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Ginger Zhe Jin, University of Maryland, et al.; 2013-011

Background:  The  HIV  epidemic continues to grow among  MSM  in countries across sub-Saharan Africa including  Nigeria . To inform prevention efforts, we used a  phylogenetic cluster  method to characterize  HIV  genetic clusters and factors associated with cluster formation among  MSM  living with  HIV  in  Nigeria . Methods:  We analyzed  HIV -1 pol sequences from 417  MSM  living with  HIV  enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos,  Nigeria . A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with  HIV  genetic cluster membership and size. Results:  Among 417  MSM  living with  HIV , 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04–2.86), no female partners (AOR = 3.66; 95% CI: 1.97–6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08–10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants,  MSM  who had high school education (AOR = 23.84; 95% CI: 2.66–213.49), were employed (AOR = 3.41; 95% CI: 1.89–10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89–17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25–19.37) had higher odds of being in a large cluster (size > 4). Conclusion:  Comprehensive  HIV  prevention packages should include behavioral and biological components, including early diagnosis and treatment of both  HIV  and bacterial sexually transmitted infections to optimally reduce the risk of  HIV  transmission and acquisition.

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