Genetic clustering analysis for HIV infection among MSM in Nigeria
implications for intervention
implications for intervention
File(s)LiHIVGeneticClusteringamongNigerianMSM_revised.docx (158.47 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The HIV epidemic continues to grow among MSM in countries across sub-Saharan Africa including Nigeria. To inform prevention efforts, we used a phylogenetic cluster method to characterize HIV genetic clusters and factors associated with cluster formation among MSM living with HIV in Nigeria. METHODS: We analyzed HIV-1 pol sequences from 417 MSM living with HIV enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos, Nigeria. A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with HIV genetic cluster membership and size. RESULTS: Among 417 MSM living with HIV, 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04-2.86), no female partners (AOR = 3.66; 95% CI: 1.97-6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08-10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants, MSM who had high school education (AOR = 23.84; 95% CI: 2.66-213.49), were employed (AOR = 3.41; 95% CI: 1.89-10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89-17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25-19.37) had higher odds of being in a large cluster (size > 4). CONCLUSION: Comprehensive HIV prevention packages should include behavioral and biological components, including early diagnosis and treatment of both HIV and bacterial sexually transmitted infections to optimally reduce the risk of HIV transmission and acquisition.
Date Issued
2020-02-01
Date Acceptance
2019-10-01
Citation
AIDS, 2020, 34 (2), pp.227-236
ISSN
0269-9370
Publisher
Lippincott, Williams & Wilkins
Start Page
227
End Page
236
Journal / Book Title
AIDS
Volume
34
Issue
2
Copyright Statement
© 2019 Lippincott Williams & Wilkins, Inc. This is a non-final version of an article published in final form in https://doi.org/10.1097/QAD.0000000000002409.
Sponsor
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31634185
Grant Number
5R01AI120913
MR/R015600/1
Subjects
TRUST/RV368 Study Group
Virology
06 Biological Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status
Published online
Coverage Spatial
England
Date Publish Online
2019-10-11