The International Dimension of the U.S. HIV Transmission Network and Onward Transmission of HIV Recently Imported into the United States

WertheimJoel, O; OsterAlexandra, M; HernandezAngela, L; SaduvalaNeeraja,; Cheryl, Bañez OcfemiaM.; Irene, HallH.

doi:10.1089/aid.2015.0272

Cited by 40 publications

(34 citation statements)

References 31 publications

(40 reference statements)

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“…2 It is possible that individuals from these areas arrived to the United States infected with HIV (knowingly or unknowingly) with transmission partners also infected with HIV, or that the availability of larger numbers of potential sexual partners from their own regions, with whom these individuals shared culture and language, was a facilitator for new immigrants to get infected or infect others in their newly established sexual networks. HIV transmission links among foreign-born sharing the same language have been reported previously, 13 indicating that shared culture and language is a possible path that facilitates HIV transmission among foreign-born individuals.…”

Section: Discussionmentioning

confidence: 58%

“…* Second, although others have used different thresholds to calculate the Tamura-Nei 93 genetic distance between two sequences; 33 the decision to use the 0.015 threshold was based on previous molecular transmission analyses of NHSS data, which reported robust results using this threshold even when comparing results using different thresholds (0.010 & 0.020). 11,13 Third, some foreign-born persons travel home seasonally and may have partners there. If these persons also had a link to someone in the US and were therefore included in the analyses of where foreign-born persons’ partners were from, this would result in an overestimate of the proportion of foreign-born persons with a US contact.…”

Section: Limitationsmentioning

confidence: 99%

“…A previous CDC analysis identified potential transmission links between HIV-diagnosed individuals in the United States and persons in other countries, but did not explore the extent and characteristics of those relationships. 13 Another study focusing on HIV transmission patterns among Hispanics/Latinos in North Carolina showed that foreign-born Hispanics/Latinos were more likely to be in clusters with other Hispanics/Latinos compared to U.S.-born Hispanics/Latinos. 14 …”

Section: Introductionmentioning

confidence: 99%

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HIV Transmission Dynamics Among Foreign-Born Persons in the United States

Valverde

Oster

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background In the United States (U.S.), foreign-born persons are disproportionately affected by HIV and differ epidemiologically from U.S.-born persons with diagnosed HIV infection. Understanding HIV transmission dynamics among foreign-born persons is important to guide HIV prevention efforts for these populations. We conducted molecular transmission network analysis to describe HIV transmission dynamics among foreign-born persons with diagnosed HIV. Methods Using HIV-1 polymerase nucleotide sequences reported to the U.S. National HIV Surveillance System for persons with diagnosed HIV infection during 2001–2013, we constructed a genetic distance based transmission network using HIV-TRACE and examined the birth region of potential transmission partners in this network. Results Of 77,686 people, 12,064 (16%) were foreign-born. Overall, 28% of foreign-born persons linked to at least one other person in the transmission network. Of potential transmission partners, 62% were born in the United States, 31% were born in the same region as the foreign-born person, and 7% were born in another region of the world. The majority of transmission partners of male foreign-born persons (63%) were born in the United States, whereas the majority of transmission partners of female foreign-born (57%) were born in their same world region. Discussion These finding suggests that a majority of HIV infections among foreign-born persons in our network occurred after immigrating to the United States. Efforts to prevent HIV infection among foreign-born persons in the U.S. should include information of the transmission networks in which these individuals acquire or transmit HIV in order to develop more targeted HIV prevention interventions.

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Section: Discussionmentioning

confidence: 58%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HIV Transmission Dynamics Among Foreign-Born Persons in the United States

Valverde

Oster

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…[28][29][30][31] Transmission clusters can provide insight into shifts in social and structural dynamics influencing transmission over time and the role of social distance and other structural influences on transmission, independent of participant-reported history. 32 There is great potential for using these data to help identify segments of the population at highest risk for incident HIV infection, which can inform the mechanisms, upper limits of reach, and targeting for network-based HIV testing and care interventions, PrEP, and other social and behavioral intervention.…”

Section: Identifying Transmission Clustersmentioning

confidence: 99%

Identifying Transmission Clusters with Cluster Picker and HIV-TRACE

Rose¹,

Lamers²,

Dollar³

et al. 2017

AIDS Research and Human Retroviruses

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We compared the behavior of two approaches (Cluster Picker and HIV-TRACE) at varying genetic distances to identify transmission clusters. We used three HIV gp41 sequence datasets originating from the Rakai Community Cohort Study: (1) next-generation sequence (NGS) data from nine linked couples; (2) NGS data from longitudinal sampling of 14 individuals; and (3) Sanger consensus sequences from a cross-sectional dataset (n = 1,022) containing 91 epidemiologically linked heterosexual couples. We calculated the optimal genetic distance threshold to separate linked versus unlinked NGS datasets using a receiver operating curve analysis. We evaluated the number, size, and composition of clusters detected by Cluster Picker and HIV-TRACE at six genetic distance thresholds (1%-5.3%) on all three datasets. We further tested the effect of using all NGS, versus only a single variant for each patient/time point, for datasets (1) and (2). The optimal gp41 genetic distance threshold to distinguish linked and unlinked couples and individuals was 5.3% and 4%, respectively. HIV-TRACE tended to detect larger and fewer clusters, whereas Cluster Picker detected more clusters containing only two sequences. For NGS datasets (1) and (2), HIV-TRACE and Cluster Picker detected all linked pairs at 3% and 4% genetic distances, respectively. However, at 5.3% genetic distance, 20% of couples in dataset (3) did not cluster using either program, and for >1/3 of couples cluster assignment were discordant. We suggest caution in choosing thresholds for clustering analyses in a generalized epidemic.

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“…However, those putative viral transmission links between individuals from different nations were likely the result of human migration or travel, facilitated by having a common language throughout the region. Such transmission links between geographically disparate populations may impact the overall epidemic by bridging susceptible populations (45), and may result in onward transmission (46). …”

Section: Discussionmentioning

confidence: 99%

Identification of major routes of HIV transmission throughout Mesoamerica

Chaillon

Ávila‐Ríos²,

Wertheim

et al. 2017

Infection, Genetics and Evolution

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Background Migration and travel are major drivers of the spread of infectious diseases. Geographic proximity and a common language facilitate travel and migration in Mesoamerica, which in turn could affect the spread of HIV in the region. Methods 6,092 HIV-1 subtype B partial pol sequences sampled from unique antiretroviral treatment-naive individuals from Mexico (40.7%), Guatemala (24.4%), Honduras (19%), Panama (8.2%), Nicaragua (5.5%), Belize (1.4%), and El Salvador (0.7%) between 2011–2016 were included. Phylogenetic and genetic network analyses were performed to infer putative relationships between HIV sequences. The demographic and geographic associations with clustering were analyzed and viral migration patterns were inferred using the Slatkin-Maddison approach on 100 iterations of random subsets of equal number of sequences per location. Results A total of 1,685/6,088 (27.7%) of sequences linked with at least one other sequence, forming 603 putative transmission clusters (range: 2–89 individuals). Clustering individuals were significantly more likely to be younger (median age 29 vs 33 years, p<0.01) and men-who-have-sex-with-men (40.4% vs 30.3%, p<0.01). Of the 603 clusters, 30 (5%) included sequences from multiple countries with commonly observed linkages between Mexican and Honduran sequences. Eight of the 603 clusters included more than 10 individuals, including two comprised exclusively of Guatemalans (52 and 89 individuals). Phylogenetic and migration analyses suggested that the Central and Southern regions of Mexico along with Belize were major sources of HIV throughout the region (p<0.01) with genetic flow southward from Mexico to the other nations of Mesoamerica. We also found evidence of significant viral migration within Mexico. Conclusion International clusters were infrequent, suggesting moderate migration between HIV epidemics of the different Mesoamerican countries. Nevertheless, we observed important sources of transnational HIV spread in the region, including Southern and Central Mexico and Belize.

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The International Dimension of the U.S. HIV Transmission Network and Onward Transmission of HIV Recently Imported into the United States

Cited by 40 publications

References 31 publications

HIV Transmission Dynamics Among Foreign-Born Persons in the United States

HIV Transmission Dynamics Among Foreign-Born Persons in the United States

Identifying Transmission Clusters with Cluster Picker and HIV-TRACE

Identification of major routes of HIV transmission throughout Mesoamerica

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