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Background: Men and women with a migration background comprise an increasingproportion of incident HIV cases across Western Europe. Several studiesindicate a substantial proportion acquire HIV post-migration.  Methods: We used partial HIV consensus sequences with linked demographic andclinical data from the opt-out ATHENA cohort of people with HIV in theNetherlands to quantify population-level sources of transmission to Dutch-bornand foreign-born Amsterdam men who have sex with men (MSM) between 2010-2021.We identified phylogenetically and epidemiologically possible transmissionpairs in local transmission chains and interpreted these in the context ofestimated infection dates, quantifying transmission dynamics betweensub-populations by world region of birth.  Results: We estimate the majority of Amsterdam MSM who acquired theirinfection locally had a Dutch-born Amsterdam MSM source (56% [53-58%]).Dutch-born MSM were the predominant source population of infections amongalmost all foreign-born Amsterdam MSM sub-populations. Stratifying by two-yearintervals indicated shifts in transmission dynamics, with a majority ofinfections originating from foreign-born MSM since 2018, although uncertaintyranges remained wide.  Conclusions: In the context of declining HIV incidence among Amsterdam MSM,our data suggest whilst native-born MSM have predominantly driven transmissionsin 2010-2021, the contribution from foreign-born MSM living in Amsterdam isincreasing.

Sources of HIV infections among MSM with a migration background: a viral phylogenetic case study in Amsterdam, the Netherlands