HIV Transmission Patterns among Immigrant Latinos Illuminated by the Integration of Phylogenetic and Migration Data.


Dennis, AM; Hue, S; Pasquale, D; Napravnik, S; Sebastian, J; Miller, WC; Eron, JJ; (2015) HIV Transmission Patterns among Immigrant Latinos Illuminated by the Integration of Phylogenetic and Migration Data. AIDS research and human retroviruses. ISSN 0889-2229 DOI: https://doi.org/10.1089/AID.2015.0089

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Abstract

Latinos represent a growing proportion of HIV cases in North Carolina (NC). Understanding how immigrants are involved in local HIV transmission is important to guide interventions. We used phylogenetics to characterize Latino involvement in local HIV transmission chains. Transmission clusters were identified from maximum-likelihood phylogenies constructed with HIV pol sequences from 177 Latinos and 1496 non-Latinos receiving care in NC. Highly supported clusters involving ≥1 Latino were characterized. Migration data were obtained from interviews and chart-review. Factors associated with cluster membership were identified using log-binomial regression. Most Latinos were male (76%), immigrants (83%), and had HIV-1B (99%). Immigrants were more likely to report heterosexual risk (67% vs. 23%) than US-born Latinos (P<0.01). We identified 32 clusters that included ≥1 Latino; these involved 53 Latinos (30%) and 41 non-Latinos. Immigrant and US-born Latinos were equally likely to be in clusters but immigrants were more likely to be in clusters with another Latino (78% vs. 29%; P=0.02). Cluster composition by ethnicity and risk behavior varied by cluster size; larger clusters contained fewer immigrants and more MSM. Factors associated with immigrant membership in local transmission clusters included: age<30 years (RR 2.34 [95% CI 1.47-3.73]), Mexican origin (RR 2.55 [95% CI 1.29-6.88]), and residing in US longer before diagnosis (RR 1.53 [95% CI 1.09-2.15], per 10 years). While some Latinos immigrate with HIV infection, many immigrants are involved in transmission networks after arrival, particularly MSM. HIV testing and prevention interventions must consider this heterogeneity and may be better targeted by integrating phylogenetic analyses.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 26214548
Web of Science ID: 361395500006
URI: http://researchonline.lshtm.ac.uk/id/eprint/2248492

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