Community priorities for programs using HIV molecular epidemiology: A best-worst scaling.

Authors

Anne Lr Schuster, Juli Bollinger, Travis Sanchez, Jeremy Sugarman, John Fp Bridges

Published in

Journal of acquired immune deficiency syndromes (1999). Sep 24, 2026. Epub Sep 24, 2026.

Abstract

HIV molecular epidemiology (HIV-ME) uses genetic sequencing to study viral evolution, detect transmission clusters, and guide public health responses. Ethical, legal, and social implications of HIV-ME have been raised, yet quantitative evidence on community perspectives remains limited. We quantified community priorities for HIV-ME program features and examined their heterogeneity.
Adult cisgender men who have sex with men, including people living with HIV (PLWH), were recruited from the 2023-2024 American Men's Internet Survey. Best-worst scaling assessed the importance of 11 HIV-ME features across 11 choice tasks using a Youden experimental design. Aggregate results were estimated using conditional logit models and rescaled to importance scores summing to 100%. Heterogeneity in priorities was assessed using stratified models and latent class analysis.
Among 747 people who completed the survey, 18% were PLWH, 35% were under 40, 34% reported concern about stigma, and 38% resided in states with active HIV criminalization statutes. "Ensuring privacy" was the most important feature, followed by HIV-ME uses for cluster detection and response, studying viral evolution, and evaluating prevention. Priorities did not differ when stratified by HIV status (p<0.01). Two latent classes emerged: a larger "Use the Data" group (n=472, 63%) placed 64% of importance on HIV-ME uses, and a smaller 'Protect the Data' group (n=275, 37%) placed 26% of importance on HIV-ME uses and 64% on: ensuring privacy, obtaining permission for and providing disclosure about data use, and limiting law-enforcement access.
Community support is broad for HIV-ME uses, particularly with protections for data privacy, access, and use.

PMID:
42785381
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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