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 - 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 -