原创力文档using hiv transmission networks to investigate community effects in hiv prevention trials使用艾滋病毒传播网络调查社区影响艾滋病毒预防试验.pdfVIP
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using hiv transmission networks to investigate community effects in hiv prevention trials使用艾滋病毒传播网络调查社区影响艾滋病毒预防试验
Using HIV Transmission Networks to Investigate
Community Effects in HIV Prevention Trials
1 2 2 3
Joel O. Wertheim *, Sergei L. Kosakovsky Pond , Susan J. Little , Victor De Gruttola
1 Department of Pathology, University of California San Diego, San Diego, California, United States of America, 2 Department of Medicine, University of California San
Diego, San Diego, California, United States of America, 3 Department of Biostatistics, Harvard University, Cambridge, Massachusetts, United States of America
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 transm
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