用性。DNA测序可用于确定感染者之间的流行病学联系。这种联系被称为艾滋病毒传播集群，由病毒具有足够系统发育相似性的病例组成，表明最近有共同的感染源或参与了相连的传播链。确定占向前传播的最大比例的集群，并描述预测传播性的结构，行为和生物相关性，将为制定有针对性的干预措施提供信息。拟议的研究将使用生物学，流行病学，行为和心理社会研究工具的组合，以获得对艾滋病毒在男男性行为者中流行的创新观点。具体目标是：1）描述艾滋病毒传播集群和与传播相关的相关因素; 2）评估急性、近期和长期艾滋病毒感染对传播集群的相对影响; 3）评估与尝试的降低风险战略相关的艾滋病毒传播集群模式。我们准备分析病毒序列，以阐明艾滋病毒传播的关键模式。我们将通过建立一个以人口为基础的分析数据库，使城市地区的艾滋病毒/艾滋病病例登记与病毒抗药性和性传播疾病数据库协调一致，从而提高现有数据的效用。将进行定性访谈，以描述在传播集群的水平，以补充系统发育数据的社会心理和行为背景。使用适应社会生态模型作为概念框架，访谈将引出血清转换的叙述，并获得任何具体的战略，试图防止艾滋病毒传播的详细数据。对艾滋病毒传播集群数据的实时分析将使我们处于这一流行病的前沿，并能够评估高风险集群和目前的预防战略如何影响传播模式。

项目成果

Non-B variants of HIV-1 in San Francisco, California.

• DOI: 10.1016/j.meegid.2020.104677
• 发表时间: 2021-06
• 期刊: INFECTION GENETICS AND EVOLUTION
• 影响因子: 3.2
• 作者: O'Keefe, Kara J.;Pipkin, Sharon;Fatch, Robin;Scheer, Susan;Liegler, Teri;McFarland, Willi;Grant, Robert M.;Truong, Hong-Ha M.
• 通讯作者: Truong, Hong-Ha M.