Risk Prediction Score for HIV Infection: Development and Internal Validation with Cross-Sectional Data from Men Who Have Sex with Men in China.
Receptive anal intercourse, multiple partners, condomless sex, sexually transmitted infections (STIs), and drug/alcohol addiction are familiar factors that correlate with increased human immunodeficiency virus (HIV) risk among men who have sex with men (MSM). To improve estimation to HIV acquisition, we created a composite score using questions from routine survey of 3588 MSM in Beijing, China. The HIV prevalence was 13.4%. A risk scoring tool using penalized maximum likelihood multivariable logistic regression modeling was developed, deploying backward step-down variable selection to obtain a reduced-form model. The full penalized model included 19 sexual predictors, while the reduced-form model had 12 predictors. Both models calibrated well; bootstrap-corrected c-indices were 0.70 (full model) and 0.71 (reduced-form model). Non-Beijing residence, short-term living in Beijing, illegal drug use, multiple male sexual partners, receptive anal sex, inconsistent condom use, alcohol consumption before sex, and syphilis infection were the strongest predictors of HIV infection. Discriminating higher-risk MSM for targeted HIV prevention programming using a validated risk score could improve the efficiency of resource deployment for educational and risk reduction programs. A valid risk score can also identify higher risk persons into prevention and vaccine clinical trials, which would improve trial cost-efficiency.
['Yin|Lu|L|', 'Zhao|Yuejuan|Y|', 'Peratikos|Meridith Blevins|MB|', 'Song|Liang|L|', 'Zhang|Xiangjun|X|', 'Xin|Ruolei|R|', 'Sun|Zheya|Z|', 'Xu|Yunan|Y|', 'Zhang|Li|L|', 'Hu|Yifei|Y|', 'Hao|Chun|C|', 'Ruan|Yuhua|Y|', 'Shao|Yiming|Y|', 'Vermund|Sten H|SH|', 'Qian|Han-Zhu|HZ|']
D000293:Adolescent D000328:Adult D000368:Aged D000428:Alcohol Drinking D002681:China D017280:Condoms D003430:Cross-Sectional Studies D015658:HIV Infections D018451:Homosexuality, Male D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D015995:Prevalence D018570:Risk Assessment D012307:Risk Factors D012309:Risk-Taking D021841:Safe Sex D012725:Sexual Behavior D012747:Sexual Partners D000072339:Sexual and Gender Minorities D011795:Surveys and Questionnaires D013587:Syphilis D047568:Unsafe Sex D055815:Young Adult
HIV China Men who have sex with men (MSM) Risk score HIV prevention