Journal Article

Characteristics of HIV-infected U.S. Army soldiers linked in molecular transmission clusters, 2001-2012

Kijak, Gustavo H., Liu, Ying, Scoville, Stephanie L., Peel, Sheila A., Pham, Peter T., Cersovsky, Steven B., Scott, Paul T., Michael, Nelson L., Jagodzinski, Linda L., Hakre, Shilpa, Tovanabutra, Sodsai, McCutchan, Francine E.

2017

Overview

Recent surveillance data suggests the United States (U.S.) Army HIV epidemic is concentrated among men who have sex with men. To identify potential targets for HIV prevention strategies, the relationship between demographic and clinical factors and membership within transmission clusters based on baseline pol sequences of HIV-infected Soldiers from 2001 through 2012 were analyzed. We conducted a retrospective analysis of baseline partial pol sequences, demographic and clinical characteristics available for all Soldiers in active service and newly-diagnosed with HIV-1 infection from January 1, 2001 through December 31, 2012. HIV-1 subtype designations and transmission clusters were identified from phylogenetic analysis of sequences. Univariate and multivariate logistic regression models were used to evaluate and adjust for the association between characteristics and cluster membership. Among 518 of 995 HIV-infected Soldiers with available partial pol sequences, 29% were members of a transmission cluster. Assignment to a southern U.S. region at diagnosis and year of diagnosis were independently associated with cluster membership after adjustment for other significant characteristics (p<0.10) of age, race, year of diagnosis, region of duty assignment, sexually transmitted infections, last negative HIV test, antiretroviral therapy, and transmitted drug resistance. Subtyping of the pol fragment indicated HIV-1 subtype B infection predominated (94%) among HIV-infected Soldiers. These findings identify areas to explore as HIV prevention targets in the U.S. Army. An increased frequency of current force testing may be justified, especially among Soldiers assigned to duty in installations with high local HIV prevalence such as southern U.S. states.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adolescent / Adult / AIDS / Antiretroviral agents / Antiretroviral drugs / Antiretroviral therapy / Armed forces / Army / Biology and Life Sciences / Cluster analysis / Demographics / Diagnosis / Disease transmission / Drug resistance / Epidemics / Female / Health aspects / Highly active antiretroviral therapy / HIV / HIV infections / HIV Infections - epidemiology / HIV Infections - transmission / Human immunodeficiency virus / Humans / Infections / Male / Medical diagnosis / Medical examination / Medicine and health sciences / Men / Middle Aged / Military / Military personnel / Military Personnel - statistics & numerical data / People and Places / Phylogeny / Prevention / Regression analysis / Regression models / Research and Analysis Methods / Risk factors / Sexually transmitted diseases / Soldiers / STD / Target recognition / United States / Womens health