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dc.contributor.authorKahle, Erin M.
dc.contributor.authorHughes, James P.
dc.contributor.authorLingappa, Jairam R.
dc.contributor.authorJohn-Stewart, Grace
dc.contributor.authorCelum, Connie
dc.contributor.authorNakku-Joloba, Edith
dc.contributor.authorNjuguna, Stella
dc.contributor.authorMugo, Nelly
dc.contributor.authorBukusi, Elizabeth
dc.contributor.authorManongi, Rachel
dc.contributor.authorBaeten, Jared M.
dc.date.accessioned2002-03-23T21:43:34Z
dc.date.available2002-03-23T21:43:34Z
dc.date.issued2013
dc.identifier.citationKahle, E et al (2013). An Empiric Risk Scoring Tool for Identifying High-Risk Heterosexual HIV-1–Serodiscordant Couples for Targeted HIV-1 Prevention. J Acquir Immune Defic Syndr, 62: 339–347.en_US
dc.identifier.urihttp://hdl.handle.net/10570/2028
dc.description.abstractBackground 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.en_US
dc.description.sponsorshipBill and Melinda Gates Foundationen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.subjectHIV-1–serodiscordant couplesen_US
dc.subjectHIV-1 acquisitionen_US
dc.subjectClinical prediction ruleen_US
dc.titleAn Empiric Risk Scoring Tool for Identifying High-Risk Heterosexual HIV-1–Serodiscordant Couples for Targeted HIV-1 Preventionen_US
dc.typeJournal article, peer revieweden_US


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