Research Article

Redefining the Mode of HIV Transmission through Analysis of Risk Attribution among the Reported HIV Cases from 1993 to 2021 in Bhutan

Table 1

Assessment of all the existing risk behaviours based on the following national algorithm.

QuestionRisk factor attribution

3a. 1 Did you ever have sexual contact with a male?If male or transwoman and yes – HOM
If female and yes - HETF
Otherwise - unknown

3a. 2 Did you ever have sexual contact with a female?If male or transwoman and yes - HETM
Otherwise – Unknown

3a. 3 Did you ever have sexual contact with a transgender person?If male or transwoman and yes - HOM
Otherwise – Unknown

3a. 4 Did you ever inject any drugs not prescribed by a physician?If yes - IDU
Otherwise – Unknown

3a. 5 Did you ever receive blood or blood products transfusion or transplant?If yes - NOS
Otherwise - unknown

3a. 6 Did you ever have any invasive surgical procedures?If yes - NOS
Otherwise - unknown

3a. 7 Did you ever have intentional skin penetration, e.g., tattoo, scarring, piercing?If yes - SP
Otherwise - unknown
If heterosexual sex was reported:

3b. 1 Did you ever have heterosexual contact with an HIV-infected person?If yes – HETHIV
Otherwise - unknown

3b. 2 Did you ever provide sexual services for money, gifts, or any other kind of remuneration?If yes – SW
Otherwise - unknown

3b. 3 Did you ever have heterosexual contact with a person who injects drugs?If yes – HETIDU
Otherwise - unknown

3b. 4 Did you ever have heterosexual contact with a bisexual male?If yes – HETHOM
Otherwise - unknown

3b. 5 Did you ever have heterosexual contact with a sex worker or client of a sex worker?If yes – HETSW
Otherwise - unknown
Section 7. Viral hepatitis testingIf HCV- is positive – IDU (given the strong correlation between HCV and IDU, the presence of anti-HCV antibodies in many contexts is considered a marker of IDU-related transmission)