Cross-Border Sexual Transmission of the Newly Emerging HIV-1 Clade CRF51_01B

Cheong, Hui Ting; Ng, Kim Tien; Ong, Lai Yee; Chook, Jack Bee; Chan, Kok‐Gan; Takebe, Yutaka; Kamarulzaman, Adeeba; Tee, Kok Keng

doi:10.1371/journal.pone.0111236

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…[ 24 ] Unprotected sex while traveling, in combination with other correlated risk behaviors such as group sex, sex while using drugs, sex while drunk and multiple sex partners, amplifies disease transmission. [ 5 ] This trend is consistent with the higher burden of living with HIV noted among sex tourists in our sample. Efforts to reduce HIV/STI transmission risks while traveling may be effective in reducing disease spread upon return.…”

Section: Discussionsupporting

confidence: 89%

“…This presents a concern for disease transmission when travelers return to their home regions with lower HIV prevalence. [ 6 ] Previous studies on sex tourism in China [ 27 ] and internationally [ 5 ] have shown a trend in travel from regions of lower HIV prevalence to higher HIV prevalence, leading to transmission upon return. However, given the large migrant population in China, it may be challenging to isolate disease transmission secondary to migration from sex tourism.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] The movement of high-risk individuals across areas with markedly different HIV prevalence has been shown to drive HIV transmission. [ 5 , 6 ] Second, as sex tourists are a subgroup of clients of male sex workers, they often have greater power in deciding about condom use. [ 6 ] Third, traveling for sex is linked with unprotected anal intercourse and other behaviors that increase HIV risk.…”

Section: Introductionmentioning

confidence: 99%

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Sex tourism among Chinese men who have sex with men: a cross-sectional observational study

Mao

Tang²,

Liu³

et al. 2018

BMC Public Health

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BackgroundSex tourism among men who have sex with men (MSM) may exacerbate transmission of HIV and other sexually transmitted infections (STIs). Sex tourism is defined as purchasing sex with gifts or money outside of one’s hometown. Our objective was to characterize the frequency, socio-demographic characteristics, and sexual risk behaviors among Chinese MSM sex tourists.MethodsAn online, cross-sectional survey for high-risk MSM throughout China was conducted in November 2015 covering sociodemographic characteristics, sexual risk behaviors, and sex tourism. Univariate and multivariable logistic regressions were performed to identify correlates of sex tourism. The mean MSM HIV prevalence of sex tourism journey origins and destinations were compared.ResultsOf 1189 MSM who completed the survey, 62 (5%) men identified as sex tourists; among these sex tourists, twenty (32%) traveled primarily to purchase sex and the remainder purchased sex while traveling for another purpose. There was minimal socio-demographic and behavioral difference between the two groups. In multivariable analyses, adjusting for age and income, sex tourism was correlated with high-risk sexual behaviors, higher income (aOR 4.44, 95%CI 1.77–11.18) and living with HIV (aOR 2.79, 95%CI 1.03–7.55). Sex tourism was more often from locations with lower to higher MSM HIV prevalence (mean = 4.47, SD = 2.01 versus mean = 6.86, SD = 5.24).ConclusionMSM sex tourists were more likely to have risky sexual behaviors and travel to locations with a higher HIV prevalence. MSM sex tourists may be part of core groups that are disproportionately responsible for MSM HIV transmission. Enhanced surveillance and interventions tailored to MSM sex tourists should be considered.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sex tourism among Chinese men who have sex with men: a cross-sectional observational study

Mao

Tang²,

Liu³

et al. 2018

BMC Public Health

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“…However, certain limitations that may affect the tMRCA estimation and interpretation in the study should be addressed. For one, the genetic data used for the analyses were limited, as few near-full length genomes of CRF53_01B and CRF74_01B are available due to their low prevalence in the country [ 20 ]. Even for an established recombinant such as CRF33_01B, which has an increasingly extensive transmission network in Malaysia [ 5 , 11 ], only a few near-full length genomes are readily available for comprehensive phylogenetic analyses.…”

Section: Resultsmentioning

confidence: 99%

Genetic Characterization of a Novel HIV-1 Circulating Recombinant Form (CRF74_01B) Identified among Intravenous Drug Users in Malaysia: Recombination History and Phylogenetic Linkage with Previously Defined Recombinant Lineages

et al. 2015

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In many parts of Southeast Asia, the HIV-1 epidemic has been driven by the sharing of needles and equipment among intravenous drug users (IDUs). Over the last few decades, many studies have proven time and again that the diversity of HIV-1 epidemics can often be linked to the route of infection transmission. That said, the diversity and complexity of HIV-1 molecular epidemics in the region have been increasing at an alarming rate, due in part to the high tendency of the viral RNA to recombine. This scenario was exemplified by the discovery of numerous circulating recombinant forms (CRFs), especially in Thailand and Malaysia. In this study, we characterized a novel CRF designated CRF74_01B, which was identified in six epidemiologically unlinked IDUs in Kuala Lumpur, Malaysia. The near-full length genomes were composed of CRF01_AE and subtype B', with eight breakpoints dispersed in the gag-pol and nef regions. Remarkably, this CRF shared four and two recombination hotspots with the previously described CRF33_01B and the less prevalent CRF53_01B, respectively. Genealogy-based Bayesian phylogenetic analysis of CRF74_01B genomic regions showed that it is closely related to both CRF33_01B and CRF53_01B. This observation suggests that CRF74_01B was probably a direct descendent from specific lineages of CRF33_01B, CRF53_01B and subtype Bʹ that could have emerged in the mid-1990s. Additionally, it illustrated the active recombination processes between prevalent HIV-1 subtypes and recombinants in Malaysia. In summary, we report a novel HIV-1 genotype designated CRF74_01B among IDUs in Kuala Lumpur, Malaysia. The characterization of the novel CRF74_01B is of considerable significance towards the understanding of the genetic diversity and population dynamics of HIV-1 circulating in the region.

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“…However, HIV care and treatment in cross‐border areas face many challenges not encountered to the same extent in other areas, including an influx of mobile and transient populations, patients lost to follow‐up across international borders, and patients presenting for treatment away from their home countries, which may use different treatment regimens . Taken together, these challenges imply that people with HIV who live, socialize and travel in cross‐border areas may not be optimally served by existing HIV care and treatment programmes predominantly administered through a country‐focused lens.…”

Section: Introductionmentioning

confidence: 99%

The HIV care continuum among resident and non‐resident populations found in venues in East Africa cross‐border areas

Edwards

Arimi²,

Ssengooba

et al. 2019

J Intern AIDS Soc

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IntroductionHIV care and treatment in cross‐border areas in East Africa face challenges perhaps not seen to the same extent in other geographic areas, particularly for mobile and migrant populations. Here, we estimate the proportion of people with HIV found in these cross‐border areas in each stage of the HIV care and treatment cascade, including the proportion who knows their status, the proportion on treatment and the proportion virally suppressed.MethodsParticipants (n = 11,410) working or socializing in public places in selected East Africa cross border areas were recruited between June 2016 and February 2017 using the Priorities for Local AIDS Control Efforts method and administered a behavioural survey and rapid HIV test. This approach was designed to recruit a stratified random sample of people found in public spaces or venues in each cross border area. For participants testing positive for HIV, viral load was measured from dried blood spots. The proportion in each step of the cascade was estimated using inverse probability weights to account for the sampling design and informative HIV test refusals. Estimates are reported separately for residents of the cross border areas and non‐residents found in those areas.ResultsOverall, 43% of participants with HIV found in cross‐border areas knew their status, 87% of those participants were on antiretroviral therapy (ART), and 80% of participants on ART were virally suppressed. About 20% of people with HIV found in cross border areas were sampled outside their subdistrict or subcounty of residence. While both resident and non‐resident individuals who knew their status were likely to be on ART (85% and 96% respectively), people on ART recruited outside their area of residence were less likely to be suppressed (64% suppressed; 95% CI: 43, 81) compared to residents (84% suppressed; 95% CI: 75, 93).ConclusionsPeople living in or travelling through cross‐border areas may face barriers in learning their HIV status. Moreover, while non‐residents were more likely to be on treatment than residents, they were less likely to be suppressed, suggesting gaps in continuity of care for people in East Africa travelling outside their area of residence despite timely initiation of treatment.

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Cross-Border Sexual Transmission of the Newly Emerging HIV-1 Clade CRF51_01B

Cited by 8 publications

References 38 publications

Sex tourism among Chinese men who have sex with men: a cross-sectional observational study

Sex tourism among Chinese men who have sex with men: a cross-sectional observational study

Genetic Characterization of a Novel HIV-1 Circulating Recombinant Form (CRF74_01B) Identified among Intravenous Drug Users in Malaysia: Recombination History and Phylogenetic Linkage with Previously Defined Recombinant Lineages

The HIV care continuum among resident and non‐resident populations found in venues in East Africa cross‐border areas

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