Document Detail


An empiric risk scoring tool for identifying high-risk heterosexual HIV-1-serodiscordant couples for targeted HIV-1 prevention.
MedLine Citation:
PMID:  23187945     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Heterosexual HIV-1-serodiscordant couples are increasingly recognized as an important source of new HIV-1 infections in sub-Saharan Africa. A simple risk assessment tool could be useful for identifying couples at highest risk for HIV-1 transmission.
METHODS: Using data from 3 prospective studies of HIV-1-serodiscordant couples from 7 African countries and standard methods for development of clinical prediction rules, the authors derived and validated a risk scoring tool developed from multivariate modeling and composed of key predictors for HIV-1 risk that could be measured in standard research and clinical settings.
RESULTS: The final risk score included age of the HIV-1-uninfected partner, married and/or cohabiting partnership, number of children, unprotected sex, uncircumcised male HIV-1-uninfected partner, and plasma HIV-1 RNA in the HIV-1-infected partner. The maximum risk score was 12, scores ≥5 were associated with an annual HIV-1 incidence of >3%, and couples with a score ≥6 accounted for only 28% of the population but 67% of HIV-1 transmissions. The area under the curve for predictive ability of the score was 0.74 (95% confidence interval: 0.70 to 0.78). Internal and external validation showed similar predictive ability of the risk score, even when plasma viral load was excluded from the risk score.
CONCLUSIONS: A discrete combination of clinical and behavioral characteristics defines highest risk HIV-1-serodiscordant couples. Discriminating highest risk couples for HIV-1 prevention programs and clinical trials using a validated risk score could improve research efficiency and maximize the impact of prevention strategies for reducing HIV-1 transmission.
Authors:
Erin M Kahle; James P Hughes; Jairam R Lingappa; Grace John-Stewart; Connie Celum; Edith Nakku-Joloba; Stella Njuguna; Nelly Mugo; Elizabeth Bukusi; Rachel Manongi; Jared M Baeten;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-08-08     Completed Date:  2013-08-20     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-47     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Empirical Research
Female
HIV Infections / prevention & control*
HIV Seropositivity / diagnosis*
HIV Serosorting
HIV-1*
Heterosexuality*
Humans
Male
Predictive Value of Tests
Risk Assessment / methods*
Risk Factors
Sexual Partners
Grant Support
ID/Acronym/Agency:
R01 MH095507/MH/NIMH NIH HHS; R01-MH095507/MH/NIMH NIH HHS
Investigator
Investigator/Affiliation:
Connie Celum / ; Anna Wald / ; Jairam Lingappa / ; Jared M Baeten / ; Mary Campbell / ; Lawrence Corey / ; Robert W Coombs / ; James P Hughes / ; Amalia Magaret / ; M Juliana McElrath / ; Rhoda Morrow / ; James I Mullins / ; David Coetzee / ; Kenneth Fife / ; Edwin Were / ; Gaborone Botswana / ; Max Essex / ; Joseph Makhema / ; Elly Katabira / ; Allan Ronald / ; Susan Allen / ; Kayitesi Kayitenkore / ; Etienne Karita / ; Elizabeth Bukusi / ; Craig Cohen / ; Susan Allen / ; William Kanweka / ; Susan Allen / ; Bellington Vwalika / ; Saidi Kapiga / ; Rachel Manongi / ; Carey Farquhar / ; Grace John-Stewart / ; James Kiarie / ; Susan Allen / ; Mubiana Inambao / ; Sinead Delany-Moretlwe / ; Helen Rees / ; Guy de Bruyn / ; Glenda Gray / ; James McIntyre / ; Nelly Rwamba Mugo / ; Connie Celum / ; Jared M Baeten / ; Deborah Donnell / ; Robert W Coombs / ; Jairam R Lingappa / ; M Juliana McElrath / ; Kenneth H Fife / ; Edwin Were / ; Elioda Tumwesigye / ; Patrick Ndase / ; Elly Katabira / ; Elly Katabira / ; Allan Ronald / ; Elizabeth Bukusi / ; Craig R Cohen / ; Jonathan Wangisi / ; James D Campbell / ; Jordan W Tappero / ; James Kiarie / ; Carey Farquhar / ; Grace John-Stewart / ; Nelly R Mugo / ; James D Campbell / ; Jordan W Tappero / ; Jonathan Wangisi /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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