Molecular epidemiology of HIV-1 subtype A in former Soviet Union countries

Abstract

Despite global declines, HIV incidence is rising in the former Soviet Union (FSU). The study analyzed 2,705 publicly available HIV‑1 subtype A pol sequences from 13 FSU countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Ukraine, Uzbekistan). Phylogenetic analyses revealed intermixing of clusters across countries, suggesting cross-border migration plays a major role in transmission. Injection drug use was the most common transmission route, and mixing between PWID (people who inject drugs) and heterosexual transmission indicated bridging across populations. To combat the expanding epidemic, harm-reduction efforts should prioritize three key transmission routes: cross-border migration, injection drug use, and heterosexual contact.