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Research Article

The Role of Viral Introductions in Sustaining Community-Based HIV Epidemics in Rural Uganda: Evidence from Spatial Clustering, Phylogenetics, and Egocentric Transmission Models

  • Mary K. Grabowski,

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Justin Lessler mail,

    jlessler@jhsph.edu

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Andrew D. Redd,

    Affiliation: Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America

    X
  • Joseph Kagaayi,

    Affiliation: Rakai Health Sciences Program, Kalisizo, Uganda

    X
  • Oliver Laeyendecker,

    Affiliations: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Anthony Ndyanabo,

    Affiliation: Rakai Health Sciences Program, Kalisizo, Uganda

    X
  • Martha I. Nelson,

    Affiliation: Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America

    X
  • Derek A. T. Cummings,

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • John Baptiste Bwanika,

    Affiliation: Rakai Health Sciences Program, Kalisizo, Uganda

    X
  • Amy C. Mueller,

    Affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Steven J. Reynolds,

    Affiliations: Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America, Rakai Health Sciences Program, Kalisizo, Uganda, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Supriya Munshaw,

    Affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

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  • Stuart C. Ray,

    Affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Tom Lutalo,

    Affiliation: Rakai Health Sciences Program, Kalisizo, Uganda

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  • Jordyn Manucci,

    Affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Aaron A. R. Tobian,

    Affiliations: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, Rakai Health Sciences Program, Kalisizo, Uganda, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Larry W. Chang,

    Affiliations: Rakai Health Sciences Program, Kalisizo, Uganda, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

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  • Chris Beyrer,

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

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  • Jacky M. Jennings,

    Affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Fred Nalugoda,

    Affiliation: Rakai Health Sciences Program, Kalisizo, Uganda

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  • David Serwadda,

    Affiliations: Rakai Health Sciences Program, Kalisizo, Uganda, School of Public Health, College of Medicine, Makerere University, Kampala, Uganda

    X
  • Maria J. Wawer,

    Affiliations: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, Rakai Health Sciences Program, Kalisizo, Uganda

    X
  • Thomas C. Quinn,

    Affiliations: Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Ronald H. Gray,

    Affiliations: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America, Rakai Health Sciences Program, Kalisizo, Uganda

    X
  • the Rakai Health Sciences Program
  • Published: March 04, 2014
  • DOI: 10.1371/journal.pmed.1001610

About the Authors

Mary K. Grabowski, Justin Lessler, Oliver Laeyendecker, Derek A. T. Cummings, Aaron A. R. Tobian, Chris Beyrer, Maria J. Wawer, Ronald H. Gray
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
Andrew D. Redd, Oliver Laeyendecker, Steven J. Reynolds, Thomas C. Quinn
Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
Joseph Kagaayi, Anthony Ndyanabo, John Baptiste Bwanika, Steven J. Reynolds, Tom Lutalo, Aaron A. R. Tobian, Larry W. Chang, Fred Nalugoda, David Serwadda, Maria J. Wawer, Ronald H. Gray
Rakai Health Sciences Program, Kalisizo, Uganda
Oliver Laeyendecker, Amy C. Mueller, Steven J. Reynolds, Supriya Munshaw, Stuart C. Ray, Jordyn Manucci, Aaron A. R. Tobian, Larry W. Chang, Jacky M. Jennings, Thomas C. Quinn
School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
Martha I. Nelson
Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
David Serwadda
School of Public Health, College of Medicine, Makerere University, Kampala, Uganda

Corresponding Author

Email: jlessler@jhsph.edu

Competing Interests

JL is a PLOS Medicine Statistical Advisor. CB is a member of the Editorial Board of PLOS Medicine. DC has acted as a consultant to Medimmune on issues unrelated to HIV (influenza). The authors declare no other competing interests exist.

Author Contributions

Conceived and designed the experiments: MKG JL ADR MJW DS RHG. Performed the experiments: MKG AM JM. Analyzed the data: MKG JL MIN AN JBB. Contributed reagents/materials/analysis tools: OL MIN TCQ. Wrote the first draft of the manuscript: MKG JL RG. Contributed to the writing of the manuscript: MKG JL ADR JK OL AN MIN DATC JBB ACM SCR SM SCR TL JM AART LWC CB JMJ FN DS MJW TCQ RHG. ICMJE criteria for authorship read and met: MKG JL ADR JK OL AN MIN DATC JBB ACM SCR SM SCR TL JM AART LWC CB JMJ FN DS MJW TCQ RHG. Agree with manuscript results and conclusions: MKG JL ADR JK OL AN MIN DATC JBB ACM SCR SM SCR TL JM AART LWC CB JMJ FN DS MJW TCQ RHG. Enrolled patients: FN JK DS SJR.