Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Sexual intermingling of Arab and Jewish MSM in Israel

results of a molecular epidemiology study

Zuckerman, Neta S.a,*; Mor, Zoharb,c,*; Bucris, Efrata; Wax, Marinaa; Mendelson, Ellaa,c; Mor, Ornaa,c

doi: 10.1097/QAD.0000000000002057

Objectives: MSM comprise ∼30% of new HIV infections in Israel, a country with mixed Jewish and Arab populations. We molecularly characterized HIV-1 in the Arab and Jewish MSM (AMSM, JMSM) populations to reveal possible interethnical connections.

Design: Cross-sectional study.

Methods: All Israeli-born, HIV-1-infected MSM diagnosed between 2005 and 2016 (n = 1143) were cross-matched with the National Civil Registry to identify religion (Jews/Muslims/Christians). Transmitted drug-resistance mutations (TDRM) and HIV-1 subtypes were determined on the first partial protease and reverse transcriptase sequences from treatment-naive patients and phylogenetic trees were constructed.

Results: Among MSM, 6.4% (73/1143) were Arabs and 93.6% (1070/1143) were Jews. Interestingly, a higher proportion of Arabs was identified among non-MSM (19%, 46/247 versus 6.4%, 73/1143, P < 0.01). Subtype analysis of 62 HIV-1 AMSM and 440 randomly selected HIV-1 JMSM sequences revealed 80.6, 8.1, 4.8 and 6.5% of AMSM and 82.3, 9.5, 4.1 and 4.1% of JMSM had B, A, C and non-A/B/C, respectively. Overall, 13.1% (66/502) had TDRM; reverse transcriptase-K103N/S, M184 V, T215S and protease-L90M were the most common. TDRM prevalence was not significantly higher in JMSM compared to AMSM (P = 0.1) and no temporal changes were observed in their frequency. Phylogenetic analysis demonstrated AMSM and JMSM clusters including L90M, K103N/S or T215S TDRM.

Conclusion: Intermingling of AMSM and JMSM HIV-1 in clusters of HIV-1 sequences suggest interethnical sexual contacts among these MSM. Interventions aiming to prevent HIV-transmission in MSM should similarly address both populations groups. The high TDRM frequency requires continuation of resistance testing.

aCentral Virology Laboratory, Sheba Medical Center, Ministry of Health, Ramat-Gan

bTel Aviv Department of Health, Ministry of Health, Tel-Aviv

cSchool of Public Health, Sackler School of Medicine,Tel-Aviv university, Ramat-Aviv, Israel.

Correspondence to Orna Mor, Director, National HIV Reference Laboratory, Head, Laboratory of Clinical Virology, Ministry of Health, Sheba Medical Center, Ramat-Gan; School of Public Health, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel. Tel: +972 3 5302458. fax: +972 3 5307362; e-mail:

Received 9 August, 2018

Accepted 27 September, 2018

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (

Copyright © 2019 Wolters Kluwer Health, Inc.