François Cholette, Lisa Lazarus, Pascal Macharia, Jeffrey Walimbwa, Samuel Kuria, Parinita Bhattacharjee, Helgar Musyoki, Mary Mugambi, Martin K Ongaro, Kennedy Olango, Janet Musimbi, Faran Emmanuel, Shajy Isac, Michael Pickles, Marissa L Becker, Sharmistha Mishra, Lyle R McKinnon, James Blanchard, John Ho, Omari Henry, Rissa Fabia, Paul Sandstrom, Robert Lorway, Souradet Y Shaw
{"title":"艾滋病毒系统发育群表明肯尼亚男男性行为者的艾滋病毒预防、检测和治疗需求尚未得到满足。","authors":"François Cholette, Lisa Lazarus, Pascal Macharia, Jeffrey Walimbwa, Samuel Kuria, Parinita Bhattacharjee, Helgar Musyoki, Mary Mugambi, Martin K Ongaro, Kennedy Olango, Janet Musimbi, Faran Emmanuel, Shajy Isac, Michael Pickles, Marissa L Becker, Sharmistha Mishra, Lyle R McKinnon, James Blanchard, John Ho, Omari Henry, Rissa Fabia, Paul Sandstrom, Robert Lorway, Souradet Y Shaw","doi":"10.1186/s12879-024-10052-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.</p><p><strong>Methods: </strong>Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.</p><p><strong>Results: </strong>Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).</p><p><strong>Conclusions: </strong>Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1323"},"PeriodicalIF":3.4000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580190/pdf/","citationCount":"0","resultStr":"{\"title\":\"HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya.\",\"authors\":\"François Cholette, Lisa Lazarus, Pascal Macharia, Jeffrey Walimbwa, Samuel Kuria, Parinita Bhattacharjee, Helgar Musyoki, Mary Mugambi, Martin K Ongaro, Kennedy Olango, Janet Musimbi, Faran Emmanuel, Shajy Isac, Michael Pickles, Marissa L Becker, Sharmistha Mishra, Lyle R McKinnon, James Blanchard, John Ho, Omari Henry, Rissa Fabia, Paul Sandstrom, Robert Lorway, Souradet Y Shaw\",\"doi\":\"10.1186/s12879-024-10052-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.</p><p><strong>Methods: </strong>Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.</p><p><strong>Results: </strong>Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).</p><p><strong>Conclusions: </strong>Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. 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引用次数: 0
摘要
背景：肯尼亚的艾滋病疫情仍然是一个重大的公共卫生问题，尤其是在男同性恋、双性恋和其他男男性行为者（GBMSM）中，他们仍然承受着不成比例的疫情负担。本研究旨在描述肯尼亚男同性恋、双性恋和其他男男性行为者（GBMSM）中不同亚群的 HIV 系统发育集群，包括那些使用实体热点、虚拟空间或两者结合来寻找男性性伴侣的人群：方法：分别于 2019 年（基线）和 2020 年（端线）在肯尼亚基苏木、蒙巴萨和基安布县收集了 GBMSM 的干血斑（DBS）。对所有血清反应阳性的 DBS 进行了 HIV pol 测序。使用每个位点的核苷酸替换≤ 0.02 的父系距离截止值推断出 HIV 系统发生群。我们使用描述性统计方法分析了按聚类状况分层的社会人口学特征和危险行为：在 2450 名参与者（基线和终点）中，有 453 人（18.5%）感染了艾滋病毒。只有一小部分血清阳性的 DBS 标本成功测序（n = 36/453；7.9%），这可能是因为大多数研究参与者的病毒得到了抑制（87.4%）。在这些序列中，13 个（36.1%）形成了 8 个不同的群组，包括 7 个二联体和 1 个三联体。这些群组主要由在网上寻找伴侣的 GBMSM（n = 10/13；76.9%）和检测频率低于肯尼亚指南建议的 GBMSM（n = 11/13；84.6%）组成：我们的研究在肯尼亚的 GBMSM 中发现了 HIV 系统发育集群，这些人主要通过网络寻找性伴侣，且检测频率较低。这些发现凸显了这一人群中潜在的未得到满足的 HIV 预防、检测和治疗需求。此外，这些结果还强调了定制 HIV 项目的重要性，以满足肯尼亚 GBMSM 在不同场所（包括实体热点和网络平台）的不同需求，从而确保采取全面的预防和护理策略。
HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya.
Background: The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study's objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.
Methods: Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.
Results: Of the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).
Conclusions: Our study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.
期刊介绍：
BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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