Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Substance Abuse Treatment Evaluation and Interventions, RTI International, Research Triangle Park, NC.
J Acquir Immune Defic Syndr. 2018 Aug 1;78(4):367-375. doi: 10.1097/QAI.0000000000001695.
Partner notification is an important component of public health test and treat interventions. To enhance this essential function, we assessed the potential for molecular methods to supplement routine partner notification and corroborate HIV networks.
All persons diagnosed with HIV infection in Wake County, NC, during 2012-2013 and their disclosed sexual partners were included in a sexual network. A data set containing HIV-1 pol sequences collected in NC during 1997-2014 from 15,246 persons was matched to HIV-positive persons in the network and used to identify putative transmission clusters. Both networks were compared.
The partner notification network comprised 280 index cases and 383 sexual partners and high-risk social contacts (n = 131 HIV-positive). Of the 411 HIV-positive persons in the partner notification network, 181 (44%) did not match to a HIV sequence, 61 (15%) had sequences but were not identified in a transmission cluster, and 169 (41%) were identified in a transmission cluster. More than half (59%) of transmission clusters bridged sexual network partnerships that were not recognized in the partner notification; most of these clusters were dominated by men who have sex with men.
Partner notification and HIV sequence analysis provide complementary representations of the existent partnerships underlying the HIV transmission network. The partner notification network components were bridged by transmission clusters, particularly among components dominated by men who have sex with men. Supplementing the partner notification network with phylogenetic data highlighted avenues for intervention.
伙伴通知是公共卫生检测和治疗干预的重要组成部分。为了增强这一重要功能，我们评估了分子方法补充常规伙伴通知和证实 HIV 网络的潜力。
所有在北卡罗来纳州威克县 2012-2013 年期间被诊断为 HIV 感染的人和他们披露的性伴侣都被纳入性网络。包含 HIV-1 pol 序列的数据集是从 1997-2014 年期间在北卡罗来纳州从 15246 人收集的，与网络中的 HIV 阳性者相匹配，并用于识别可能的传播簇。两个网络进行了比较。
伙伴通知网络包括 280 个索引病例和 383 个性伴侣和高危社会接触者（n = 131 个 HIV 阳性者）。在伙伴通知网络中的 411 个 HIV 阳性者中，181 人（44%）与 HIV 序列不匹配，61 人（15%）有序列但未在传播簇中识别出，169 人（41%）在传播簇中识别出。超过一半（59%）的传播簇连接了在伙伴通知中未被识别的性网络伙伴关系；这些簇大多数由男男性行为者主导。
伙伴通知和 HIV 序列分析提供了 HIV 传播网络中现存伙伴关系的互补表示。伙伴通知网络的组成部分被传播簇连接起来，特别是在由男男性行为者主导的组成部分中。用系统发育数据补充伙伴通知网络突出了干预的途径。
