title: High Transmissibility During Early HIV Infection Among Men Who Have Sex With Men-San Francisco, California.
abstract: We estimate the relative transmission rate in early versus later infection among men who have sex with men (MSM) in San Francisco, California, by studying the characteristics of a sample of transmitters, recruited through newly diagnosed, recently infected MSM between 1996 and 2009. Of 36 transmitters identified, 9 were determined on the basis of testing history and serologic testing to have been recently infected. The unadjusted odds ratio of transmitting during early infection was 15.2 (95% confidence interval [CI], 6.3-33.4; P < .001); the odds ratio was 8.9 (95% CI, 4.1-19.4) after adjustment for self-reported antiretroviral treatment. This high transmissibility could be due to both high infectiousness and high rates of sex partner change or concurrent partnerships.
authors.affiliation: Warwick Infectious Disease Epidemiology Research, Warwick Mathematics Institute School of Life Sciences, University of Warwick, Coventry Department of Clinical Sciences, Liverpool School of Tropical Medicine.
authors.forename: T Déirdre
authors.initials: TD
authors.lastname: Hollingsworth
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California-San Francisco.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Pilcher
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California-San Francisco.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Hecht
authors.affiliation: HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California-San Francisco.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Deeks
authors.affiliation: MRC Centre for Outbreak Analysis and Modelling, Department for Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom.
authors.forename: Christophe
authors.initials: C
authors.lastname: Fraser
mesh_terms: D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012495:San Francisco / Q000453:epidemiology
keywords: HIV; San Francisco; early infection; men who have sex with men; transmission rate