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
. 2017 Jul 31;12(7):e0182376.
doi: 10.1371/journal.pone.0182376. eCollection 2017.

Characteristics of HIV-infected U.S. Army soldiers linked in molecular transmission clusters, 2001-2012

Shilpa Hakre  1   2 , Linda L Jagodzinski  1 , Ying Liu  1   2 , Peter T Pham  1   2 , Gustavo H Kijak  1   2 , Sodsai Tovanabutra  1   2 , Francine E McCutchan  2 , Stephanie L Scoville  3 , Steven B Cersovsky  3 , Nelson L Michael  1 , Paul T Scott  1 , Sheila A Peel  1
Affiliations

Characteristics of HIV-infected U.S. Army soldiers linked in molecular transmission clusters, 2001-2012

Shilpa Hakre et al. PLoS One. .

Abstract

Objective: Recent surveillance data suggests the United States (U.S.) Army HIV epidemic is concentrated among men who have sex with men. To identify potential targets for HIV prevention strategies, the relationship between demographic and clinical factors and membership within transmission clusters based on baseline pol sequences of HIV-infected Soldiers from 2001 through 2012 were analyzed.

Methods: We conducted a retrospective analysis of baseline partial pol sequences, demographic and clinical characteristics available for all Soldiers in active service and newly-diagnosed with HIV-1 infection from January 1, 2001 through December 31, 2012. HIV-1 subtype designations and transmission clusters were identified from phylogenetic analysis of sequences. Univariate and multivariate logistic regression models were used to evaluate and adjust for the association between characteristics and cluster membership.

Results: Among 518 of 995 HIV-infected Soldiers with available partial pol sequences, 29% were members of a transmission cluster. Assignment to a southern U.S. region at diagnosis and year of diagnosis were independently associated with cluster membership after adjustment for other significant characteristics (p<0.10) of age, race, year of diagnosis, region of duty assignment, sexually transmitted infections, last negative HIV test, antiretroviral therapy, and transmitted drug resistance. Subtyping of the pol fragment indicated HIV-1 subtype B infection predominated (94%) among HIV-infected Soldiers.

Conclusion: These findings identify areas to explore as HIV prevention targets in the U.S. Army. An increased frequency of current force testing may be justified, especially among Soldiers assigned to duty in installations with high local HIV prevalence such as southern U.S. states.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: All authors, except Dr. Francine McCutchan, have no competing interests to declare. Dr. McCutchan was hired as a consultant through the Henry M. Jackson Foundation for the Advancement of Military Medicine to work on a project that includes the findings reported in this article. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

References

    1. Office of the Press Secretary USW. FACT SHEET: The National HIV/AIDS Strategy: Updated to 2020 2015 [cited 2016 August 18, 2016]. Available from: https://www.whitehouse.gov/the-press-office/2015/07/30/fact-sheet-nation....
    1. Centers for Disease Control and Prevention. Selected National HIV Prevention and Care Outcomes in the United States 2016 [cited 2016 August 18, 2016]. Available from: https://www.cdc.gov/hiv/pdf/library/factsheets/cdc-hiv-national-hiv-care....
    1. Oster AM, Wertheim JO, Hernandez AL, Ocfemia MC, Saduvala N, Hall HI. Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States. J Acquir Immune Defic Syndr. 2015;70(4):444–51. Epub 2015/08/25. doi: 10.1097/QAI.0000000000000809 ; PubMed Central PMCID: PMC4878401. - DOI - PMC - PubMed
    1. Hakre S, Scoville SL, Pacha LA, Peel SA, Kim JH, Michael NL, et al. Brief Report: Sexual Risk Behaviors of HIV Seroconverters in the US Army, 2012–2014. J Acquir Immune Defic Syndr. 2015;70(4):456–61. Epub 2015/08/08. doi: 10.1097/QAI.0000000000000778 ; PubMed Central PMCID: PMC4627169. - DOI - PMC - PubMed
    1. Pacha LA, Hakre S, Myles O, Sanders-Buell EE, Scoville SL, Kijak GH, et al. Centralized HIV Program Oversight: An Investigation of a Case Series of New HIV Infections among US Army Soldiers, 2012 to 2013. Medicine (Baltimore). 2015;94(46):e2093 Epub 2015/11/19. 10.1097/MD.000000000000209300005792-201511170-00027 [pii]. PubMed Central PMCID: PMC4652831. doi: 10.1097/MD.0000000000002093 - DOI - PMC - PubMed