Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec 1;70(4):444-51.
doi: 10.1097/QAI.0000000000000809.

Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States

Alexandra M Oster  1 , Joel O Wertheim, Angela L Hernandez, Marie Cheryl Bañez Ocfemia, Neeraja Saduvala, H Irene Hall
Affiliations

Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States

Alexandra M Oster et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Studying HIV transmission networks provides insight into the spread of HIV and opportunities for intervention. We identified transmission dynamics among risk groups and racial/ethnic groups in the United States.

Methods: For HIV-1 pol sequences reported to the US National HIV Surveillance System during 2001-2012, we calculated pairwise genetic distance, identified linked pairs of sequences (those with distance ≤1.5%), and examined transmission category and race/ethnicity of these potential transmission partners.

Results: Of 40,950 sequences, 12,910 (32%) were linked to ≥1 other sequence. Of men who have sex with men (MSM) who were linked to ≥1 sequence, 88% were linked to other MSM and only 4% were linked to heterosexual women. Of heterosexual women for whom we identified potential transmission partners, 29% were linked to MSM, 21% to heterosexual men, and 12% to persons who inject drugs. Older and black MSM were more likely to be linked to heterosexual women. Assortative mixing was present for all racial/ethnic groups; 81% of blacks/African Americans linked to other blacks.

Conclusions: This analysis is the first use of US surveillance data to infer an HIV transmission network. Our data suggest that HIV infections among heterosexual women predominantly originate from MSM, followed by heterosexual men. Although few MSM were linked to women, suggesting that a minority of MSM are involved in transmission with heterosexual women, these transmissions represent a substantial proportion of HIV acquisitions by heterosexual women. Interventions that reduce transmissions involving MSM are likely to also reduce HIV acquisition among other risk groups.

PubMed Disclaimer

Conflict of interest statement

The authors do not have commercial or other associations that might pose a conflict of interest.

Figures

Figure 1
Figure 1
Jurisdictions participating in collection of HIV-1 nucleotide sequence data, 2001–2012. Jurisdictions shaded in gray have participated in collection of nucleotide sequence data.
Figure 2
Figure 2
Depiction of various terms used to describe the transmission network.
Figure 3
Figure 3
(a) Race/ethnicity and (b) transmission category of potential transmission partners. These figures show, for persons in the transmission network of a given (a) race/ethnicity or (b) transmission category, the (a) race/ethnicity or (b) transmission category of their potential transmission partners. MSM: men who have sex with men; PWID: persons who inject drugs; NHOPI: Native Hawaiian or Other Pacific Islander.
See this image and copyright information in PMC

References

    1. Dennis AM, Herbeck JT, Brown AL, et al. Phylogenetic studies of transmission dynamics in generalized HIV epidemics: An essential tool where the burden is greatest? J Acquir Immune Defic Syndr. 2014 - PMC - PubMed
    1. Hue S, Brown AE, Ragonnet-Cronin M, et al. Phylogenetic analyses reveal HIV-1 infections between men misclassified as heterosexual transmissions. Aids. 2014 - PubMed
    1. Fitch WM. Networks and viral evolution. Journal of molecular evolution. 1997;44(Suppl 1):S65–S75. - PubMed
    1. Hughes GJ, Fearnhill E, Dunn D, Lycett SJ, Rambaut A, Leigh Brown AJ. Molecular phylodynamics of the heterosexual HIV epidemic in the United Kingdom. PLoS pathogens. 2009;5:e1000590. - PMC - PubMed
    1. Leigh Brown AJ, Lycett SJ, Weinert L, Hughes GJ, Fearnhill E, Dunn DT. Transmission network parameters estimated from HIV sequences for a nationwide epidemic. J Infect Dis. 2011;204:1463–1469. - PMC - PubMed

Publication types

MeSH terms

Substances