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HIV-1 transmission dynamics among people who inject drugs on the US/Mexico border during the COVID-19 pandemic: a prosepective cohort study.
Skaathun, Britt; Strathdee, Steffanie A; Shrader, Cho-Hee; Nacht, Carrie L; Borquez, Annick; Artamonova, Irina; Harvey-Vera, Alicia; Vera, Carlos F; Rangel, Gudelia; Ignacio, Caroline; Woodworth, Brendon; Chaillon, Antoine; Vasylyeva, Tetyana I.
Afiliación
  • Skaathun B; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • Strathdee SA; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • Shrader CH; Department of Epidemiology, Columbia University, 116th and Broadway, New York, NY 10027, United States.
  • 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.
  • Borquez A; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • Artamonova I; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • 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.
  • Vera CF; U.S.-Mexico Border Health Commission, Paseo del Centenario 10851, Zona Urbana Rio Tijuana, Tijuana, BC 22320, Mexico.
  • Rangel G; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • Ignacio C; U.S.-Mexico Border Health Commission, Paseo del Centenario 10851, Zona Urbana Rio Tijuana, Tijuana, BC 22320, Mexico.
  • Woodworth B; El Colegio de la Frontera Norte, Carretera Escenica Tijuana-Ensenada Toll Boot Escenica Tijuana-Ensenada Sn San Antonio del Mar, Tijuana, BC 22560, Mexico.
  • Chaillon A; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
  • Vasylyeva TI; Division of Infectious Diseases and Global Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States.
Lancet Reg Health Am ; 33: 100751, 2024 May.
Article en En | MEDLINE | ID: mdl-38711788
ABSTRACT

Background:

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:

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:

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:

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:

This research was supported by the James B. Pendleton Charitable Trust and the San Diego Center for AIDS Research.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Mexico Idioma: En Revista: Lancet Reg Health Am Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Mexico Idioma: En Revista: Lancet Reg Health Am Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido