HIV drug resistance, tropism, and genetic diversity in Black men who have sex with men
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Black men who have sex with men (MSM) are disproportionately affected by HIV in the United States (US). Despite representing less than 1% of the US population, Black MSM accounted for the highest number of new HIV diagnoses in 2014. Culturally-tailored interventions are needed to control the HIV epidemic in this population. The HIV Prevention Trials Network (HPTN) 061 study was designed to assess the feasibility of a multi-component intervention for reducing HIV incidence among Black MSM. The HPTN 061 study enrolled 348 HIV-infected men and 1,205 HIV-uninfected men; 28 men seroconverted during the study for an annual incidence rate of 3.0% overall and 5.9% among younger men (aged 18-30 years). Men in the HPTN 061 study completed detailed demographic and behavioral assessments at each study visit, which included an evaluation of risk behaviors associated with HIV transmission and acquisition. Demographic and behavioral factors that influence HIV transmission and acquisition may also impact the characteristics of infecting viral populations and their subsequent evolution. The work in this dissertation analyzed factors associated with HIV drug resistance, tropism, and genetic diversity in this cohort of Black MSM in the US. These findings provided new insights relevant to HIV treatment and prevention in this high-risk population.