Evidence from HIV sequencing for blood-borne transmission in Africa
Background: The consensus view that heterosexual transmission dominates human immunodeficiency viruses (HIV) epidemics in sub-Saharan Africa survives side-by-side with surveys and studies reporting infections in children with HIV-negative mothers, in virgins, and in adolescents and adults who claim...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2025-04-01
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| Series: | Journal of Public Health in Africa |
| Subjects: | |
| Online Access: | https://publichealthinafrica.org/index.php/jphia/article/view/715 |
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| Summary: | Background: The consensus view that heterosexual transmission dominates human immunodeficiency viruses (HIV) epidemics in sub-Saharan Africa survives side-by-side with surveys and studies reporting infections in children with HIV-negative mothers, in virgins, and in adolescents and adults who claim no possible sexual exposure to HIV.
Aim: In this scoping review, we aim to show what phylogenetic analyses of HIV sequences say about the possible contribution of blood-borne transmission to HIV epidemics.
Setting: The focus was on sub-Saharan Africa.
Method: The authors conducted a search on PubMed and other platforms for studies reporting phylogenetic analyses of HIV in blood samples collected from at least 100 infected adults through community-based surveys in sub-Saharan Africa. They focussed on identifying information pertinent to assessing blood-borne transmission.
Results: Sixteen reports met the search criteria and provided information to assess blood-borne transmission. In five studies, similar HIV sequences from (reported or assumed) household couples identified a likely heterosexual source for 0.3% – 7.5% of community adults with sequenced HIV. In 10 studies, a median of 43% of sequence pairs linked two people of the same sex. Two studies report clusters of recent infections too large to be easily explained by sexual transmission.
Conclusion: Evidence from sequencing agrees with much other evidence that blood-borne HIV transmission is not rare in sub-Saharan Africa. Evidence also allows that blood-borne transmission could be making a major contribution to Africa’s HIV epidemics.
Contribution: Evidence of harm is sufficient to stimulate discussions about what more could be done to address this continuing problem. |
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| ISSN: | 2038-9922 2038-9930 |