HIV-1 pol gene sequencing among young and middle-aged AIDS patients in Pudong New Area

The Pudong New Area of Shanghai is an internationalized, highly informatized and highly mobile city, where HIV-1 transmission is more insidious. Based on the analysis of viral gene sequences, transmission networks that cannot be recognized by conventional HIV surveillance can be identified. In this study, we conducted a molecular epidemiological study of HIV-1 in the population of young and middle-aged infected persons in the Pudong New Area from 2018 to 2021, to characterize the distribution of genotypes and the molecular transmission networks, analyze the influencing factors that promote the network inclusion, and assess the roles and status of young and middle-aged populations in the whole HIV transmission network in Pudong New Area. This study further combined on-site epidemiologic investigation and social network analysis to identify HIV-negative individuals and undiagnosed infected individuals in the network who were at high risk of infection and provided targeted preventive measures, such as pre-exposure prophylaxis (PrEP) and antiviral vaginal rings for women. This could be of great significance in reducing the rate of new infections.