Abstract
BackgroundYunnan has been severely affected by HIV/AIDS in China. Recently, the reported prevalence of HIV-1 among men who have sex with men (MSM) in Yunnan was high in China. To monitor dynamic HIV-1 epidemic among Yunnan MSM, HIV-1 genetic characteristics and transmitted drug resistance (TDR) were investigated.MethodsBlood samples from 131 newly HIV-1 diagnosed MSM were continuously collected at fixed sites from January 2010 to December 2012 in Kunming City, Yunnan Province. Partial gag, pol and env genes were sequenced. Phylogenetic, evolutionary and genotypic drug resistance analyses were performed.ResultsMultiple genotypes were identified among MSM in Kunming, including CRF01_AE (64.9%), CRF07_BC (25.2%), unique recombinant forms (URFs, 5.3%), subtype B (3.1%) and CRF08_BC (1.5%). CRF01_AE and CRF07_BC were the predominant strains. The mean of genetic distance within CRF01_AE were larger than that within CRF07_BC. The estimated introducing time of CRF01_AE in Yunnan MSM (1996.9) is earlier than that of CRF07_BC (2002.8). In this study, subtype B was first identified in Yunnan MSM. CRF08_BC seems to be the distinctive strain in Yunnan MSM, which was seldom found among MSM outside Yunnan. The proportion of URFs increased, which further contributed to genetic diversity among MSM. Strikingly, genetic relatedness was found among these strains with MSM isolates from multiple provinces, which suggested that a nationwide transmission network may exist. TDR-associated mutations were identified in 4.6% individuals. The multivariate analysis revealed that non-native MSM and divorced/widowed MSM were independently associated with a higher TDR rate.ConclusionThis work revealed diverse HIV-1 genetics, national transmission networks and a baseline level of TDR in MSM. These findings enhance our understanding of the distribution and evolution of HIV-1 in MSM, and are valuable for developing HIV prevention strategies for MSM.
Highlights
The term men who have sex with men (MSM) refers to behavior rather than identity or sexual orientation, and covers a large variety of settings and contexts in which male-to-male sex takes place
Study Participants and Sample Collection A total of 131 newly confirmed human immunodeficiency virus (HIV)-1-positive MSM blood samples were continuously collected between January 2010 and December 2012 through fixed voluntary counseling and testing sites (VCT) and non-government organizations in Kunming City, Yunnan Province
Demographic Characteristics of Study Subjects A total of 131 newly confirmed HIV-positive MSM samples were collected in Kunming City from 2010 to 2012
Summary
The term MSM refers to behavior rather than identity or sexual orientation, and covers a large variety of settings and contexts in which male-to-male sex takes place. A fast-spreading HIV epidemic among MSM constitutes a new challenge in China. Between 2006–2011, the annual rate of newly reported HIV cases attributed to homosexually transmitted infection in China increased from 2.5% to 13.7% [5]. In 2008, a cross-sectional study from 18,000 MSM in 61 cities of China found an average HIV prevalence of 4.9% with incidence ranging between 2.6 to 5.4 per 100 person-years [8]. These studies suggested that MSM are an important target population for HIV prevention in China. The reported prevalence of HIV-1 among men who have sex with men (MSM) in Yunnan was high in China. To monitor dynamic HIV-1 epidemic among Yunnan MSM, HIV-1 genetic characteristics and transmitted drug resistance (TDR) were investigated
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