Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda

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dc.contributor.authorRatmann, Oliver
dc.contributor.authorKagaayi, Joseph
dc.contributor.authorHall, Matthew
dc.contributor.authorGolubchick, Tanya
dc.contributor.authorKigozi, Godfrey
dc.contributor.authorNakigozi, Gertrude
dc.contributor.authorBazaale, Jeremiah
dc.contributor.authorKalibbala, Sarah
dc.contributor.authorNalugoda, Fred
dc.contributor.authorSsekubugu, Robert
dc.contributor.authorSerwadda, David
dc.date.accessioned2022-08-28T12:34:19Z
dc.date.available2022-08-28T12:34:19Z
dc.date.issued2020
dc.description.abstractInternational and global organisations advocate targeting interventions to areas of high HIV prevalence (ie, hotspots). To better understand the potential benefits of geo-targeted control, we assessed the extent to which HIV hotspots along Lake Victoria sustain transmission in neighbouring populations in south-central Uganda. Methods We did a population-based survey in Rakai, Uganda, using data from the Rakai Community Cohort Study. The study surveyed all individuals aged 15–49 years in four high-prevalence Lake Victoria fishing communities and 36 neighbouring inland communities. Viral RNA was deep sequenced from participants infected with HIV who were antiretroviral therapy-naive during the observation period. Phylogenetic analysis was used to infer partial HIV transmission networks, including direction of transmission. Reconstructed networks were interpreted through data for current residence and migration history. HIV transmission flows within and between high-prevalence and low-prevalence areas were quantified adjusting for incomplete sampling of the population. Findings Between Aug 10, 2011, and Jan 30, 2015, data were collected for the Rakai Community Cohort Study. 25 882 individuals participated, including an estimated 75·7% of the lakeside population and 16·2% of the inland population in the Rakai region of Uganda. 5142 participants were HIV-positive (2703 [13·7%] in inland and 2439 [40·1%] in fishing communities). 3878 (75·4%) people who were HIV-positive did not report antiretroviral therapy use, of whom 2652 (68·4%) had virus deep-sequenced at sufficient quality for phylogenetic analysis. 446 transmission networks were reconstructed, including 293 linked pairs with inferred direction of transmission. Adjusting for incomplete sampling, an estimated 5·7% (95% credibility interval 4·4–7·3) of transmissions occurred within lakeside areas, 89·2% (86·0–91·8) within inland areas, 1·3% (0·6–2·6) from lakeside to inland areas, and 3·7% (2·3–5·8) from inland to lakeside areas.en_US
dc.identifier.citationRatmann, O., Kagaayi, J., Hall, M., Golubchick, T., Kigozi, G., Xi, X., ... & Tobian, A. (2020). Quantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Uganda. The Lancet HIV. https://doi.org/10.1016/ S2352-3018(19)30378-9en_US
dc.identifier.urihttps://doi.org/10.1016/ S2352-3018(19)30378-9
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4472
dc.language.isoenen_US
dc.publisherThe Lancet HIVen_US
dc.subjectHIV transmission flowen_US
dc.subjectHotspotsen_US
dc.subjectCommunitiesen_US
dc.subjectUgandaen_US
dc.titleQuantifying HIV transmission flow between high-prevalence hotspots and surrounding communities: a population-based study in Rakai, Ugandaen_US
dc.typeArticleen_US
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