Integrating HIV Cluster Analysis in Routine Public Health Prevention Efforts: Lessons Learned from a Statewide Public Health–Academic Partnership

摘要: Background: HIV transmission remains a significant global problem. In the US, HIV incidence has remained stubbornly high despite comprehensive prevention initiatives. Contact tracing, one of the oldest methods of epidemic response, has been used extensively in the US to limit the transmission of HIV, yet tends to yield suboptimal results, mostly because a non-trivial proportion of newly-diagnosed individuals are reluctant or unable to identify contacts. Recently, the use of molecular HIV cluster analysis to supplement contact tracing has shown promise in addressing HIV outbreaks. However, the potential of HIV cluster analysis as an adjunct to daily, case-by-case HIV prevention efforts remains unknown.Methods: We documented lessons learned within a unique public-health–academic partnership, while guiding workaday HIV prevention efforts with near-real-time statewide molecular cluster analysis. Our team of academicians and public-health staff recorded perceptions encountered in an 18-month study evaluating integration of molecular cluster analysis with HIV contact-tracing for public-health benefit, focusing on monthly case conferences where molecular clustering of each new statewide diagnosis was discussed to facilitate targeted interventions, and re-interviews of all newly HIV-diagnosed persons statewide whose HIV sequences clustered, to increase partner naming.Findings: Three main themes emerged: First, multidisciplinary case conferences are substantially beneficial for gleaning actionable inferences from integrating molecular cluster analysis and public-health data. Second, universal re-interviews may have negative …