Emerging and Existing Molecular HIV Clusters in Georgia, 2021–2023
Abstract
Background
Molecular HIV cluster detection uses similar nucleotide sequences to identify clusters, which indicate recent HIV transmission. The HIV transmission rates in molecular clusters average 8-11 times higher than the national rate. Cluster analysis over time could identify priority groups and interrupt transmission. This analysis examined molecular HIV clusters in Georgia between 2021 and 2023 to identify demographic differences between emerging and existing clusters.
Methods
We analyzed data reported in the Georgia Department of Public Health enhanced HIV/AIDS Reporting System for HIV diagnoses occurring between 2021 and 2023. Secure HIV-TRACE was used to identify clusters, defined as 2 or more HIV nucleotide sequences with genetic distance of ≤0.5% from the past 3 years. Clusters were categorized based on number of members between 2021 and 2023 as emerging (0 members in 2021 and had members in 2023) or existing (had members in 2021). Demographic characteristics of emerging and existing clusters were compared.
Results
Overall, 947 cluster members were included in this analysis, 316 members from 133 emerging clusters and 631 members from 182 existing clusters. In emerging compared to existing clusters, there was a higher percentage diagnosed in the past 12 months (44.6% versus 16.3%), HIV transmission attributed to heterosexual contact (19.3% versus 14.9%), assigned female sex at birth (16.1% versus 12.7%), Hispanic/Latino (14.6% versus 11.6%), and had a lab in the past 12 months (92.1% versus 84.6%).
Conclusion
There were differences between emerging and existing clusters. There were more infections attributed to heterosexual contact, Hispanic/Latinos, and higher lab visits in emerging compared to existing clusters. Higher percentages of HIV transmission attributed to heterosexual contact and Hispanics/Latinos may signal shifts in local transmission. HIV cluster size can be affected by sequence completeness each year. HIV cluster detection can help identify groups affected by recent transmission and could help direct HIV treatment and prevention resources.
Keywords
HIV, epidemiology, molecular clusters, nucleotide sequences
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Emerging and Existing Molecular HIV Clusters in Georgia, 2021–2023
Background
Molecular HIV cluster detection uses similar nucleotide sequences to identify clusters, which indicate recent HIV transmission. The HIV transmission rates in molecular clusters average 8-11 times higher than the national rate. Cluster analysis over time could identify priority groups and interrupt transmission. This analysis examined molecular HIV clusters in Georgia between 2021 and 2023 to identify demographic differences between emerging and existing clusters.
Methods
We analyzed data reported in the Georgia Department of Public Health enhanced HIV/AIDS Reporting System for HIV diagnoses occurring between 2021 and 2023. Secure HIV-TRACE was used to identify clusters, defined as 2 or more HIV nucleotide sequences with genetic distance of ≤0.5% from the past 3 years. Clusters were categorized based on number of members between 2021 and 2023 as emerging (0 members in 2021 and had members in 2023) or existing (had members in 2021). Demographic characteristics of emerging and existing clusters were compared.
Results
Overall, 947 cluster members were included in this analysis, 316 members from 133 emerging clusters and 631 members from 182 existing clusters. In emerging compared to existing clusters, there was a higher percentage diagnosed in the past 12 months (44.6% versus 16.3%), HIV transmission attributed to heterosexual contact (19.3% versus 14.9%), assigned female sex at birth (16.1% versus 12.7%), Hispanic/Latino (14.6% versus 11.6%), and had a lab in the past 12 months (92.1% versus 84.6%).
Conclusion
There were differences between emerging and existing clusters. There were more infections attributed to heterosexual contact, Hispanic/Latinos, and higher lab visits in emerging compared to existing clusters. Higher percentages of HIV transmission attributed to heterosexual contact and Hispanics/Latinos may signal shifts in local transmission. HIV cluster size can be affected by sequence completeness each year. HIV cluster detection can help identify groups affected by recent transmission and could help direct HIV treatment and prevention resources.
