BOSTON – Using existing analyses of viruses generated by drug-resistance testing among people diagnosed with HIV, a U.S. Centers for Disease Control and Prevention study identified 60 clusters of people across the United States among whom the virus was spreading at 11 times the rate — at 44 transmissions per 100 person years — than would be expected from average transmission rates.
The identification of the clusters, disproportionately among Hispanic men who have sex with men, can inform locally driven targeted services to populations at greatest risk, Dr. Ann Marie France of the CDC said during her presentation here today.
U.S. guidelines recommend drug-resistance testing for all people diagnosed with HIV. The CDC drew on data on more than 280,000 people living with HIV in the U.S. gathered from 2013 to 2016.
Routinely analyzing that information and identifying characteristics of clusters can maximize the efficiency and effectiveness of state and local health department resources and responses, Dr. France said. “We think this is a tremendous opportunity.”
She presented the study findings at a session on new approaches to surveillance and epidemiology that included unexpected findings on transmission patterns among transgender women in Los Angeles, also drawing on information culled from drug-resistance tests. That research, presented by Manon Ragonnet-Cronin of the University of California, San Diego, found transmission patterns indicating that transgender women were “far more likely to link to other transgender women than expected,” and that linking to one transgender woman increased the odds of linking to another transgender woman nine-fold. The findings can help to propel partner services, PrEP access, and linkage to treatment and care, she noted.
Also presented at the session was an analysis of geographical mapping and viral genetic sequencing to identify “hot spots” driving transmission in South Africa communities and to target prevention measures.