{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:58:30Z","timestamp":1768323510160,"version":"3.49.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Dehong prefecture, Yunnan province on China\u2019s southwestern border was the gateway of the country\u2019s AIDS epidemic. Studies on HIV-1 molecular epidemiology will provide key information on virus transmission dynamics and help to inform HIV prevention strategies. HIV-1 infected youths (age 16\u201325 years) diagnosed in the continuous 3 months in 2009 to 2012 were enrolled. By means of phylogenetic and statistical analyses, It was showed that two thirds (133\/205) of youths in Dehong, of which 74.1% were infected sexually, were infected by uncharacterized recombinant HIV-1 strains. Among them about 59.4% (79\/131) were unique recombinant forms (URFs) and 40.6% (54\/131) formed 11 transmission clusters, termed potential circulating recombinant forms (pCRFs). The emergence of recombinants was statistically significant related with people of low education, residents outside the capital city of Dehong and being Myanmar residents. It was the first report with ongoing HIV-1 recombinant strains in a sexually driven epidemic area in China. Great efforts should be put on reducing multiple risk exposures behavior in local young people, containing the spread of pCRFs to other regions and preventing the URFs from evolving into future CRFs. Collaborative prevention across border is needed to better control the local AIDS epidemic.<\/jats:p>","DOI":"10.1038\/srep11323","type":"journal-article","created":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T12:56:54Z","timestamp":1435841814000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The sexually driven epidemic in youths in China\u2019s southwestern border region was caused by dynamic emerging multiple recombinant HIV-1 strains"],"prefix":"10.1038","volume":"5","author":[{"given":"Huamian","family":"Wei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Xing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny H.","family":"Hsi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manhong","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cui","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shitang","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhua","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingjie","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanling","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunda","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiming","family":"Shao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2015,7,2]]},"reference":[{"key":"BFsrep11323_CR1","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1097\/QAD.0b013e328342ff93","volume":"25","author":"J Hemelaar","year":"2011","unstructured":"Hemelaar, J. et al. Global trends in molecular epidemiology of HIV-1 during 2000-2007. AIDS 25, 679\u2013689, doi:10.1097\/QAD.0b013e328342ff93 (2011).","journal-title":"AIDS"},{"key":"BFsrep11323_CR2","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1126\/science.288.5463.55d","volume":"288","author":"DL Robertson","year":"2000","unstructured":"Robertson, D. L. et al. HIV-1 nomenclature proposal. Science 288, 55\u201356 (2000).","journal-title":"Science"},{"key":"BFsrep11323_CR3","doi-asserted-by":"publisher","first-page":"e47289","DOI":"10.1371\/journal.pone.0047289","volume":"7","author":"X He","year":"2012","unstructured":"He, X. et al. A comprehensive mapping of HIV-1 genotypes in various risk groups and regions across China based on a nationwide molecular epidemiologic survey. PLoS One 7, e47289, doi:10.1371\/journal.pone.0047289 (2012).","journal-title":"PLoS One"},{"key":"BFsrep11323_CR4","first-page":"184","volume":"11","author":"Y MA","year":"1990","unstructured":"MA, Y., Li, Z. & Zhao, S. HIV infected people were first identified in intravenous drug users in China. Chin J Epidemiol 11, 184\u2013185 (1990).","journal-title":"Chin J Epidemiol"},{"key":"BFsrep11323_CR5","first-page":"291","volume":"10","author":"Y Shao","year":"1994","unstructured":"Shao, Y. et al. Sequence analysis of HIV env genes among HIV infected drug injecting users in Dehong epidemic area of Yunnan province, China. Chin J Virol 10, 291\u2013299 (1994).","journal-title":"Chin J Virol"},{"key":"BFsrep11323_CR6","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/S0140-6736(95)90792-0","volume":"345","author":"CC Luo","year":"1995","unstructured":"Luo, C. C. et al. HIV-1 subtype C in China. Lancet 345, 1051\u20131052 (1995).","journal-title":"Lancet"},{"key":"BFsrep11323_CR7","doi-asserted-by":"publisher","first-page":"11367","DOI":"10.1128\/JVI.74.23.11367-11376.2000","volume":"74","author":"L Su","year":"2000","unstructured":"Su, L. et al. Characterization of a virtually full-length human immunodeficiency virus type 1 genome of a prevalent intersubtype (C\/B\u2019) recombinant strain in China. J Virol 74, 11367\u201311376 (2000).","journal-title":"J Virol"},{"key":"BFsrep11323_CR8","doi-asserted-by":"publisher","first-page":"9206","DOI":"10.1128\/JVI.00399-08","volume":"82","author":"KK Tee","year":"2008","unstructured":"Tee, K. K. et al. Temporal and spatial dynamics of human immunodeficiency virus type 1 circulating recombinant forms 08_BC and 07_BC in Asia. J Virol 82, 9206\u20139215, doi:10.1128\/JVI.00399-08 (2008).","journal-title":"J Virol"},{"key":"BFsrep11323_CR9","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1097\/QAD.0b013e328351430d","volume":"26","author":"Z Li","year":"2012","unstructured":"Li, Z. et al. Tracing the origin and history of HIV-1 subtype B\u2019 epidemic by near full-length genome analyses. AIDS 26, 877\u2013884, doi:10.1097\/QAD.0b013e328351430d (2012).","journal-title":"AIDS"},{"key":"BFsrep11323_CR10","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1097\/QAD.0b013e3283522c97","volume":"26","author":"W Pang","year":"2012","unstructured":"Pang, W. et al. Extensive and complex HIV-1 recombination between B\u2019, C and CRF01_AE among IDUs in south-east Asia. AIDS 26, 1121\u20131129, doi:10.1097\/QAD.0b013e3283522c97 (2012).","journal-title":"AIDS"},{"key":"BFsrep11323_CR11","doi-asserted-by":"publisher","first-page":"e65337","DOI":"10.1371\/journal.pone.0065337","volume":"8","author":"X Han","year":"2013","unstructured":"Han, X. et al. High Prevalence of HIV-1 Intersubtype B\u2019\/C Recombinants among Injecting Drug Users in Dehong, China. PloS one 8, e65337 (2013).","journal-title":"PloS one"},{"key":"BFsrep11323_CR12","doi-asserted-by":"publisher","first-page":"6241","DOI":"10.1128\/JVI.00077-10","volume":"84","author":"KJ Bar","year":"2010","unstructured":"Bar, K. J. et al. Wide variation in the multiplicity of HIV-1 infection among injection drug users. J Virol 84, 6241\u20136247, doi:10.1128\/jvi.00077-10 (2010).","journal-title":"J Virol"},{"key":"BFsrep11323_CR13","doi-asserted-by":"publisher","first-page":"S39","DOI":"10.1097\/01.aids.0000304695.54884.4f","volume":"21 Suppl 8","author":"Y Ruan","year":"2007","unstructured":"Ruan, Y. et al. Incidence of HIV, hepatitis C and hepatitis B viruses among injection drug users in southwestern China: a 3-year follow-up study. AIDS 21 Suppl 8, S39\u201346, doi:10.1097\/01.aids.0000304695.54884.4f (2007).","journal-title":"AIDS"},{"key":"BFsrep11323_CR14","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/S1473-3099(13)70245-7","volume":"13","author":"L Zhang","year":"2013","unstructured":"Zhang, L. et al. HIV prevalence in China: integration of surveillance data and a systematic review. The Lancet infectious diseases 13, 955\u2013963, doi:10.1016\/s1473-3099(13)70245-7 (2013).","journal-title":"The Lancet infectious diseases"},{"key":"BFsrep11323_CR15","doi-asserted-by":"publisher","first-page":"e46777","DOI":"10.1371\/journal.pone.0046777","volume":"7","author":"L Li","year":"2012","unstructured":"Li, L. et al. Recombination form and epidemiology of HIV-1 unique recombinant strains identified in Yunnan, China. PLoS One 7, e46777, doi:10.1371\/journal.pone.0046777 (2012).","journal-title":"PLoS One"},{"key":"BFsrep11323_CR16","doi-asserted-by":"publisher","first-page":"e60101","DOI":"10.1371\/journal.pone.0060101","volume":"8","author":"M Chen","year":"2013","unstructured":"Chen, M. et al. Emerging Variability in HIV-1 Genetics among Recently Infected Individuals in Yunnan, China. PLoS One 8, e60101, doi:10.1371\/journal.pone.0060101 (2013).","journal-title":"PLoS One"},{"key":"BFsrep11323_CR17","doi-asserted-by":"publisher","first-page":"e54322","DOI":"10.1371\/journal.pone.0054322","volume":"8","author":"J Wu","year":"2013","unstructured":"Wu, J. et al. New emerging recombinant HIV-1 strains and close transmission linkage of HIV-1 strains in the Chinese MSM population indicate a new epidemic risk. PLoS One 8, e54322, doi:10.1371\/journal.pone.0054322 (2013).","journal-title":"PLoS One"},{"key":"BFsrep11323_CR18","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1089\/aid.2007.0269","volume":"24","author":"L Bao","year":"2008","unstructured":"Bao, L. et al. Molecular tracing of sexual HIV Type 1 transmission in the southwest border of China. AIDS Res Hum Retroviruses 24, 733\u2013742, doi:10.1089\/aid.2007.0269 (2008).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR19","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1089\/aid.2011.0246","volume":"28","author":"Q Su","year":"2012","unstructured":"Su, Q., Liang, H., Cen, P., Bi, Z. & Zhou, P. HIV type 1 subtypes based on the pol gene and drug resistance mutations among antiretroviral-naive patients from Guangxi, Southern China. AIDS Res Hum Retroviruses 28, 725\u2013728, doi:10.1089\/AID.2011.0246 (2012).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR20","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1097\/00002030-200207050-00012","volume":"16","author":"R Yang","year":"2002","unstructured":"Yang, R. et al. On-going generation of multiple forms of HIV-1 intersubtype recombinants in the Yunnan Province of China. AIDS 16, 1401\u20131407 (2002).","journal-title":"AIDS"},{"key":"BFsrep11323_CR21","doi-asserted-by":"publisher","first-page":"e443","DOI":"10.1371\/journal.pmed.0030443","volume":"3","author":"Y Zhang","year":"2006","unstructured":"Zhang, Y. et al. Dominance of HIV-1 subtype CRF01_AE in sexually acquired cases leads to a new epidemic in Yunnan province of China. PLoS medicine 3, e443, doi:10.1371\/journal.pmed.0030443 (2006).","journal-title":"PLoS medicine"},{"key":"BFsrep11323_CR22","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1186\/1471-2334-12-382","volume":"12","author":"M Chen","year":"2012","unstructured":"Chen, M. et al. Genetic diversity and drug resistance among newly diagnosed and antiretroviral treatment-naive HIV-infected individuals in western Yunnan: a hot area of viral recombination in China. BMC Infect Dis 12, 382, doi:10.1186\/1471-2334-12-382 (2012).","journal-title":"BMC Infect Dis"},{"key":"BFsrep11323_CR23","doi-asserted-by":"publisher","first-page":"2418","DOI":"10.1017\/S0950268812002713","volume":"141","author":"YZ Su","year":"2013","unstructured":"Su, Y. Z. et al. Update on diversity and distribution of HIV-1 subtypes in Yunnan province. Epidemiology and infection 141, 2418\u20132427, doi:10.1017\/S0950268812002713 (2013).","journal-title":"Epidemiology and infection"},{"key":"BFsrep11323_CR24","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1089\/aid.2005.21.1046","volume":"21","author":"KK Tee","year":"2005","unstructured":"Tee, K. K., Saw, T. L., Pon, C. K., Kamarulzaman, A. & Ng, K. P. The evolving molecular epidemiology of HIV type 1 among injecting drug users (IDUs) in Malaysia. AIDS Res Hum Retroviruses 21, 1046\u20131050, doi:10.1089\/aid.2005.21.1046 (2005).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR25","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.3390\/v3091650","volume":"3","author":"K Delviks-Frankenberry","year":"2011","unstructured":"Delviks-Frankenberry, K. et al. Mechanisms and factors that influence high frequency retroviral recombination. Viruses 3, 1650\u20131680, doi:10.3390\/v3091650 (2011).","journal-title":"Viruses"},{"key":"BFsrep11323_CR26","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1097\/QAI.0b013e3181806c0e","volume":"48","author":"E Delgado","year":"2008","unstructured":"Delgado, E. et al. High prevalence of unique recombinant forms of HIV-1 in Ghana: molecular epidemiology from an antiretroviral resistance study. J Acquir Immune Defic Syndr 48, 599\u2013606, doi:10.1097\/QAI.0b013e3181806c0e (2008).","journal-title":"J Acquir Immune Defic Syndr"},{"key":"BFsrep11323_CR27","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1089\/aid.2004.20.1352","volume":"20","author":"K Kita","year":"2004","unstructured":"Kita, K. et al. Genetic diversity of HIV type 1 in Likasi, southeast of the Democratic Republic of Congo. AIDS Res Hum Retroviruses 20, 1352\u20131357, doi:10.1089\/aid.2004.20.1352 (2004).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR28","first-page":"75","volume":"9","author":"DM Tebit","year":"2007","unstructured":"Tebit, D. M., Nankya, I., Arts, E. J. & Gao, Y. HIV diversity, recombination and disease progression: how does fitness \u201cfit\u201d into the puzzle. AIDS reviews 9, 75\u201387 (2007).","journal-title":"AIDS reviews"},{"key":"BFsrep11323_CR29","first-page":"263","volume":"29","author":"L Yang","year":"2013","unstructured":"Yang, L. et al. Analysis on AIDS epidemic posture and control effect in Dehong in 2011. J Med Pest Control 29, 263\u2013265 (2013).","journal-title":"J Med Pest Control"},{"key":"BFsrep11323_CR30","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/135965350801302S04","volume":"13 Suppl 2","author":"DE Bennett","year":"2008","unstructured":"Bennett, D. E., Myatt, M., Bertagnolio, S., Sutherland, D. & Gilks, C. F. Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antiviral therapy 13 Suppl 2, 25\u201336 (2008).","journal-title":"Antiviral therapy"},{"key":"BFsrep11323_CR31","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1089\/aid.2007.0050","volume":"23","author":"L Liao","year":"2007","unstructured":"Liao, L. et al. Genotypic analysis of the protease and reverse transcriptase of HIV type 1 isolates from recently infected injecting drug users in western China. AIDS Res Hum Retroviruses 23, 1062\u20131065, doi:10.1089\/aid.2007.0050 (2007).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR32","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1089\/aid.2013.0104","volume":"29","author":"H Wei","year":"2013","unstructured":"Wei, H. et al. Near full-length genomic characterization of a novel HIV type 1 CRF07_BC\/01_AE recombinant in men who have sex with men from Sichuan, China. AIDS Res Hum Retroviruses 29, 1173\u20131176, doi:10.1089\/AID.2013.0104 (2013).","journal-title":"AIDS Res Hum Retroviruses"},{"key":"BFsrep11323_CR33","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1093\/sysbio\/syq010","volume":"59","author":"S Guindon","year":"2010","unstructured":"Guindon, S. et al. New algorithms and methods to estimate maximum-likelihood phylogenies: assessing the performance of PhyML 3.0. Systematic biology 59, 307\u2013321, doi:10.1093\/sysbio\/syq010 (2010).","journal-title":"Systematic biology"},{"key":"BFsrep11323_CR34","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1128\/JVI.73.1.152-160.1999","volume":"73","author":"KS Lole","year":"1999","unstructured":"Lole, K. S. et al. Full-length human immunodeficiency virus type 1 genomes from subtype C-infected seroconverters in India, with evidence of intersubtype recombination. J Virol 73, 152\u2013160 (1999).","journal-title":"J Virol"},{"key":"BFsrep11323_CR35","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1089\/aid.1995.11.1413","volume":"11","author":"AC Siepel","year":"1995","unstructured":"Siepel, A. C., Halpern, A. L., Macken, C. & Korber, B. T. A computer program designed to screen rapidly for HIV type 1 intersubtype recombinant sequences. AIDS Res Hum Retroviruses 11, 1413\u20131416 (1995).","journal-title":"AIDS Res Hum Retroviruses"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep11323","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep11323.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep11323.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T18:05:32Z","timestamp":1672941932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep11323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,2]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,9,1]]}},"alternative-id":["BFsrep11323"],"URL":"https:\/\/doi.org\/10.1038\/srep11323","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,2]]},"assertion":[{"value":"17 November 2014","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2015","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11323"}}