A Proportion of Self-Collected Rectal Swabs Yield Human Immunodeficiency Virus Sequences Phylogenetically Related to Those from Plasma Human Immunodeficiency Virus RNA.

We determined HIV-1 pol gene sequences from self-collected rectal swabs of HIV-positive young men who have sex with men and transgender women. HIV-1 pol was amplified from 39/96 (41%) rectal swabs, including 29/77 (38%) prevalent and 10/19 (53%) incident HIV-1 infections (p < .001). Pol did not amplify from rectal swabs from participants with plasma viral load <1,000 copies/mL. Each rectal swab-derived amplicon consensus sequence was most closely related to the paired plasma virion RNA-derived sequence from the same participant. Results document a rectal mucosal source of HIV-1 in infected persons and suggest usefulness for noninvasive study of biological mechanisms underlying the epidemiologic risk to an insertive partner of HIV-1 acquisition during condomless anal sex.