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HIV-1 Transmission Patterns in Men Who Have Sex with Men: Insights from Genetic Source Attribution Analysis

Stéphane Le Vu1, Oliver Ratmann2, Valerie Delpech3

  • 1Department of Infectious Disease Epidemiology, National Institute for Health Research Health Protection Research Unit on Modeling Methodology, Imperial College London, London, United Kingdom.

AIDS Research and Human Retroviruses
|July 9, 2019
PubMed

Insights

Understanding HIV transmission among men who have sex with men (MSM) is crucial. Young MSM, regardless of ethnicity, are more likely to infect each other, indicating a need for targeted public health interventions.

Area of Science:

  • Epidemiology
  • Virology
  • Public Health

Background:

  • Men who have sex with men (MSM) account for a significant proportion of new HIV infections in the UK.
  • Age-disassortative partnerships in MSM are implicated in HIV epidemic spread and ethnic disparities.
  • Understanding sexual mixing patterns is vital for risk assessment and intervention strategies.

Purpose of the Study:

  • To analyze transmission patterns within the MSM population using epidemiological and viral sequence data.
  • To infer transmission dynamics and identify at-risk groups for HIV infection among MSM.
  • To investigate the role of age, ethnicity, and region in HIV transmission networks.

Main Methods:

  • Phylodynamic source attribution modeling was applied to national-level HIV data.
  • Analysis included epidemiological data and viral sequences from 14,603 MSM patients diagnosed with HIV.
  • Transmission probabilities between patient pairs were calculated to infer mixing patterns.

Main Results:

  • Potential transmitters of HIV subtype B were, on average, 8 months older than recipients.
  • Moderate assortativity of transmission was observed by ethnic group, with stronger assortativity by region.
  • Young MSM, across ethnic groups (Black and White), showed higher within-group transmission than random mixing would suggest.

Conclusions:

  • HIV transmission among MSM in the UK exhibits modest age-assortative mixing, with a limited net flow from older to younger individuals.
  • Sexual mixing patterns among young MSM, irrespective of ethnicity, contribute significantly to HIV transmission.
  • Findings highlight the importance of considering within-group transmission dynamics for effective HIV prevention in MSM populations.
Keywords:
HIV epidemiologyage-mixingphylodynamicsphylogenetic

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