Epidemiological Evaluation of Phylogenetic Clustering and Meeting Sexual Partners at Social Venues Among Men Who Have Sex With Men and Transgender Women in Lima, Peru

New HIV infections in the Americas are predominately occurring among men who have sex with men (MSM) and transgender women (TW).1 In Peru, there is a concentrated epidemic among MSM and TW, for whom the HIV prevalence exceeds 20% while the general HIV prevalence is less than one percent.2 This study sought to identify geographic or behavioral traits associated with HIV infection among MSM and TW in Lima, Peru, using spatial clustering and phylogenetic clustering analyses. The spatial clustering analysis evaluated the association of residential location with HIV infections using kernel density estimations using a case-cohort design and included 375 HIV cases and 322 in the sub-cohort as controls. This analysis did not find significant evidence of clustering of HIV infections by residential location. The phylogenetic clustering analysis assessed the association between belonging to a phylogenetic cluster and sexual partnering at specific venues within 60 days of incident HIV infection for 202 participants. We found an association between belonging to a phylogenetic cluster and reporting meeting a sexual partner at any venue or a specific venue (OR for any venue compared to reporting meeting a sexual partner at no venues 60 days before diagnosis= 2.33, p<0.01; OR for Vale Todo compared to none= 2.02, p=0.03). These findings provide support for more targeted HIV prevention interventions in social venues rather than traditional HIV outreach activities in residential neighborhoods.