Use of a risk scoring tool to identify higher-risk HIV-1 serodiscordant couples for an antiretroviral-based HIV-1 prevention intervention

BMC Infectious Diseases

Research Article

Josephine Odoyo¹  Elizabeth M. Irungu²  Kenneth Ngure³  Nelly Mugo⁴  Renee Heffron⁵  Connie Celum⁶  Jared M. Baeten⁶  Elizabeth Bukusi⁷  Elly Katabira⁸  Nulu Bulya⁹  Stephen Asiimwe^1,10  Edna Tindimwebwa^1,10 

[1] Center for Microbiology Research, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya;College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, P. O. Box 62000-00200, Nairobi, Kenya;College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, P. O. Box 62000-00200, Nairobi, Kenya;Department of Global Health, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Global Health, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Centre for Clinical Research, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya;Department of Global Health, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Epidemiology, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Global Health, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Epidemiology, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Medicine, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Global Health, University of Washington, 325 Ninth Avenue, 98104, Seattle, WA, USA;Department of Obstetrics & Gynaecology, University of Nairobi, Uhuru Highway, 00100, Nairobi, Kenya;Center for Microbiology Research, Kenya Medical Research Institute, Mbagathi Road, Nairobi, Kenya;Department of Medicine, Makerere University, PO Box 7072, Kampala, Uganda;Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda;Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda;Kabwohe Clinical Research Centre, Off Kabwohe-Ishaka HWY next to ICOBI, Box 347, Kabwohe-Itendero Town Council, Bushenyi District Kabwohe, Uganda;

关键词: HIV;    Serodiscordant couples;    Screening tool;    PrEP;    Delivery;    Africa;   

DOI  :  10.1186/s12879-016-1899-y

 received in 2016-01-26, accepted in 2016-10-05,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAntiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) reduce HIV-1 transmission within heterosexual HIV-1 serodiscordant couples. Prioritizing couples at highest HIV-1 transmission risk for ART and PrEP would maximize impact and minimize costs.MethodsThe Partners Demonstration Project is an open-label, delivery study of integrated PrEP and ART for HIV-1 prevention among high risk HIV-1 serodiscordant couples in Kenya and Uganda. We evaluated the feasibility of using a validated risk score that weighs a combination of easily measurable factors (age, children, marital status, male circumcision status, condom use, plasma HIV-1 levels) to identify couples at highest risk for HIV-1 transmission for enrollment. Couples scoring ≥5 met the risk score eligibility criteria.ResultsWe screened 1694 HIV-1 serodiscordant couples and enrolled 1013. Of the screened couples, 1331 (78.6 %) scored ≥5 (with an expected incidence >3 % per year) and 76 % of these entered the study. The median age of the HIV-1 uninfected partner was 29 years [IQR 26, 36] and 20 % were <25 years of age. The HIV-1 uninfected partner was male in 67 % of partnerships, 33 % of whom were uncircumcised, 57 % of couples had no children, and 65 % reported unprotected sex in the month prior to enrollment. Among HIV-1 infected partners, 41 % had plasma viral load >50,000 copies/ml.ConclusionA risk scoring tool identified HIV-1 serodiscordant couples for a demonstration project of PrEP and ART with high HIV-1 risk. The tool may be feasible for research and public health settings to maximize efficiency and minimize HIV-1 prevention costs.

【 授权许可】

CC BY   
© The Author(s). 2016