Official websites use. Share sensitive information only on official, secure websites. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. Ending the HIV pandemic must involve new tools to rapidly identify and control local outbreaks and prevent the emergence of recombinant strains with epidemiological advantages. Phylogenetic analyses of HIV sequences routinely generated for drug resistance genotyping before in French laboratories were employed to detect the transmission chain.
The CRF involved was characterised by almost full-length viral sequencing for six cases. Where possible, epidemiological information was collected with a questionnaire. The molecular proximity of this CRF to X4 strains and the high median viraemia, exceeding 5.
Overall, 41 cases were diagnosed in the Ile-de-France region and 45 were men who have sex with men. Among 24 cases with available information, 20 reported finding partners through a geosocial networking app. Prevention activities in the area and population affected were undertaken. We advocate the systematic use of routinely generated HIV molecular data by a dedicated reactive network, to improve and accelerate targeted prevention interventions. Geosocial networking apps can play a role in the spread of outbreaks, but could also deliver local targeted preventive alerts.
Nevertheless, the incidence of HIV-1 infection has not decreased sufficiently, particularly among men who have sex with men MSM [ 3 , 4 ]. Screening for infection and upstream prevention are the weak links in the chain.
In France, self-testing kits for HIV infection are now available over-the-counter and pre-exposure prophylaxis PrEP is supported by the healthcare system [ 5 - 7 ]. Recent advances in molecular epidemiology could facilitate the identification of transmission clusters and outbreaks, as well as the initiation of rapid and focused preventive activities to limit HIV spread, but their routine use is not easy [ 8 - 12 ].
