title: Acquisition of HIV by African-born residents of Victoria, Australia: insights from molecular epidemiology.
abstract: African-born Australians are a recognised "priority population" in Australia's Sixth National HIV/AIDS Strategy. We compared exposure location and route for African-born people living with HIV (PLHIV) in Victoria, Australia, with HIV-1 pol subtype from drug resistance assays and geographical origin suggested by phylogenetic analysis of env gene. Twenty adult HIV positive African-born Victorian residents were recruited via treating doctors. HIV exposure details were obtained from interviews and case notes. Viral RNA was extracted from participant stored plasma or whole blood. The env V3 region was sequenced and compared to globally representative reference HIV-1 sequences in the Los Alamos National Library HIV Database. Twelve participants reported exposure via heterosexual sex and two via iatrogenic blood exposures; four were men having sex with men (MSM); two were exposed via unknown routes. Eight participants reported exposure in their countries of birth, seven in Australia, three in other countries and two in unknown locations. Genotype results (pol) were available for ten participants. HIV env amplification was successful in eighteen cases. HIV-1 subtype was identified in all participants: eight both pol and env; ten env alone and two pol alone. Twelve were subtype C, four subtype B, three subtype A and one subtype CRF02_AG. Reported exposure location was consistent with the phylogenetic clustering of env sequences. African Australians are members of multiple transnational social and sexual networks influencing their exposure to HIV. Phylogenetic analysis may complement traditional surveillance to discern patterns of HIV exposure, providing focus for HIV prevention programs in mobile populations.
authors.affiliation: Centre for Population Health, The Burnet Institute, Melbourne, Victoria, Australia ; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia ; Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Lemoh
authors.affiliation: Centre for Biomedical Research, The Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Ryan
authors.affiliation: Centre for Biomedical Research, The Burnet Institute, Melbourne, Victoria, Australia ; Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia.
authors.forename: Zamberi
authors.initials: Z
authors.lastname: Sekawi
authors.affiliation: Centre for Biomedical Research, The Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Hearps
authors.affiliation: Centre for Biomedical Research, The Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Eman
authors.initials: E
authors.lastname: Aleksic
authors.affiliation: HIV State Reference Laboratory, Victorian Infectious Disease Reference Laboratory, Melbourne, Victoria, Australia.
authors.forename: Doris
authors.initials: D
authors.lastname: Chibo
authors.affiliation: Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Grierson
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Samia
authors.initials: S
authors.lastname: Baho
authors.affiliation: Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Street
authors.affiliation: Centre for Population Health, The Burnet Institute, Melbourne, Victoria, Australia ; Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.affiliation: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia ; Victorian Infectious Disease Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Beverley-Ann
authors.initials: BA
authors.lastname: Biggs
authors.affiliation: Centre for Biomedical Research, The Burnet Institute, Melbourne, Victoria, Australia ; Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Crowe
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D001315:Australia / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D019143:Evolution, Molecular; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D012725:Sexual Behavior / Q000208:ethnology*