HIV-1 transmission networks in high risk fishing communities on the shores of Lake Victoria in Uganda: A phylogenetic and epidemiological approach

Kiwuwa-Muyingo, Sylvia; Nazziwa, Jamirah; Ssemwanga, Deogratius; Ilmonen, Pauliina; Njai, Harr Freeya; Ndembi, Nicaise; Parry, Chris M.; Kitandwe, Paul Kato; Asiki, Gershim; Mpendo, Juliet; Neilsen, Leslie; Seeley, Janet; Seppälä, Heikki; Lyagoba, Fred; Kamali, Anatoli; Kaleebu, Pontiano

doi:10.1371/journal.pone.0185818

Cited by 30 publications

(50 citation statements)

References 50 publications

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“…FCs in Uganda are characterised by their limited health care and other social services [22,45,46,52,53]. Both Nsazi and Kigungu have one government health facility at health centre II/III level which provide reliable FP information.…”

Section: Discussionmentioning

confidence: 99%

Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

Nanvubya

Wanyenze

Nakaweesa

et al. 2020

Preprint

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BackgroundKnowledge of family planning (FP) is a key determinant of contraceptive use which ultimately plays a role in attainment of good health and in conduct of clinical research. People living in fishing communities (FCs) have limited access to health services including FP and are targeted for future clinical research but their knowledge of FP and its correlates are scantily known. We determined correlates of knowledge of FP among people living in FCs of L. Victoria in Uganda to inform future FP education programs in FCs. MethodsWe conducted a comparative cross-sectional survey among participants aged 15-49 years from Kigungu and Nsazi. Participants were asked if they were aware of any FP method. All those who responded in the affirmative were further asked to mention what FP methods they had heard of or knew. Those who reported knowledge of at least one FP method were asked a series of questions about FP methods and their side effects. Knowledge was categorized into good or poor knowledge based on their mean total score. Poor knowledge constituted a score below the mean while good knowledge constituted a score of more than or equal to the mean total score. To further explore attitudes and perceptions of FP, ten in-depth interviews and four focus group discussions were conducted. ResultsOf the 1,410 screened participants, 94.5% were aware of at least one FP method. Pills and injectable hormonal methods were the most commonly known methods. Slightly over a third (38%) had good knowledge of FP. Correlates of knowledge of FP were; being female (aOR: 1.92 95% CI: 1.39-2.67), residing in Kigungu (aOR: 4.01 95% CI: 2.77-5.81), being married (aOR: 1.59 95% CI: 1.11-2.28) and currently being in a sexual relationship (aOR: 1.75 95% CI: 1.18-2.60). Concerns about safety and effectiveness of some modern FP methods exist. Misconceptions on effects of FP like sterility, cancers and foetal abnormalities were common. ConclusionFP awareness among people living in FCs of L. Victoria in Uganda is high. However, good knowledge about specific methods tends to be low. Correlates of knowledge of FP include gender, residence, marital status and sexual engagement.

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Section: Discussionmentioning

confidence: 99%

Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

Nanvubya

Wanyenze

Nakaweesa

et al. 2020

Preprint

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“…Blantyre, Zomba, Lilongwe and fishing villages along Lake Malawi may also be important sources and be sustaining micro-epidemics in the surrounding rural communities. Phylogenetic analysis could be used, as in Uganda [11,12] and South Africa [27], to differentiate between localized and imported strains and determine (for specific communities) where transmission is occurring. Such analyses would provide important information regarding where to locate interventions and what type of intervention would be most effective; e.g., pre-exposure prophylaxis or voluntary mass circumcision.…”

Section: Discussionmentioning

confidence: 99%

“…Migrants and travelers in many SSA countries have been found to engage in riskier behaviors when they are away from home and are more likely to be infected with HIV than non-migrants/travelers. Additionally, several phylogenetic studies of HIV in SSA have shown that in certain communities, strains are being "imported" from other geographic locations [11,12]; the introduction of viral strains may be due to visitors infecting residents, or residents becoming infected when they travel.…”

Section: Introductionmentioning

confidence: 99%

Source-sink dynamics could sustain HIV epidemics in rural communities in sub-Saharan Africa: the case of Malawi

Okano

Sharp

Palk

et al. 2018

Preprint

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Background: Approximately 25.5 million individuals are infected with HIV in sub-Saharan Africa (SSA).Epidemics in this region are generalized, show substantial geographic variation in prevalence, and are driven by heterosexual transmission; populations are highly mobile. We propose that generalized HIV epidemics should be viewed as a series of micro-epidemics occurring in multiple connected communities. Using a mathematical model, we test the hypothesis that travel can sustain HIV micro-epidemics in communities where transmission is too low to be self-sustaining. We use Malawi as a case study. Methods:We first conduct a mapping exercise to visualize geographic variation in HIV prevalence and population-level mobility. We construct maps by spatially interpolating georeferenced HIV-testing and mobility data from a nationally representative population-level survey: the 2015-16 Malawi Demographic and Health Survey. To test our hypothesis, we construct a novel HIV epidemic model that includes three transmission pathways: resident-to-resident, visitor-caused and travel-related. The model consists of communities functioning as "sources" and "sinks". A community is a source if transmission is high enough to be self-sustaining, and a sink if it is not.Results: HIV prevalence ranges from zero to 27%. Mobility is high, 27% of the population took a trip lasting at least a month in the previous year. Prevalence is higher in urban centers than rural areas, but long-duration travel is higher in rural areas than urban centers. We show that a source-community can sustain a micro-epidemic in a sink-community, but only if specific epidemiological and demographic threshold conditions are met. The threshold depends upon the level of transmission in the source-and sink-communities, as well as the relative sizes of the two communities. The larger the source than the sink, the lower transmission in the source-community needs to be for sustainability. Discussion:Our results support our hypothesis, and suggest that it may be rather easy for large urban communities to sustain HIV micro-epidemics in small rural communities; this may be occurring in northern Malawi. Visitor-generated and travel-related transmission may also be sustaining micro-epidemics in rural communities in other SSA countries with highly-mobile populations. It is essential to consider mobility when developing HIV elimination strategies.

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“…Clustering performed based on partial pol was mostly sustained by the env sequences (Fig 2-B), except that two pol clusters were identi ed as 4 clusters because of two env clusters divided into two smaller clusters respectively. Thus, 36 robust clusters including 110 individuals (25.2%, 110/436) were identi ed according the clustering consistency analyzed and reference to relevant literature [14,15] . Of the 110 clustered individuals in the 36 clusters, 78.2% (86/110) were in 32 small clusters (including 2-5 nodes) and 21.8% (24/110) were in four large clusters (including >5 nodes) (Fig 1 and Fig 2).…”

Section: Characteristics Of Transmission Clusteringmentioning

confidence: 99%

Characteristics of HIV-1 Molecular Transmission Networks and Drug Resistance Among Men Who Have Sex with Men in Tianjin, China (2014-2018)

Zheng

Chen

et al. 2020

Preprint

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BackgroundIn Tianjin, China, there is a relatively high prevalence of HIV in men who have sex with men (MSM). The number of cases of HIV in Tianjin is also increasing. We investigated the HIV molecular transmission network, genetic tropisms, and drug resistance mutations in Tianjin. MethodsBlood samples were collected from 510 newly diagnosed antiretroviral therapy (ART)-naïve HIV-1-infected subjects among MSM in Tianjin. Partial pol and env genes were sequenced and used for phylogenetic, genetic tropism, and genotypic drug resistance analyses. Molecular clusters were identified with 1.5% genetic distance and 90% bootstrap support.ResultsAmong the 436 HIV-1 pol sequences obtained from the study participants, various genotypes were identified, including CRF01_AE (56.9%), CRF07_BC (27.8%), B (7.3%), CRF55_01B (4.1%), unique recombinant forms (URFs) (3.7%), and CRF59_01B (0.2%). A higher prevalence of X4 viruses was observed in individuals infected with CRF55_01B (56.3%) and CRF01_AE (46.2%) than with other subtypes. Of all 110 sequences in the 36 clusters, 62 (56.4%) were observed in 23 CRF01_AE clusters and 18 (16.4%) in four CRF07_BC clusters. Nine sequences clustered with at least one other shared the same drug resistance mutation (DRM). In different cluster sizes, the distributions of individuals by age, presence of sexually transmitted disease, and presence of DRMs, were significantly different. ConclusionWe revealed the characteristics of HIV molecular transmission, tropism, and DRMs of ART-naïve HIV-infected individuals among the MSM population in Tianjin. Identifying infected persons at risk of transmission is necessary for proposing counseling and treating these patients to reduce the risk of HIV transmission.

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HIV-1 transmission networks in high risk fishing communities on the shores of Lake Victoria in Uganda: A phylogenetic and epidemiological approach

Cited by 30 publications

References 50 publications

Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

Correlates of knowledge of family planning among people living in fishing communities of Lake Victoria, Uganda

Source-sink dynamics could sustain HIV epidemics in rural communities in sub-Saharan Africa: the case of Malawi

Characteristics of HIV-1 Molecular Transmission Networks and Drug Resistance Among Men Who Have Sex with Men in Tianjin, China (2014-2018)

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