TY - JOUR
T1 - Use of a risk scoring tool to identify higher-risk HIV-1 serodiscordant couples for an antiretroviral-based HIV-1 prevention intervention
AU - for the Partners Demonstration Project Team
AU - Irungu, Elizabeth M.
AU - Heffron, Renee
AU - Mugo, Nelly
AU - Ngure, Kenneth
AU - Katabira, Elly
AU - Bulya, Nulu
AU - Bukusi, Elizabeth
AU - Odoyo, Josephine
AU - Asiimwe, Stephen
AU - Tindimwebwa, Edna
AU - Celum, Connie
AU - Baeten, Jared M.
AU - Donnell, Deborah
AU - Barnabas, Ruanne
AU - Haberer, Jessica
AU - Haugen, Harald
AU - Hendrix, Craig
AU - Kidoguchi, Lara
AU - Marzinke, Mark
AU - Morrison, Susan
AU - Morton, Jennifer
AU - Ware, Norma
AU - Wyatt, Monique
N1 - Funding Information:
This work was supported by NIH Research Training Grant # R25 TW009345 funded by the Fogarty International Center, the NIH Office of the Director Office of AIDS Research, the NIH Office of the Director Office of Research on Women’s Health, the National Heart, Lung and Blood Institute, the National Institute of Mental Health and the National Institute of General Medical Sciences. The Partners Demonstration Project is funded by the Bill & Melinda Gates Foundation (OPP1056051), the National Institute of Mental Health of the US National Institutes of Health (R01 MH095507) and the United States Agency for International Development (AID-OAA-A-12–00023). This work is made possible by the generous support of the American people through USAID; the contents are the responsibility of the authors and do not necessarily reflect the views of USAID, NIH, or the United States Government.
Publisher Copyright:
© 2016 The Author(s).
PY - 2016/10/17
Y1 - 2016/10/17
N2 - Background: Antiretroviral 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. Methods: The 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. Results: We 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. Conclusion: A 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.
AB - Background: Antiretroviral 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. Methods: The 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. Results: We 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. Conclusion: A 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.
KW - Africa
KW - Delivery
KW - HIV
KW - PrEP
KW - Screening tool
KW - Serodiscordant couples
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UR - http://www.scopus.com/inward/citedby.url?scp=85001060894&partnerID=8YFLogxK
U2 - 10.1186/s12879-016-1899-y
DO - 10.1186/s12879-016-1899-y
M3 - Article
C2 - 27751179
AN - SCOPUS:85001060894
SN - 1471-2334
VL - 16
JO - BMC infectious diseases
JF - BMC infectious diseases
IS - 1
M1 - 571
ER -