# Increasing the yield of HIV contact tracing for prevention using network models

> **NIH NIH R21** · DUKE UNIVERSITY · 2024 · $197,233

## Abstract

PROJECT SUMMARY
Despite the significant advances in HIV antiretroviral therapies for effective treatment and prophylaxis
regimens, young Black men and transwomen in North Carolina (NC) continue to be affected by HIV at nearly
the same rates over the last 10 years. The new diagnosis rate in NC for Black men aged 13-24 years was
104.7/100k population in 2009 and 114.6/100k population in 2019. Viral suppression failures lead to higher
rates of uncontrolled HIV in the sexual networks of young Black men who have sex with men (YBMSM).
YBMSM who are HIV-negative are significantly less likely to be on pre-exposure prophylaxis (PrEP), especially
in states which have not or have only recently expanded Medicaid.
There are both clinical and public health points of intervention where YBMSM could be given greater access to
PrEP. Clinical guidelines indicate PrEP based on individual-level risk factors (e.g., bacterial diagnosis) or on
partner-level risk factors (e.g., HIV+ partner). However, YBMSM are more likely to be part of a sexual network
where both HIV and bacterial sexually transmitted infections are circulating. If using the concept of “degrees of
separation”, YBMSM in the US South tend to be fewer degrees away from someone with HIV, so accounting
only for their person-level or first degree partner-level risk factors fails to place the person in context. Clinically,
an understanding of the partners of the partners may turn out to be an indicator for PrEP that is not currently
assessed. From a public health standpoint, PrEP can benefit not only the person taking it but also the larger
community if preventing one person’s infection also protects future partners. It can thus have a positive effect
across the sexual network, as has been demonstrated by simulation studies. As resources to provide PrEP are
extremely limited, identifying network members who would themselves benefit from PrEP and whose partners
would benefit as a result is key.
These gaps suggest that to better assess HIV risk – and recommend prophylaxis – an understanding of risk
within the entire sociosexual network is needed as the individual-level risk is a product of the local network
beyond just partners. In this project, we aim to quantify the additional risk of HIV among YBMSM who are
positive for syphilis or who are partners of someone positive for syphilis compared to the risk among other
demographic groups and to develop a model that can be applied at the time of the public health interview to
predict HIV seroconversion within 3 years. We also aim to test methods to scale up to the underlying
transmission network using the subset of relationships which are observed during public health interactions.

## Key facts

- **NIH application ID:** 11007676
- **Project number:** 1R21AI181649-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Dana Kristine Pasquale
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $197,233
- **Award type:** 1
- **Project period:** 2024-06-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11007676

## Citation

> US National Institutes of Health, RePORTER application 11007676, Increasing the yield of HIV contact tracing for prevention using network models (1R21AI181649-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11007676. Licensed CC0.

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