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. 2018 Jul;22(Suppl 1):35-44.
doi: 10.1007/s10461-018-2141-2.

An Empiric Risk Score to Guide PrEP Targeting Among MSM in Coastal Kenya

Elizabeth Wahome  1 , Alexander N Thiong'o  2 , Grace Mwashigadi  3 , Oscar Chirro  2 , Khamisi Mohamed  2 , Evans Gichuru  2 , John Mwambi  2 , Matt A Price  4   5 , Susan M Graham  2   6 , Eduard J Sanders  2   7
Affiliations

An Empiric Risk Score to Guide PrEP Targeting Among MSM in Coastal Kenya

Elizabeth Wahome et al. AIDS Behav. 2018 Jul.

Abstract

Men who have sex with men (MSM), who have heterogeneous HIV-acquisition risks are not specifically targeted in Kenyan pre-exposure prophylaxis (PrEP) guidelines. We used data from an open cohort, which followed 753 initially HIV-negative MSM participants for more than 1378.5 person-years, to develop an empiric risk score for targeting PrEP delivery. Independent predictors of incident HIV-1 infection in this cohort were an age of 18-24 years, having only male sex partners, having receptive anal intercourse, having any unprotected sex, and having group sex. Poisson model coefficients were used to assign a numeric score to each statistically significant predictor. A risk score of ≥ 1 corresponded to an HIV-1 incidence of ≥ 2.2 [95% confidence interval (CI) 1.2-4.1] and identified 81.3% of the cohort participants as being at high risk for HIV-1 acquisition. The area under the receiver operating characteristic curve was 0.76 (95% CI 0.71-0.80). This empiric risk score may help Kenyan health care providers to assess HIV-1 acquisition risk and encourage PrEP uptake by high-risk MSM.

Keywords: HIV-1 acquisition; Kenya; MSM; PrEP; Risk score.

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Conflict of interest statement

Conflicts of Interest: The authors declare that their research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest.

This paper has not been submitted elsewhere. Preliminary results were presented at the Conference on Retroviruses and Opportunistic Infections (CROI) 2017 (#1601).

Figures

Figure 1.
Figure 1.
HIV-1 incidence (95% CI, sensitivity, specificity) and proportion of men with a risk score at or above each cutoff point, among 753 MSM in Kilifi, Kenya, 2005–2016.
See this image and copyright information in PMC

References

    1. Fonner VA, Dalglish SL, Kennedy CE, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS 2016;30:1973–1983. - PMC - PubMed
    1. WHO. WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP) http://www.who.int/hiv/pub/prep/policy-brief-prep-2015/en/. Accessed January 14, 2017.
    1. Ministry of Health, National AIDS & STI Control Programme. Guidelines on use of antiretroviral drugs for treating and preventing HIV infection in Kenya 2016. www.prepwatch.org/wp-content/uploads/2016/08/Guidelines-on-ARV-for-Treat.... Accessed July 6, 2017.
    1. National AIDS & STI Control Programme. http://www.nascop.or.ke/. Accessed July 6, 2017.
    1. NASCOP. Framework for the implementation of pre-exposure prophylaxis of HIV in Kenya http://www.prepwatch.org/wp-content/uploads/2017/05/Kenya_PrEP_Implement.... Accessed July 6, 2017.