Stichting HIV Monitoring data contributes to research on the sources and prevention of HIV infection among MSM
A study using data from the Dutch ATHENA cohort has found that the majority of new HIV infections among men who have sex with men could be averted with a combination of prevention strategies, including increased HIV testing, earlier treatment initiation and pre-exposure prophylaxis. In collaboration with Stichting HIV Monitoring, a research team led by Dr. Oliver Ratmann and Professor Christophe Fraser at Imperial College London, studied the sources of HIV transmission to men having sex with men (MSM) confirmed as having been recently infected at time of diagnosis. The study aimed to quantify the origin of these transmissions in terms of the position of the transmitter in the infection and care continuum, from early infection before diagnosis to past treatment initiation, and then to identify which prevention strategies could have averted these transmissions most effectively. The research team used the genetic relationship of viruses isolated from patients in the Dutch ATHENA observational cohort as a marker to trace who could have infected whom. Clinical and demographic data from the ATHENA cohort were then used to interpret phylogenetically probable transmission events. The analysis revealed that ART was highly effective in preventing transmissions. Furthermore, among MSM, an estimated 4 out of 10 transmissions originated from individuals in their first year of infection. These new infections are challenging to prevent, also because far fewer phylogenetically probable transmitters had a recorded last negative HIV test compared to the average diagnosed MSM. The researchers conclude that the majority of infections could have been averted with more comprehensive HIV testing, earlier start of ART and the use of antiretrovirals by uninfected men before sex, but none of these three strategies in isolation. The paper was published on 6 January in Science Translational Medicine. Follow this link to read the abstract.