title: Transmission clustering drives the onward spread of the HIV epidemic among men who have sex with men in Quebec.
abstract: Phylodynamic analysis and epidemiologic data identified 3 patterns of spread of primary human immunodeficiency virus type 1 infection (PHI) among men who have sex with men (2001-2009): 420 unique PHIs, 102 small clusters (2-4 PHIs per cluster, n = 280), and 46 large clusters (5-31 PHIs per cluster, n = 450). Large clusters disproportionately increased from 25.2% of PHIs in 2005 to 39.1% in 2009 (χ(2) = 33.9, P < .001). Scalar expansion of large clusters over 11 months (interquartile range, 3.5-25.5 months) correlated with cluster membership size (r(2) = 0.174, F = 4.424, P = .047). PHI cohort data revealed variations in social networks and risk behaviors among the 3 groups, suggesting the need for tailored prevention measures.
authors: McGill University AIDS Centre, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec. bluma.brenner@mcgill.ca
authors: Bluma G
authors: BG
authors: Brenner
authors: Michel
authors: M
authors: Roger
authors: David
authors: D
authors: Stephens
authors: Daniela
authors: D
authors: Moisi
authors: Isabelle
authors: I
authors: Hardy
authors: Jonathan
authors: J
authors: Weinberg
authors: Reuven
authors: R
authors: Turgel
authors: Hugues
authors: H
authors: Charest
authors: James
authors: J
authors: Koopman
authors: Mark A
authors: MA
authors: Wainberg
mesh_terms: D001499:Bayes Theorem; D016000:Cluster Analysis; D015751:Genes, pol; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D058974:Phylogeography; D011792:Quebec / Q000453:epidemiology; D012309:Risk-Taking; D017422:Sequence Analysis, DNA; D012725:Sexual Behavior; D012944:Social Support; D013997:Time Factors