Concurrency and HIV transmission network characteristics among MSM with recent HIV infection.
Sexual partner concurrency is common among MSM and may increase the probability of HIV transmission during recent (acute or early) infection. We examined the relationship between concurrency and HIV transmission network characteristics (proxies for HIV transmission) among MSM with recent HIV infection.



Observational study integrating behavioral, clinical, and molecular epidemiology.



We inferred a partial HIV transmission network using 986 HIV-1 pol sequences obtained from HIV-infected individuals in San Diego, California (1996-2015). We further analyzed data from 285 recently HIV-infected MSM in the network who provided information on up to three sexual partners in the past 3 months, including the timing of intercourse with each partner. Concurrency was defined as sexual partners overlapping in time. Logistic and negative binomial regressions were used to investigate the link between concurrency and HIV transmission network characteristics (i.e. clustering and degree or number of connections to others in the network) among these MSM.



Of recently HIV-infected MSM (n = 285), 54% reported concurrent partnerships and 54% were connected by at least one putative transmission link to others (i.e. clustered) in the network (median degree = 1.0; interquartile range: 0.0-3.0). Concurrency was positively associated with HIV transmission network clustering (adjusted odds ratio = 1.83, 95% confidence interval: 1.08, 3.10) and degree (adjusted incidence rate ratio = 1.48, 95% confidence interval: 1.02, 2.15).



Our findings provide empirical evidence consistent with the hypothesis that concurrency facilitates HIV transmission during recent infection. Interventions to mitigate the impact of concurrency on HIV transmission may help curb the HIV epidemic among MSM.
aDepartment of Medicine at the University of California, San Diego bDepartment of Family Medicine and Public Health at the University of California, San Diego. *Co-senior authors.
Heather A
HA
Pines
Joel O
JO
Wertheim
Lin
L
Liu
Richard S
RS
Garfein
Susan J
SJ
Little
Maile Y
MY
Karris
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D016000:Cluster Analysis; D018562:Disease Transmission, Infectious; D005260:Female; D005838:Genotype; D006678:HIV / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D012725:Sexual Behavior; D055815:Young Adult; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
D054302:pol Gene Products, Human Immunodeficiency Virus
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