Early treatment, soon after infection, reduces HIV transmissions and benefits patients. The Transmission Reduction Intervention Project (TRIP) evaluated a network intervention to detect individuals recently infected (in the past 6 months). TRIP was conducted in Greece (2013–2015) and focused on drug injector networks. Based on HIV status, testing history, and the results of an assay to detect recent infections, TRIP classified drug injector “Seeds” into groups: Recent Seeds (RS), and Control Seeds with Long-term HIV infection (LCS). The network members of RS and LCS were traced for two steps. The analysis included 23 RS, 171 network members of the RS, 19 LCS, and 65 network members of the LCS. The per-seed number of recents detected in the network of RS was 5 times the number in the network of LCS (Ratio RS vs. LCS: 5.23; 95% Confidence Interval (CI): 1.54–27.61). The proportion of recents among HIV positives in the network of RS (27%) was approximately 3 times (Ratio RS vs. LCS: 3.30; 95% CI: 1.04–10.43) that in the network of LCS (8%). Strategic network tracing that starts with recently infected persons could support public health efforts to find and treat people early in their HIV infection.

Molecular methods can identify HIV-infected people socially linked with another person in about half of the phylogenetic clusters. This could help public health efforts to locate individuals in networks with high transmission rates.

Disclosure of Potential Conflicts of Interest. None of the authors have any conflicts of interest to declare. Leslie D. Williams declares that she has no conflict of interest. Ania Korobchuk declares that she has no conflict of interest. Eirini Pavlitina declares that she has no conflict of interest. Georgios K. Nikolopoulos declares that he has no conflict of interest. Britt Skaathun declares that she has no conflict of interest. John Schneider declares that he has no conflict of interest. Evangelia-Georgia Kostaki declares that she has no conflict of interest. Pavlo Smyrnov declares that he has no conflict of interest. Tetyana I. Vasylyeva declares that she has no conflict of interest. Mina Psichogiou declares that she has no conflict of interest. Ethan Morgan declares that he has no conflict of interest. Andria Hadjikou declares that she has no conflict of interest. Martin J. Downing, Jr. declares that he has no conflict of interest. Angelos Hatzakis declares that he has no conflict of interest. Samuel R. Friedman declares that he has no conflict of interest.

No abstract

Background: TRIP (Transmission Reduction Intervention Project) was a network-based, contact tracing approach to locate and link to care, mostly people who inject drugs (PWID) with recent HIV infection. Objective: We investigated whether sequences from HIV-infected participants with high viral load cluster together more frequently than what is expected by chance. Methods: Paired end reads were generated for 104 samples using Illumina MiSeq next-generation se-quencing. Results: 63 sequences belonged to previously identified local transmission networks of PWID (LTNs) of an HIV outbreak in Athens, Greece. For two HIV-RNA cut-offs (105 and 106 IU/mL), HIV transmissions were more likely between PWID with similar levels of HIV-RNA (p<0.001). 10 of the 14 sequences (71.4%) from PWID with HIV-RNA >106 IU/mL were clustered in 5 pairs. For 4 of these clusters (80%), there was in each one of them at least one sequence from a recently HIV-infected PWID. Conclusion: We showed that transmissions are more likely among PWID with high viremia.