Network Viral Load: A Critical Metric for HIV Elimination

Area of Science:

• Epidemiology
• Public Health
• Virology

Background:

• Community viral load (CVL) is linked to new HIV diagnoses but is geographically limited.
• A novel metric, network viral load (NVL), measures composite viral load within an individual's risk network for more precise HIV acquisition risk assessment.

Purpose of the Study:

• To examine the association between NVL and HIV infection among young men who have sex with men.
• To assess the utility of NVL as a public health tool for identifying individuals at high risk of HIV.

Main Methods:

• Utilized respondent-driven sampling to generate risk networks among young men who have sex with men in Chicago.
• Defined NVL as the prevalence of viremic individuals (viral load ≥20 k copies/mL) within a participant's network.
• Employed permutation tests to account for dependencies in network data.

Main Results:

• A positive association was found between NVL and HIV infection after controlling for covariates.
• Individuals in networks with <10% viremia had 1.85 times higher odds of HIV infection compared to HIV-seronegative networks.
• Individuals in networks with ≥10% viremia had 2.73 times higher odds of HIV infection.

Conclusions:

• NVL is positively associated with HIV seroprevalence.
• NVL offers a more precise measure of HIV acquisition risk than individual behavior or broad community indices.
• This metric has potential public health implications for targeted HIV prevention efforts.