Since its emergence as a newly recognized infectious disease in 1981, AIDS has spread rapidly to nearly every geographic region and has affected all socioeconomic groups. Population movements, in particular, have enormously accelerated the dissemination of HIV. In this regard, the relationship between HIV infection and international or recreational travel has been a principal concern of Pacific Island nations whose economies are heavily dependent on tourism. Surprisingly little, however, is known about the subtypes of HIV in the Pacific. To clarify recent trends in the molecular epidemiology of HIV infection in Hawaii and Guam, we analyzed HIV env gene sequences in 88 infected individuals. DNA, extracted from buffy coat or PBMC samples from 88 men and women (76 from Hawaii and 12 from Guam) infected with HIV between 1983 and 1998, were analyzed for a 273-nucleotide region spanning the V3 loop of the gp120- encoding HIV env gene by nested PCR. Sequence and phylogenetic analyses were facilitated by DNASTAR and CLUSTAL V. Irrespective of risk behavior, all but two of the 88 study participants from Hawaii and Guam were infected with HIV subtype B. The nonclade B cases were identified in two residents of Hawaii: a serviceman infected with subtype E presumably through commercial sex in Thailand, and an immigrant from east Africa infected with subtype D. Marked similarities exist in the descriptive epidemiology of HIV infection in Hawaii and Guam. Initial introduction of HIV to both islands is presumed to have occurred via infected homosexual men from the continental United States, and homosexual transmission of HIV still accounts for most new infections in Hawaii and Guam. Thus, the demonstration of subtype B as the only or predominant HIV clade in these islands is not unexpected. That said, in keeping with national trends, increasing numbers of AIDS cases (and of incident HIV infections) are occurring among women, particularly those belonging to ethnic minority groups, in Hawaii and on Guam. Continued collaboration with Mr. Dennis Rodriguez, Ms. Bernie Provido and Ms. Josie T. O’Mallan of the Department of Public Health and Social Services will further clarify trends of HIV infection and AIDS among Pacific Islanders on Guam.

Nerurkar, V.R., Dashwood, W.-M., Heath-Chiozzi, M.E., and Yanagihara, R.: Molecular epidemiology of HIV-1 infection in Hawaii. AIDS Research and Human Retroviruses 1995;11 (Suppl. 1):S146.

Nerurkar, V.R., Hoffman, P., Provido, B., Bulacan, A., Dashwood, W-M., Woodward, C.L., and Yanagihara, R.: Molecular epidemiology of HIV-1 infection in Hawaii and Guam. AIDS Research and Human Retroviruses (in preparation).