The Central Role of Nondisclosed Men Who Have Sex With Men in Human Immunodeficiency Virus-1 Transmission Networks in Guangzhou, China

作者：Huanchang Yan, Weiyun He, Liping Huang, Hao Wu, Yuanhao Liang, Qingmei Li, Jingwei Shui, Cheng Wang, Emmanuel Enoch Dzakah, Zhigang Han, Shixing Tang · 发表于：Open Forum Infectious Diseases · 年份：2020 · DOI：10.1093/ofid/ofaa154 · 被引用次数：23 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV/AIDS drug development and treatment

Abstract Background Men who have sex with men (MSM) are vulnerable risk group for human immunodeficiency virus (HIV)-1 infection. However, some MSM do not disclose their same-sex behavior and could impact the transmission and prevention of HIV-1 infection. Here, we evaluated the role of nondisclosed MSM in HIV-1 transmission in Guangzhou, China. Methods The HIV-1 pol sequences were obtained from HIV-infected subjects from 2008 to 2015. A transmission network was constructed using HIV TRAnsmission Cluster Engine (HIV-TRACE) at a pairwise genetic distance of 0.5%. The position of nondisclosed MSM in the network was determined by centrality analysis. Results Nondisclosed MSM were inferred in 9.92% (61 of 615) of slightly older, self-reported non-MSM (P = .006). They were more likely to be married (P = .002) and less educated (P < .001) than the MSM with whom they clustered. Closeness centrality was bigger for nondisclosed MSM than for MSM (P < .001), indicating the central position of nondisclosed MSM in the networks. The average shortest path length was smaller for nondisclosed MSM than for MSM (P < .001), whereas radiality was bigger for nondisclosed MSM than for MSM, suggesting a relatively greater contribution of nondisclosed MSM in transmitting HIV-1 than MSM. Assortativity analysis indicated that nondisclosed MSM were more likely to link each other with coefficient of 0.025. Conclusions Nondisclosed MSM are a specific group, and they play an important ...