HIV-1 transmission dynamics among people who inject drugs on the US/Mexico border during the COVID-19 pandemic: a prosepective cohort study.

Cross-border transmission HIV People who inject drugs Phylodynamics Tijuana

Journal

Lancet regional health. Americas
ISSN: 2667-193X
Titre abrégé: Lancet Reg Health Am
Pays: England
ID NLM: 9918232503006676

Informations de publication

Date de publication:
May 2024
Historique:
received: 13 11 2023
revised: 11 04 2024
accepted: 12 04 2024
medline: 7 5 2024
pubmed: 7 5 2024
entrez: 7 5 2024
Statut: epublish

Résumé

We examined HIV prevalence and transmission dynamics among people who inject drugs in the U.S./Mexico border region during the COVID-19 pandemic. People who inject drugs aged ≥18 years from 3 groups were recruited: people who inject drugs who live in San Diego (SD) and engaged in cross-border drug use in Tijuana, Mexico (SD CBDUs), and people who inject drugs in SD and Tijuana (TJ) who did not engage in cross-border drug use (NCBDUs). We computed HIV prevalence at baseline and bivariate incidence-density rates (IR) at 18-month follow-up. Bayesian phylogenetic analysis was used to identify local transmission clusters, estimate their age, and effective reproductive number (Re) over time within the clusters. At baseline (n = 612), 26% of participants were female, 9% engaged in sex work, and HIV prevalence was 8% (4% SD CBDU, 4% SD NCBDU, 16% TJ NCBDU). Nine HIV seroconversions occurred over 18 months, IR: 1.357 per 100 person-years (95% CI: 0.470, 2.243); 7 in TJ NCBDU and 2 in SD CBDU. Out of 16 identified phylogenetic clusters, 9 (56%) had sequences from both the U.S. and Mexico (mixed-country). The age of three youngest mixed-country dyads (2018-2021) overlapped with the COVID-related US-Mexico border closure in 2020. One large mixed-country cluster (N = 15) continued to grow during the border closure (Re = 4.8, 95% Highest Posterior Density (HPD) 1.5-9.1) with 47% engaging in sex work. Amidst the COVID-19 pandemic and the border closure, cross-border HIV clusters grew. Efforts to end the HIV epidemic in the U.S. should take into account cross-border HIV-1 transmission from Tijuana. Mobile harm reduction services and coordination with municipal HIV programs to initiate anti-retroviral therapy and pre-exposure prophylaxisis are needed to reduce transmission. This research was supported by the James B. Pendleton Charitable Trust and the San Diego Center for AIDS Research.

Sections du résumé

Background UNASSIGNED
We examined HIV prevalence and transmission dynamics among people who inject drugs in the U.S./Mexico border region during the COVID-19 pandemic.
Methods UNASSIGNED
People who inject drugs aged ≥18 years from 3 groups were recruited: people who inject drugs who live in San Diego (SD) and engaged in cross-border drug use in Tijuana, Mexico (SD CBDUs), and people who inject drugs in SD and Tijuana (TJ) who did not engage in cross-border drug use (NCBDUs). We computed HIV prevalence at baseline and bivariate incidence-density rates (IR) at 18-month follow-up. Bayesian phylogenetic analysis was used to identify local transmission clusters, estimate their age, and effective reproductive number (Re) over time within the clusters.
Findings UNASSIGNED
At baseline (n = 612), 26% of participants were female, 9% engaged in sex work, and HIV prevalence was 8% (4% SD CBDU, 4% SD NCBDU, 16% TJ NCBDU). Nine HIV seroconversions occurred over 18 months, IR: 1.357 per 100 person-years (95% CI: 0.470, 2.243); 7 in TJ NCBDU and 2 in SD CBDU. Out of 16 identified phylogenetic clusters, 9 (56%) had sequences from both the U.S. and Mexico (mixed-country). The age of three youngest mixed-country dyads (2018-2021) overlapped with the COVID-related US-Mexico border closure in 2020. One large mixed-country cluster (N = 15) continued to grow during the border closure (Re = 4.8, 95% Highest Posterior Density (HPD) 1.5-9.1) with 47% engaging in sex work.
Interpretation UNASSIGNED
Amidst the COVID-19 pandemic and the border closure, cross-border HIV clusters grew. Efforts to end the HIV epidemic in the U.S. should take into account cross-border HIV-1 transmission from Tijuana. Mobile harm reduction services and coordination with municipal HIV programs to initiate anti-retroviral therapy and pre-exposure prophylaxisis are needed to reduce transmission.
Funding UNASSIGNED
This research was supported by the James B. Pendleton Charitable Trust and the San Diego Center for AIDS Research.

Identifiants

DOI: 10.1016/j.lana.2024.100751 PMID: 38711788 PMC: PMC11070707
pubmed: 38711788
doi: 10.1016/j.lana.2024.100751
pii: S2667-193X(24)00078-4
pmc: PMC11070707
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100751

Informations de copyright

© 2024 The Authors. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Auteurs

Britt Skaathun (B)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Steffanie A Strathdee (SA)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Cho-Hee Shrader (CH)

Department of Epidemiology, Columbia University, 116th and Broadway, New York, NY 10027, United States.

Carrie L Nacht (CL)

Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Annick Borquez (A)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Irina Artamonova (I)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Alicia Harvey-Vera (A)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
U.S.-Mexico Border Health Commission, Paseo del Centenario 10851, Zona Urbana Rio Tijuana, Tijuana, BC 22320, Mexico.

Carlos F Vera (CF)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Gudelia Rangel (G)

U.S.-Mexico Border Health Commission, Paseo del Centenario 10851, Zona Urbana Rio Tijuana, Tijuana, BC 22320, Mexico.
El Colegio de la Frontera Norte, Carretera Escenica Tijuana-Ensenada Toll Boot Escenica Tijuana-Ensenada Sn San Antonio del Mar, Tijuana, BC 22560, Mexico.

Caroline Ignacio (C)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Brendon Woodworth (B)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Antoine Chaillon (A)

Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.

Tetyana I Vasylyeva (TI)

Department of Population Health and Disease Prevention, University of California Irvine, Irvine, CA 92617, United States.

Classifications MeSH