Abstract:

Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013-2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied the birth-death skyline model to the sequences from Odessa (n = 275) and Kyiv (n = 92) in order to estimate changes in the epidemic's effective reproductive number (R(e)) and rate of becoming uninfectious (δ). We identified 12 transmission clusters in Odessa; phylogenetic clustering was correlated with younger age and higher average viral load at the time of sampling. Estimated R(e) were similar in Odessa and Kyiv before the initiation of TRIP; R(e) started to decline in 2013 and is now below R(e) = 1 in Odessa (R(e) = 0.4, 95%HPD 0.06-0.75), but not in Kyiv (R(e) = 2.3, 95%HPD 0.2-5.4). Similarly, estimates of δ increased in Odessa after the initiation of TRIP. Given that both cities shared the same HIV prevention programs in 2013-2019, apart from TRIP, the observed changes in transmission parameters are likely attributable to the TRIP intervention. We propose that molecular epidemiology analysis can be used as a post-intervention effectiveness assessment tool.

Notes:

1999-4915Vasylyeva, Tetyana IZarebski, AlexanderSmyrnov, PavloWilliams, Leslie DKorobchuk, AniaLiulchuk, MariiaZadorozhna, ViktoriiaNikolopoulos, GeorgiosParaskevis, DimitriosSchneider, JohnSkaathun, BrittPybus, Oliver GFriedman, Samuel RDP1 DA034989/DA/NIDA NIH HHS/United StatesP30 AI036214/NH/NIH HHS/United StatesR01AI136056/NH/NIH HHS/United StatesJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tViruses. 2020 Apr 20;12(4):469. doi: 10.3390/v12040469.