Abstract
Abstract Introduction Understand age-mixing patterns in HIV transmission is a key to design and implement HIV prevention interventions. As such, the use of phylogenetic tree seems promising since this approach is based on data from a transmission network. Methods Through a simulation study, we used transmission clusters computed from phylogenetic trees to investigate age-mixing patterns. From transmission clusters, we estimated a transmission network using pairings. We inferred measurements, which depict age-mixing patterns in transmission i.e. ‘proportions of men/women of a certain age-group paired with women/men of another age-group’, and mean, median, and standard deviation of average age difference between women/men with their respective pairs. We investigated the uncertainty around these measurements as a function of sampling coverage in different sequence missingness scenarios. Results According to the simulation set-up of age mixing in partnership, there are relationships, which are less likely and others highly likely. Explicitly, partnerships between younger men (<25 years) and older women (25 to 50 years) are less likely to happen in the sexual network, whereas partnership between younger women (<25 years) and older men (25 to 50 years) are more likely to happen as are age group relationship having intermediate magnitude in partnership. Conclusion Transmission clusters allow us to strive with more improved information regarding cross-generation transmission. It enables us to understand the importance of age mixing beyond describing the mean age difference, and that one needs to consider the variation of age differences between pairs of individuals as well as among the partners of a given individual.
Highlights
An age-disparate relationship is defined as a relationship where the male partner is 5 or more years older than the female partner [1]
We can see that in the transmission network constructed from the phylogenetic tree, age-mixing patterns in Human Immunodeficiency Virus (HIV) transmission were depicted through proportions of phylogenetic pairings between men and women across different age groups; and the mean, and standard deviation of their age difference
Assessing the uncertainty around age-mixing patterns in HIV transmission inferred from phylogenetic trees older men (40–49 years) were the key age groups that would make the infection to persist. These findings showed that, when age-mixing patterns in HIV transmission exist in any population, we can be able to unveil these patterns through proportions of pairings between men and women, and age difference statistics across different age groups
Summary
An age-disparate relationship is defined as a relationship where the male partner is 5 or more years older than the female partner [1]. Patterns of age-related sexual partner choices are known as age-mixing patterns [1]. Patterns of Human Immunodeficiency Virus (HIV) transmission across different age groups define the age-mixing patterns in HIV transmission. The inter-generational transmission of HIV infection can make it persistent within populations. As explained by Beauclair [1], the bridge width (number of years difference between the maximum and the minimum partner age for someone in more than one sexual partnership) can explain an individual’s ability to transmit HIV infection to different age groups or generations. At a time point when an HIV positive individual is in two or more discordant relationships with large and small age-differences with his/her partners, this individual has the potential to transmit the infection between the two generations. The same can happen for individuals who have transient relationships with different age preferences over time
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