John A Schneider1,2, Christina Hayford3, Anna Hotton1, Irina Tabidze4, Joel O Wertheim5, Santhoshini Ramani2, Camden Hallmark6, Ethan Morgan7, Patrick Janulis3, Aditya Khanna8, Jonathan Ozik2,9, Kayo Fujimoto10, Rey Flores1,2, Rich D'aquila3, Nanette Benbow3. 1. University of Chicago Medicine. 2. Chicago Center for HIV Elimination. 3. Northwestern University Feinberg School of Medicine. 4. Chicago Public Health Department, Chicago, Illinois. 5. Department of Medicine, University of California, San Diego, La Jolla, California. 6. Houston Health Department, Houston, Texas. 7. College of Public Health, Ohio State University, Columbus, Ohio. 8. School of Public Health, Brown University, Providence, Rhode Island. 9. Department of Public Health Science, University of Chicago, Chicago, Illinois. 10. University of Texas Health Science Center at Houston, Houston, Texas, USA.
Abstract
OBJECTIVES: We examined whether molecular cluster membership was associated with public health identification of HIV transmission potential among named partners in Chicago. DESIGN: Historical cohort study. METHODS: We matched and analyzed HIV surveillance and partner services data from HIV diagnoses (2012-2016) prior to implementation of cluster detection and response interventions. We constructed molecular clusters using HIV-TRACE at a pairwise genetic distance threshold of 0.5% and identified clusters exhibiting recent and rapid growth according to the Centers for Disease Control and Prevention definition (three new cases diagnosed in past year). Factors associated with identification of partners with HIV transmission potential were examined using multivariable Poisson regression. RESULTS: There were 5208 newly diagnosed index clients over this time period. Average age of index clients in clusters was 28; 47% were Black, 29% Latinx/Hispanic, 6% female and 89% MSM. Of the 537 named partners, 191 (35.6%) were linked to index cases in a cluster and of those 16% were either new diagnoses or viremic. There was no statistically significant difference in the probability of identifying partners with HIV transmission potential among index clients in a rapidly growing cluster versus those not in a cluster [adjusted relative risk 1.82, (0.81-4.06)]. CONCLUSION: Partner services that were initiated from index clients in a molecular cluster yielded similar new HIV case finding or identification of those with viremia as did interviews with index clients not in clusters. It remains unclear whether these findings are due to temporal disconnects between diagnoses and cluster identification, unobserved cluster members, or challenges with partner services implementation.
OBJECTIVES: We examined whether molecular cluster membership was associated with public health identification of HIV transmission potential among named partners in Chicago. DESIGN: Historical cohort study. METHODS: We matched and analyzed HIV surveillance and partner services data from HIV diagnoses (2012-2016) prior to implementation of cluster detection and response interventions. We constructed molecular clusters using HIV-TRACE at a pairwise genetic distance threshold of 0.5% and identified clusters exhibiting recent and rapid growth according to the Centers for Disease Control and Prevention definition (three new cases diagnosed in past year). Factors associated with identification of partners with HIV transmission potential were examined using multivariable Poisson regression. RESULTS: There were 5208 newly diagnosed index clients over this time period. Average age of index clients in clusters was 28; 47% were Black, 29% Latinx/Hispanic, 6% female and 89% MSM. Of the 537 named partners, 191 (35.6%) were linked to index cases in a cluster and of those 16% were either new diagnoses or viremic. There was no statistically significant difference in the probability of identifying partners with HIV transmission potential among index clients in a rapidly growing cluster versus those not in a cluster [adjusted relative risk 1.82, (0.81-4.06)]. CONCLUSION: Partner services that were initiated from index clients in a molecular cluster yielded similar new HIV case finding or identification of those with viremia as did interviews with index clients not in clusters. It remains unclear whether these findings are due to temporal disconnects between diagnoses and cluster identification, unobserved cluster members, or challenges with partner services implementation.
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