@article{530aed45cf9b459b9afb898006dcfc80,
title = "Genetic clustering analysis for HIV infection among MSM in Nigeria: Implications for intervention",
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.",
keywords = "HIV, MSM, Nigeria, intervention, phylogenetic cluster",
author = "Yuruo Li and Hongjie Liu and Ramadhani, {Habib O.} and Nicaise Ndembi and Crowell, {Trevor A.} and Gustavo Kijak and Robb, {Merlin L.} and Ake, {Julie A.} and Afoke Kokogho and Nowak, {Rebecca G.} and Charlotte Gaydos and Baral, {Stefan D.} and Erik Volz and Sodsai Tovanabutra and Man Charurat",
note = "Funding Information: aDepartment of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, bInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA, cInstitute of Human Virology Nigeria, Abuja, Nigeria, dUS Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, eHenry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, fJohns Hopkins University School of Medicine, Baltimore, gDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, hDepartment of Infectious Disease Epidemiology, Imperial College, London, UK, iHenry M. Jackson Foundation Medical Research International, and jUS Army Medical Research Directorate-Africa/Nigeria, Abuja, Nigeria. Correspondence to Yuruo Li, Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 4200 Valley Drive, Suite 2242, College Park, MD 20742, USA. Tel: +1 404 539 6249; e-mail: yuruo.li12@gmail.com *Current affiliation: GSK Vaccines, Rockville, Maryland, USA. Received: 6 June 2019; revised: 24 September 2019; accepted: 25 September 2019. Funding Information: The work was supported by a cooperative agreement between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the US Department of Defense (W81XWH-11-2-0174); the National Institutes of Health (R01 MH099001, R01 AI120913, R01 MH110358); Fogarty Epidemiology Research Training for Public Health Impact in Nigeria program (D43TW010051); and the President{\textquoteright}s Emergency Plan for AIDS Relief through a cooperative agreement between the Department of Health and Human Services/Centers for Disease Control and Prevention, and the Institute for Human Virology-Nigeria (NU2GGH002099). Funding Information: The institutional review boards at the Nigerian Federal Capital Territory Health Research Ethics Committee, the Nigerian Ministry of Defense, the University of Maryland Baltimore, and the Walter Reed Army Institute of Research reviewed and approved the research protocol. All participants provided written informed consent and data were deidentified prior to analysis. Funding Information: The work was supported by a cooperative agreement between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the US Department of Defense (W81XWH-11-2-0174); the National Institutes of Health (R01 MH099001, R01 AI120913, R01 MH110358); Fogarty Epidemiology Research Training for Public Health Impact in Nigeria program (D43TW010051); and the President's Emergency Plan for AIDS Relief through a cooperative agreement between the Department of Health and Human Services/Centers for Disease Control and Prevention, and the Institute for Human Virology-Nigeria (NU2GGH002099). Funding Information: The TRUST/RV368 Study Group includes Principal Investigators: Manhattan Charurat (IHV, University of Maryland, Baltimore, MD, USA), Julie Ake (MHRP, Walter Reed Army Institute of Research, Silver Spring, MD, USA); Coinvestigators: Sylvia Adebajo, Stefan Baral, Erik Billings, Trevor Crowell, George Eluwa, Abiola Fasina, Charlotte Gaydos, Sosthenes Ketende, Afoke Kokogho, Hongjie Liu, Jennifer Malia, Olumide Makanjuola, Nelson Michael, Nicaise Ndembi, Jean Njab, Rebecca Nowak, Oluwasolape Olawore, Zahra Parker, Sheila Peel, Habib Ramadhani, Merlin Robb, Cristina Rodriguez-Hart, Eric Sanders-Buell, Sodsai Tovanabutra, Erik Volz; Institutions: Institute of Human Virology at the University of Maryland School of Medicine (IHV-UMB), University of Maryland School of Public Health (UMD SPH), Johns Hopkins Bloomberg School of Public Health (JHSPH), Johns Hopkins University School of Medicine (JHUSOM), US Military HIV Research Program (MHRP), Walter Reed Army Institute of Research (WRAIR), Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), Henry M. Jackson Foundation Medical Research International (HJFMRI), Institute of Human Virology Nigeria (IHVN), International Centre for Advocacy for the Right to Health (ICARH), The Initiative for Equal Rights (TIERS), Population Council (Pop Council) Nigeria, Imperial College London. Publisher Copyright: {\textcopyright} 2019 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2020",
month = feb,
day = "1",
doi = "10.1097/QAD.0000000000002409",
language = "English (US)",
volume = "34",
pages = "227--236",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "2",
}