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Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina
Transmission of HIV continues in the United States (US), despite prevention efforts aimed at education and treatment. Concurrently, drug resistance in HIV, particularly in patients being infected with HIV for the first time, poses a threat to the continued success of treatment for HIV positive indiv...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919766/ https://www.ncbi.nlm.nih.gov/pubmed/24520392 http://dx.doi.org/10.1371/journal.pone.0088512 |
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author | Carrel, Margaret Eron, Joseph J. Emch, Michael Hurt, Christopher B. |
author_facet | Carrel, Margaret Eron, Joseph J. Emch, Michael Hurt, Christopher B. |
author_sort | Carrel, Margaret |
collection | PubMed |
description | Transmission of HIV continues in the United States (US), despite prevention efforts aimed at education and treatment. Concurrently, drug resistance in HIV, particularly in patients being infected with HIV for the first time, poses a threat to the continued success of treatment for HIV positive individuals. In North Carolina, nearly one in five individuals with acute HIV infection (AHI) is infected with a drug-resistant strain, a phenomenon known as transmitted drug resistance (TDR). Few studies of AHI or TDR take into account both the spatial aspects of residence at time of infection and the genetic characteristics of the viruses, and questions remain about how viruses are transmitted across space and the rural-urban divide. Using AHI strains from North Carolina, we examined whether differences exist in the spatial patterns of AHI versus AHI with TDR, as well as whether the genetic characteristics of these HIV infections vary by rural-urban status and across Health Service Areas. The highest amounts of TDR were detected in persons under age 30, African Americans, and men who have sex with men (MSM) - similar to the populations where the highest numbers of AHI without TDR are observed. Nearly a quarter of patients reside in rural areas, and there are no significant differences between rural and urban residence among individuals infected with drug resistant or drug susceptible viruses. We observe similar levels of genetic distance between HIV found in rural and urban areas, indicating that viruses are shared across the rural-urban divide. Genetic differences are observed, however, across Health Service Areas, suggesting that local areas are sites of genetic differentiation in viruses being transmitted to newly infected individuals. These results indicate that future efforts to prevent HIV transmission need to be spatially targeted, focusing on local-level transmission in risky populations, in addition to statewide anti- HIV efforts. |
format | Online Article Text |
id | pubmed-3919766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-39197662014-02-11 Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina Carrel, Margaret Eron, Joseph J. Emch, Michael Hurt, Christopher B. PLoS One Research Article Transmission of HIV continues in the United States (US), despite prevention efforts aimed at education and treatment. Concurrently, drug resistance in HIV, particularly in patients being infected with HIV for the first time, poses a threat to the continued success of treatment for HIV positive individuals. In North Carolina, nearly one in five individuals with acute HIV infection (AHI) is infected with a drug-resistant strain, a phenomenon known as transmitted drug resistance (TDR). Few studies of AHI or TDR take into account both the spatial aspects of residence at time of infection and the genetic characteristics of the viruses, and questions remain about how viruses are transmitted across space and the rural-urban divide. Using AHI strains from North Carolina, we examined whether differences exist in the spatial patterns of AHI versus AHI with TDR, as well as whether the genetic characteristics of these HIV infections vary by rural-urban status and across Health Service Areas. The highest amounts of TDR were detected in persons under age 30, African Americans, and men who have sex with men (MSM) - similar to the populations where the highest numbers of AHI without TDR are observed. Nearly a quarter of patients reside in rural areas, and there are no significant differences between rural and urban residence among individuals infected with drug resistant or drug susceptible viruses. We observe similar levels of genetic distance between HIV found in rural and urban areas, indicating that viruses are shared across the rural-urban divide. Genetic differences are observed, however, across Health Service Areas, suggesting that local areas are sites of genetic differentiation in viruses being transmitted to newly infected individuals. These results indicate that future efforts to prevent HIV transmission need to be spatially targeted, focusing on local-level transmission in risky populations, in addition to statewide anti- HIV efforts. Public Library of Science 2014-02-10 /pmc/articles/PMC3919766/ /pubmed/24520392 http://dx.doi.org/10.1371/journal.pone.0088512 Text en © 2014 Carrel et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Carrel, Margaret Eron, Joseph J. Emch, Michael Hurt, Christopher B. Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title | Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title_full | Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title_fullStr | Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title_full_unstemmed | Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title_short | Spatial Epidemiology of Recently Acquired HIV Infections across Rural and Urban Areas of North Carolina |
title_sort | spatial epidemiology of recently acquired hiv infections across rural and urban areas of north carolina |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919766/ https://www.ncbi.nlm.nih.gov/pubmed/24520392 http://dx.doi.org/10.1371/journal.pone.0088512 |
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