Browsing by Author "Hughes, James P. PhD"

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    Antiretroviral Drug Use and HIV Drug Resistance Among Young Women in Rural South Africa: HPTN 068
    (2018-11-01) Zhang, Yinfeng PhD; Sivay, Mariya V. PhD; Hudelson, Sarah E. BS; Clarke, William PhD; Breaud, Autumn MS; Wang, Jing MS, MA; Piwowar-Manning, Estelle BS, MT (ASCP); Agyei, Yaw MPH, BS, MT (ASCP); Fogel, Jessica M. PhD; Hamilton, Erica L. MPH; Selin, Amanda MHS; MacPhail, Catherine PhD; Kahn, Kathleen MD, PhD; Gómez-Olivé, Francesc Xavier MD, PhD; Hughes, James P. PhD; Pettifor, Audrey PhD, MPH; Eshleman, Susan H. MD, PhD
    Background: Antiretroviral (ARV) drugs are used for HIV treatment and prevention. We analyzed ARV drug use and HIV drug resistance in a cohort of young women in rural South Africa enrolled in the HIV Prevention Trials Network (HPTN) 068 study, which evaluated the use of a cash transfer conditional on school attendance to reduce HIV incidence. Methods: ARV drug testing was performed using plasma samples from 2526 young women. This included 2526 enrollment samples (80 HIV-infected and 2446 HIV-uninfected) and 162 seroconversion samples (first HIV-positive study visit). Testing was performed using a qualitative assay that detects 20 ARV drugs from 5 drug classes. HIV drug resistance testing was performed with the ViroSeq HIV-1 Genotyping System for samples that had HIV viral loads ≥400 copies per milliliter. Results: At enrollment, ARV drugs were detected in 10 (12.5%) of 80 HIV-infected young women. None of 2446 HIV-uninfected young women had ARV drugs detected at enrollment. ARV drugs were also detected in 16 (9.9%) of 162 seroconverters. At enrollment, 9 (13.4%) of 67 young women with genotyping results had HIV drug resistance; resistance was also detected in 9 (6.9%) of 131 seroconverters with genotyping results. Conclusions: Most of the HIV-infected young women in this cohort from rural South Africa were not taking ARV drugs, suggesting they were unaware of their HIV status or were not in care. HIV drug resistance was detected in young women with both prevalent and new HIV infection.
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    Sexual Partner Types and Incident HIV Infection Among Rural South African Adolescent Girls and Young Women Enrolled in HPTN 068: A Latent Class Analysis
    (2019-09-01) Nguyen, Nadia PhD; Powers, Kimberly A. PhD; Miller, William C. MD, PhD, MPH; Howard, Annie Green PhD; Halpern, Carolyn T. PhD; Hughes, James P. PhD; Wang, Jing MS, MA; Twine, Rhian MPH; Gomez-Olive, F. Xavier MD, PhD; MacPhail, Catherine PhD; Kahn, Kathleen MD, PhD; Pettifor, Audrey E. PhD
    Background: Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions. Methods: We conducted a secondary analysis of data from AGYW (aged 13–23 years) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral and demographic characteristics of their 3 most recent sexual partners, categorized each partner using prespecified labels, and received HIV testing. We used latent class analysis (LCA) to identify partner types from reported characteristics, and generalized estimating equations to estimate the relationship between both LCA-identified and prespecified partner types and incident HIV infection. Results: Across 2140 AGYW visits, 1034 AGYW made 2968 partner reports and 63 AGYW acquired HIV infection. We identified 5 LCA partner types, which we named monogamous HIV-negative peer partner; one-time protected in-school peer partner; out-of-school older partner; anonymous out-of-school peer partner; and cohabiting with children in-school peer partner. Compared to AGYW with only monogamous HIV-negative peer partners, AGYW with out-of-school older partners had 2.56 times the annual risk of HIV infection (95% confidence interval: 1.23 to 5.33), whereas AGYW with anonymous out-of-school peer partners had 1.72 times the risk (95% confidence interval: 0.82 to 3.59). Prespecified partner types were not associated with incident HIV. Conclusion: By identifying meaningful combinations of partner characteristics and predicting the corresponding risk of HIV acquisition among AGYW, LCA-identified partner types may provide new insights for the design of tailored HIV prevention interventions.
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    Variations in HIV Risk by Young Women's Age and Partner Age Disparity in Rural South Africa (HPTN 068)
    (2020-04-01) Topazian, Hillary M. MSc; Stoner, Marie C. D. PhD; Edwards, Jessie K. PhD; Kahn, Kathleen PhD; Gómez-Olivé, Francesc Xavier PhD; Twine, Rhian PhD; Hughes, James P. PhD; Cohen, Myron S. MD; Pettifor, Audrey PhD
    Background: Nearly all population-level research showing positive associations between age-disparate partnerships and HIV acquisition among adolescent girls and young women (AGYW) has classified age disparity as ≥5 or ≥10 years. We describe variations in 1-year risk of HIV infection after exposure to sexual partner(s) of continuous age disparities. Methods: Longitudinal data from the HPTN 068 randomized trial in South Africa were used to estimate 1-year risk of HIV infection at various age pairings. The parametric g-formula was used to estimate risk at up to 5 annual time points, stratified by maximum partner age difference, maximum partner age, and AGYW age. Results: AGYW reported an older partner in 86% of 5351 age pairings. The 1-year risk of HIV infection rapidly increased with maximum partner age difference among girls ages 13–14 years, from 0·01 with a same-age partner, to 0·21 with a partner 10 years older, and 0·24 with a partner 15 years older. A gradual increase occurred among AGYW ages 15–16 years, up to 0·13 with a partner 15 years older, and 0·09 among AGYW 17–18 years with partners 8–11 years older. Risk of HIV infection among AGYW ages 19–21 years remained relatively constant across maximum partner age differences. Conclusions: Age differences between AGYW and their sexual partners have a greater effect on HIV-risk infection in younger compared with older AGYW. Considering both the age of an AGYW and her sexual partners provides granular insight into identifying key groups for HIV transmission prevention efforts.
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    Variations in HIV Risk by Young Women's Age and Partner Age Disparity in Rural South Africa (HPTN 068)
    (2020-04-01) Topazian, Hillary M. MSc; Stoner, Marie C. D. PhD; Edwards, Jessie K. PhD; Kahn, Kathleen PhD; Gómez-Olivé, Francesc Xavier PhD; Twine, Rhian PhD; Hughes, James P. PhD; Cohen, Myron S. MDh; Pettifor, Audrey PhDa
    Background: Nearly all population-level research showing positive associations between age-disparate partnerships and HIV acquisition among adolescent girls and young women (AGYW) has classified age disparity as ≥5 or ≥10 years. We describe variations in 1-year risk of HIV infection after exposure to sexual partner(s) of continuous age disparities. Methods: Longitudinal data from the HPTN 068 randomized trial in South Africa were used to estimate 1-year risk of HIV infection at various age pairings. The parametric g-formula was used to estimate risk at up to 5 annual time points, stratified by maximum partner age difference, maximum partner age, and AGYW age. Results: AGYW reported an older partner in 86% of 5351 age pairings. The 1-year risk of HIV infection rapidly increased with maximum partner age difference among girls ages 13–14 years, from 0·01 with a same-age partner, to 0·21 with a partner 10 years older, and 0·24 with a partner 15 years older. A gradual increase occurred among AGYW ages 15–16 years, up to 0·13 with a partner 15 years older, and 0·09 among AGYW 17–18 years with partners 8–11 years older. Risk of HIV infection among AGYW ages 19–21 years remained relatively constant across maximum partner age differences. Conclusions: Age differences between AGYW and their sexual partners have a greater effect on HIV-risk infection in younger compared with older AGYW. Considering both the age of an AGYW and her sexual partners provides granular insight into identifying key groups for HIV transmission prevention efforts.