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Here, we infer the HIV genetic network of Mexico City in 2020, and identify actively growing clusters that could represent relevant targets for intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All new diagnoses, referrals from other institutions, as well as persons returning to care, enrolling at the largest HIV clinic in Mexico City were invited to participate in the study. The network was inferred from HIV <jats:italic>pol<\/jats:italic> sequences, using pairwise genetic distance methods, with a locally hosted, secure version of the HIV\u2010TRACE tool: Seguro HIV\u2010TRACE. Socio\u2010demographic, clinical and behavioural metadata were overlaid across the network to design focused prevention interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3168 HIV sequences from unique individuals were included. One thousand and one\u2010hundred and fifty (36%) sequences formed 1361 links within 386 transmission clusters in the network. Cluster size varied from 2 to 14 (63% were dyads). After adjustment for covariates, lower age (adjusted odds ratio [aOR]: 0.37, <jats:italic>p<\/jats:italic>&lt;0.001; &gt;34 vs. &lt;24 years), being a man who has sex with men (MSM) (aOR: 2.47, <jats:italic>p<\/jats:italic> = 0.004; MSM vs. cisgender women), having higher viral load (aOR: 1.28, <jats:italic>p<\/jats:italic>&lt;0.001) and higher CD4+ T cell count (aOR: 1.80, <jats:italic>p<\/jats:italic>&lt;0.001; \u2265500 vs. &lt;200 cells\/mm<jats:sup>3<\/jats:sup>) remained associated with higher odds of clustering. Compared to MSM, cisgender women and heterosexual men had significantly lower education (none or any elementary: 59.1% and 54.2% vs. 16.6%, <jats:italic>p<\/jats:italic>&lt;0.001) and socio\u2010economic status (low income: 36.4% and 29.0% vs. 18.6%, <jats:italic>p<\/jats:italic> = 0.03) than MSM. We identified 10 (2.6%) clusters with constant growth, for prioritized intervention, that included intersecting sexual risk groups, highly connected nodes and bridge nodes between possible sub\u2010clusters with high growth potential.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HIV transmission in Mexico City is strongly driven by young MSM with higher education level and recent infection. Nevertheless, leveraging network inference, we identified actively growing clusters that could be prioritized for focused intervention with demographic and risk characteristics that do not necessarily reflect the ones observed in the overall clustering population. Further studies evaluating different models to predict growing clusters are warranted. Focused interventions will have to consider structural and risk disparities between the MSM and the heterosexual populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25836","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T17:14:37Z","timestamp":1636650877000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Characteristics and growth of the genetic HIV transmission network of Mexico City during 2020"],"prefix":"10.1002","volume":"24","author":[{"given":"Vanessa","family":"D\u00e1vila\u2010Conn","sequence":"first","affiliation":[{"name":"Centre for Research in Infectious Diseases National Institute of Respiratory Diseases  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Garc\u00eda\u2010Morales","sequence":"additional","affiliation":[{"name":"Centre for Research in Infectious Diseases National Institute of Respiratory 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