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ABSTRACT: Background
Understanding sexual networks involving acute human immunodeficiency virus (HIV)-1 infections (AHI) may lead to prevention opportunities to mitigate high rates of onward transmission. We evaluated HIV-1 phylogenetic and behavioral characteristics among persons with AHI and their referred partners.Methods
Between 2012 and 2014, 46 persons with AHI in Malawi participated in a combined behavioral and biomedical intervention. Participants referred sexual partners by passive referral. Demographics and sexual behaviors were collected through interviews and HIV-1 genetic relationships were assessed with phylogenetics.Results
Among 45 AHI participants with HIV-1 sequences, none was phylogenetically-linked with another AHI index. There were 19 (42%) AHI participants who referred a single partner that returned for testing. Most partners (n = 17) were HIV-infected, with 15 (88%) presenting with an established infection. There were 14 index-partner pairs that had sequences available; 13 (93%) pairs were phylogenetically-linked dyads. The AHI index was female in 7/13 (54%) dyads. Age-disparate relationships among dyads were common (≥5-year age difference in 67% of dyads), including 3/6 dyads involving a male index and a younger woman. Index participants with a referred partner were more likely to report no casual partners and to be living with their current partner than participants not in dyads.Conclusions
Passive-partner referral successfully identified partners with genetically-similar HIV infections-the likely source of infection-but only 40% of index cases referred partners who presented for HIV-1 testing. Future work evaluating assisted partner notification may help reach susceptible partners or more people with untreated HIV-1 infections connected to acute transmission.Clinical trials registration
NCT01450189.
SUBMITTER: Dennis AM
PROVIDER: S-EPMC6695510 | biostudies-literature | 2019 Aug
REPOSITORIES: biostudies-literature
Dennis Ann M AM Cohen Myron S MS Rucinski Katherine B KB Rutstein Sarah E SE Powers Kimberly A KA Pasquale Dana K DK Phiri Sam S Hosseinipour Mina C MC Kamanga Gift G Nsona Dominic D Massa Cecilia C Hoffman Irving F IF Pettifor Audrey E AE Miller William C WC
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20190801 5
<h4>Background</h4>Understanding sexual networks involving acute human immunodeficiency virus (HIV)-1 infections (AHI) may lead to prevention opportunities to mitigate high rates of onward transmission. We evaluated HIV-1 phylogenetic and behavioral characteristics among persons with AHI and their referred partners.<h4>Methods</h4>Between 2012 and 2014, 46 persons with AHI in Malawi participated in a combined behavioral and biomedical intervention. Participants referred sexual partners by passiv ...[more]