HIV-1 Genetic and Contact Networks Among Men Who Have Sex With Men May Inform Public Health Efforts.

Despite decreases in overall HIV-1 incidence in the United States, incidence has been stable or increasing among Black men who have sex with men (MSM), particularly among those aged 25 to 34 years. National incidence trends also obscure significant localized trends, with estimated HIV-1 prevalence rates higher than 30% among MSM in some US counties and metropolitan areas. Remarkable progress in HIV-1 prevention can be made through expansion of antiretroviral therapy for treatment and preexposure prophylaxis. However, reaching and engaging persons who would benefit the most are challenging and often hampered by societal factors that disproportionately affect US Black men, including high rates of incarceration, poverty, unemployment, and lack of access to affordable preventive medical care and health insurance. Societal factors coupled with smaller sexual networks, more same-race partnerships, and higher HIV-1 prevalence compared with other racial/ethnic groups contribute to the heightened HIV infection risk among Black MSM. Altogether, new avenues leveraging network-based interventions to disrupt ongoing HIV-1 transmission are needed.