{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T16:19:28Z","timestamp":1787156368081,"version":"build-2736575974"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV\/AIDS remains a significant public health challenge. This study aimed to investigate the molecular transmission network and drug resistance characteristics among HIV-1 infected individuals through commercial heterosexual contact in Yubei District which located in a southwest city in China, thereby assessing HIV transmission risks in the region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Blood samples were collected from newly diagnosed HIV-1 patients in Yubei District in Chongqing city between 2020 and 2024, all of whom acquired the infection through commercial heterosexual contact. The HIV-1 pol region was amplified and sequenced to construct a phylogenetic tree. Drug resistance mutation sites were obtained by comparing with the Stanford Drug Resistance database. A molecular transmission network was constructed using a genetic distance threshold of 1.3%. Univariate and multivariate logistic regression analyses were used to determine potential factors influencing network entry and the formation of large clusters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 404 sequences, CRF07_BC was the predominant genotype (55.9%). The pretreatment drug resistance rate was 4.70% for all cases of commercial heterosexual exposure. Molecular network analysis revealed that 223 sequences (with an entry rate of 55.2%) formed 39 clusters, including 6 large clusters with more than 10 nodes. Multivariate logistic regression models identified age \u2265 60\u202fyears, household registration in Yubei District, and CRF85_BC genotype as risk factors for network inclusion and large cluster formation. Additionally, the study identified a transmission cluster with significant geographic aggregation, featuring one female sex worker who posed a high transmission risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIV-1 infections transmitted through commercial heterosexual contact exhibit pronounced geographic clustering, with over half of the cases belonging to the CRF07_BC genotype. Although the pretreatment drug resistance prevalence remains low, establishing a sustained resistance surveillance system remains essential. Targeted management and precise interventions are required for identified high-risk transmission networks to effectively curb further spread of HIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1826363","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:55:15Z","timestamp":1777442115000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular transmission network and drug resistance analysis of 404 HIV-1 cases infected through commercial heterosexual contact (2020\u20132024)"],"prefix":"10.3389","volume":"14","author":[{"given":"Lian","family":"Ma","sequence":"first","affiliation":[{"name":"College of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Yubei District Center for Disease Control and Prevention","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingjing","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Public Health, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Public Health, Chongqing Medical University","place":["Chongqing, China"]},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref1","year":"2025"},{"key":"ref2","year":"2025"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2492208","DOI":"10.1080\/22221751.2025.2492208","article-title":"Grand challenges on HIV\/AIDS in China \u2013 the 5th symposium, Yunnan 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