Genetic diversity and evolutionary analysis of HIV-1 among migration populations: a five-year cross-sectional molecular epidemiology study.

It is crucial to conduct strict surveillance on the diversity of HIV-1 to aid the generation of evidence-based biomedical and behavioral prevention programs to HIV/AIDS. In the current study, the social demographic characteristics, HIV-1 viral diversity among migration populations between 2017 and 2021 were investigated comprehensively and were compared with those in the previous five-year, between 2012 and 2016. Epidemiological investigation indicated that the male-to-female ratio decreased from 10.34:1 to 5.12:1, indicating significantly more female were infected when compared to the previous five years (p = 0.004). Moreover, an inversion on both the gender and nationality was found when comparison between study participants from southeastern ports and northwestern ports (p < 0.05) during the ten-year study period. Molecular epidemiology study revealed that two subtypes C/BC and CRF01_AE dominated, with the emerging of novel unique recombinant forms, including CRF01_AE/C/BC, CRF03_AB/C/BC, A/D, CRF01_AE/C, CRF08_BC/B, CRF01_AE/B, and B/CRF01_AE/C between 2017 and 2021. In addition, a significant higher proportion of drug-resistant viruses was found among this population when compared with the previous five-year (p < 0.001). In conclusion, the altered social demographic characteristics, co-circulation of CRF01_AE, C/BC recombinants, multiple URFs, and increasing amount of multiple drug-resistant viruses, indicated a new trend of the HIV-1 molecular epidemic in this population, which called for enhanced public health responses and prioritization of resources.