Derivation of an HIV Risk Score for African Women Who Engage in Sex Work.
Alexandra C WillcoxBarbra A RichardsonJuma ShafiEmmanuel KabareJohn KinuthiaWalter JaokoKishorchandra MandaliyaJulie OverbaughR Scott McClellandPublished in: AIDS and behavior (2021)
No tool exists to stratify HIV risk in contemporary African female sex worker (FSW) populations. Data from a cohort of HIV-negative FSWs in Mombasa, Kenya from 2010 to 2017 were used to conduct a survival analysis assessing predictors of HIV infection. Stepwise regression was used to construct a multivariable model that formed the basis for the score. Seventeen HIV infections occurred over 1247 person-years of follow-up contributed by 670 women. Using depot medroxyprogesterone acetate (DMPA), having a curable sexually transmitted infection (STI), and being married contributed points to the score. HIV incidence was 0.85/100 person-years in a lower-risk group and 3.10/100 person-years in a higher-risk group. In a cohort with overall HIV incidence < 1.50/100 person-years, this risk score identified a subgroup of FSWs with HIV incidence > 3.00/100 person-years, which is the threshold used by the World Health Organization for initiating pre-exposure prophylaxis (PrEP). If validated in an external population, this tool could be useful for targeted PrEP promotion among higher-risk FSWs.
Keyphrases
- antiretroviral therapy
- hiv positive
- hiv testing
- men who have sex with men
- hiv infected
- human immunodeficiency virus
- hiv aids
- hepatitis c virus
- risk factors
- polycystic ovary syndrome
- south africa
- drug delivery
- metabolic syndrome
- pregnant women
- skeletal muscle
- cancer therapy
- insulin resistance
- deep learning
- double blind
- big data