Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 8;11(3):ofae011.
doi: 10.1093/ofid/ofae011. eCollection 2024 Mar.

Identifying Individuals at High Risk for HIV and Sexually Transmitted Infections With an Artificial Intelligence-Based Risk Assessment Tool

Phyu M Latt  1   2 , Nyi N Soe  1   2 , Xianglong Xu  1   3 , Jason J Ong  2   4 , Eric P F Chow  2   4   5 , Christopher K Fairley  2   4 , Lei Zhang  1   2   6
Affiliations

Identifying Individuals at High Risk for HIV and Sexually Transmitted Infections With an Artificial Intelligence-Based Risk Assessment Tool

Phyu M Latt et al. Open Forum Infect Dis. .

Abstract

Background: We have previously developed an artificial intelligence-based risk assessment tool to identify the individual risk of HIV and sexually transmitted infections (STIs) in a sexual health clinical setting. Based on this tool, this study aims to determine the optimal risk score thresholds to identify individuals at high risk for HIV/STIs.

Methods: Using 2008-2022 data from 216 252 HIV, 227 995 syphilis, 262 599 gonorrhea, and 320 355 chlamydia consultations at a sexual health center, we applied MySTIRisk machine learning models to estimate infection risk scores. Optimal cutoffs for determining high-risk individuals were determined using Youden's index.

Results: The HIV risk score cutoff for high risk was 0.56, with 86.0% sensitivity (95% CI, 82.9%-88.7%) and 65.6% specificity (95% CI, 65.4%-65.8%). Thirty-five percent of participants were classified as high risk, which accounted for 86% of HIV cases. The corresponding cutoffs were 0.49 for syphilis (sensitivity, 77.6%; 95% CI, 76.2%-78.9%; specificity, 78.1%; 95% CI, 77.9%-78.3%), 0.52 for gonorrhea (sensitivity, 78.3%; 95% CI, 77.6%-78.9%; specificity, 71.9%; 95% CI, 71.7%-72.0%), and 0.47 for chlamydia (sensitivity, 68.8%; 95% CI, 68.3%-69.4%; specificity, 63.7%; 95% CI, 63.5%-63.8%). High-risk groups identified using these thresholds accounted for 78% of syphilis, 78% of gonorrhea, and 69% of chlamydia cases. The odds of positivity were significantly higher in the high-risk group than otherwise across all infections: 11.4 (95% CI, 9.3-14.8) times for HIV, 12.3 (95% CI, 11.4-13.3) for syphilis, 9.2 (95% CI, 8.8-9.6) for gonorrhea, and 3.9 (95% CI, 3.8-4.0) for chlamydia.

Conclusions: Risk scores generated by the AI-based risk assessment tool MySTIRisk, together with Youden's index, are effective in determining high-risk subgroups for HIV/STIs. The thresholds can aid targeted HIV/STI screening and prevention.

Keywords: HIV; STIs; machine learning; risk assessment tool; sexually transmitted infections.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. All authors: no reported conflicts.

Figures

Figure 1.
Figure 1.
Sensitivity, specificity, and Youden's index with optimal cut-off points for HIV/STIs
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization . Sexually transmitted infections (STIs) fact sheets. 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-in.... Accessed 20 August 2023.
    1. Pande G, Bulage L, Kabwama S, et al. Preference and uptake of different community-based HIV testing service delivery models among female sex workers along Malaba-Kampala highway, Uganda, 2017. BMC Health Serv Res 2019; 19:799. - PMC - PubMed
    1. Fairley CK, Chow EP, Hocking JS. Early presentation of symptomatic individuals is critical in controlling sexually transmissible infections. Sex Health 2015; 12:181–2. - PubMed
    1. Power M, Dong K, Walsh J, Lewis DA, Richardson D. Barriers to HIV testing in hospital settings within a culturally diverse urban district of Sydney, Australia. Sex Health 2021; 18:340–3. - PubMed
    1. Blondell SJ, Debattista J, Griffin MP, Durham J. ‘I think they might just go to the doctor’: qualitatively examining the (un)acceptability of newer HIV testing approaches among Vietnamese-born migrants in greater-Brisbane, Queensland, Australia. Sex Health 2021; 18:50–7. - PubMed