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    Using HIV Transmission Networks to Investigate Community Effects in HIV Prevention Trials

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    Name:
    Using HIV transmission networks ...
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    Genre
    Journal Article
    Date
    2011-12-01
    Author
    Wertheim, JO
    Kosakovsky Pond, SL
    Little, SJ
    De Gruttola, V
    Subject
    Clinical Trials as Topic
    Computer Simulation
    HIV
    HIV Infections
    Humans
    Male
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/5494
    
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    DOI
    10.1371/journal.pone.0027775
    Abstract
    Effective population screening of HIV and prevention of HIV transmission are only part of the global fight against AIDS. Community-level effects, for example those aimed at thwarting future transmission, are potential outcomes of treatment and may be important in stemming the epidemic. However, current clinical trial designs are incapable of detecting a reduction in future transmission due to treatment. We took advantage of the fact that HIV is an evolving pathogen whose transmission network can be reconstructed using genetic sequence information to address this shortcoming. Here, we use an HIV transmission network inferred from recently infected men who have sex with men (MSM) in San Diego, California. We developed and tested a network-based statistic for measuring treatment effects using simulated clinical trials on our inferred transmission network. We explored the statistical power of this network-based statistic against conventional efficacy measures and find that when future transmission is reduced, the potential for increased statistical power can be realized. Furthermore, our simulations demonstrate that the network statistic is able to detect community-level effects (e.g., reduction in onward transmission) of HIV treatment in a clinical trial setting. This study demonstrates the potential utility of a network-based statistical metric when investigating HIV treatment options as a method to reduce onward transmission in a clinical trial setting. © 2011 Wertheim et al.
    Citation to related work
    Public Library of Science (PLoS)
    Has part
    PLoS ONE
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    http://dx.doi.org/10.34944/dspace/5476
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