National Phylogenetic Study of Current HIV Transmission in England

The co-ordination of a national database of HIV sequences linked with limited HIV-risk factor information, representative of new and undiagnosed HIV infections in the UK will be undertaken to research HIV transmission. Investigative techniques combining epidemiology, evolutionary biology and laboratory techniques (phylodynamics) require development and will be strengthened through building upon methodologies used in localised studies. Tools will be investigated that enable measurement of the extent that homosexual men, who have recently been infected with HIV, are transmitting their infection onwards, relative to homosexual men with longstanding HIV infections. If recently infected HIV-positive men are substantially contributing to onward HIV transmission at a population level, then HIV testing promotion will have limited success as a prevention intervention, since recently infected HIV-positive men will not yet have had the opportunity to have their HIV infection diagnosed. Additionally, the impact of specific groups (such as homosexual men and heterosexuals born-abroad) on the UK population of HIV sequences will be measured and allow prevention efforts to be better targeted. Transmission and spread of drug resistance will be monitored and information on associated risk factors collected. The creation of this resource and the information yielded may have a large impact on the prevention efforts targeted at the UK HIV epidemic.