# Timely monitoring and response to HIV transmission networks for intensified prevention

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $760,584

## Abstract

PROJECT SUMMARY
 Tracking population-based HIV transmission dynamics is critical to design and monitor effective
interventions. Despite widespread prevention, HIV incidence has failed to decline among some subgroups in
the United States (US) including young men who have sex with men (MSM). Such disparities are notable in the
Southern US which is at the epicenter of the national epidemic with the greatest burden in new and prevalent
infections. Significant disparities in HIV infection exist based on race/ethnicity and risk behaviors, but also in
geography; a higher proportion of cases are reported outside large urban areas compared to other regions.
 Delineating HIV transmission dynamics in the Southern US can identify ongoing transmission networks or
clusters where targeted prevention measures may be more impactful at reducing local incidence. However, the
success of such measures requires timely identification and response to emerging or expanding clusters.
Prospective phylogenetic analyses of HIV sequences integrated with epidemiologic and clinical surveillance
data would facilitate the timely detection and monitoring of transmission networks. When combined with
phylodynamic modeling, cluster expansion and transmission dynamics could be better predicted and the
impact of interventions assessed.
 Our overall hypotheses are: 1) Prospective phylogenetic cluster analysis allows timely identification of
transmission chains not apparent through routine surveillance, 2) Persons identified in expanding clusters
represent the leading edge of local transmission, i.e. recent infection, 3) Targeting prevention towards growing
clusters will identify a higher proportion of recent infections and ultimately reduce incidence. These hypotheses
will be addressed in North Carolina (NC) with three specific aims: Aim 1: To describe the demographic and
geographical characteristics of HIV transmission involving persons with newly reported HIV infection using
phylogenetic clustering, viral load, and risk behaviors; Aim 2: To assess HIV cluster expansion and inform
phylodynamic models by integrating large-scale deep sequencing and contact networks involving cases with
newly diagnosed HIV infection; Aim 3: To conduct a preliminary assessment of a cluster-directed partner
services intervention to interrupt HIV transmission networks.
 These aims will be addressed through a combination of strategies in collaboration with the NC Department
of Health and Human Services. A statewide prospective, automated cluster analysis system (nextHIV) will be
evaluated. Sequences from reference laboratories and deep sequencing of diagnostic specimens from public
testing sites will be analyzed in near-real time. Clusters will be characterized with detailed epidemiological data
including HIV viral loads and contact networks. A proof-of-concept, cluster-directed partner services
intervention will be assessed in an 11 county region with high HIV burden. Phylodynamic and mathematical
modeling w...

## Key facts

- **NIH application ID:** 10155405
- **Project number:** 5R01AI135970-04
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Ann Dennis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $760,584
- **Award type:** 5
- **Project period:** 2018-03-05 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10155405

## Citation

> US National Institutes of Health, RePORTER application 10155405, Timely monitoring and response to HIV transmission networks for intensified prevention (5R01AI135970-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10155405. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*