Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda

Publication date: Available online 14 January 2020Source: The Lancet HIVAuthor(s): Oliver Ratmann, Joseph Kagaayi, Matthew Hall, Tanya Golubchick, Godfrey Kigozi, Xiaoyue Xi, Chris Wymant, Gertrude Nakigozi, Lucie Abeler-Dörner, David Bonsall, Astrid Gall, Anne Hoppe, Paul Kellam, Jeremiah Bazaale, Sarah Kalibbala, Oliver Laeyendecker, Justin Lessler, Fred Nalugoda, Larry W Chang, Tulio de OliveiraSummaryBackgroundInternational and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits of geo-targeted control, we assessed the extent to which HIV hotspots along Lake Victoria sustain transmission in neighbouring populations in south-central Uganda.MethodsWe did a population-based survey in Rakai, Uganda, using data from the Rakai Community Cohort Study. The study surveyed all individuals aged 15–49 years in four high-prevalence Lake Victoria fishing communities and 36 neighbouring inland communities. Viral RNA was deep sequenced from participants infected with HIV who were antiretroviral therapy-naive during the observation period. Phylogenetic analysis was used to infer partial HIV transmission networks, including direction of transmission. Reconstructed networks were interpreted through data for current residence and migration history. HIV transmission flows within and between high-prevalence and low-prevalence areas were quantified adjusting for incomplete sampling of the population...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research