An Empiric Risk Scoring Tool for Identifying High-Risk Heterosexual HIV-1 Serodiscordant Couples for Targeting HIV-1 Prevention

March 2013 - Epidemiology

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Kahle, E.M., J.P. Hughes, J.R. Lingappa, et al. Journal of Acquired Immune Deficiency Syndromes (March 2013), Vol. 62 No. 3, pp. 339-347.

Using data from three prospective studies on heterosexual HIV serodiscordant couples in seven African countries, the authors developed and validated a quantitative risk scoring tool to determine couples at highest HIV risk. The analysis found that a separate set of factors, applied together and quantified, can identify serodiscordant couples at high risk of HIV transmission. Scores greater or equal to 5, of a maximum score of 12, were related to annual HIV incidence of more than 3 percent; e.g., a score ≥ 6 identified 67 percent of the observed HIV seroconversions among only 28 percent of the study population. The risk score model included the following factors: plasma HIV-1 RNA concentrations, unprotected sex, young age, marital status, no or few children in the partnership, and uncircumcised status of uninfected men; the combination of risk factors allows for more predictive capability. The risk scoring tool can be applied to clinical and research studies and to inform implementation of HIV prevention strategies to target those at highest risk and maximize cost-effectiveness. The authors concluded that a simple risk scoring tool could be an effective approach to identifying HIV serodiscordant couples at highest risk of HIV.

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