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https://www.arca.fiocruz.br/handle/icict/35491
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ArticleCopyright
Open access
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2020-09-11
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- INI - Artigos de Periódicos [3467]
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DEVELOPMENT AND VALIDATION OF THE PERSONALIZED SEXUAL HEALTH PROMOTION (SEXPRO) HIV RISK PREDICTION MODEL FOR MEN WHO HAVE SEX WITH MEN IN THE UNITED STATES
Author
Scott, Hyman
Vittinghoff, Eric
Irvin, Risha
Liu, Albert
Nelson, LaRon
Rio, Carlos del
Magnus, Manya
Mannheimer, Sharon
Fields, Sheldon
Tieu, Hong van
Kuo, Irene
Shoptaw, Steve
Grinsztejn, Beatriz
Sanchez, Jorge
Wakefield, Steven
Fuchs, Jonathan D.
Wheeler, Darrell
Mayer, Kenneth H.
Koblin, Beryl A.
Buchbinder, Susan
Vittinghoff, Eric
Irvin, Risha
Liu, Albert
Nelson, LaRon
Rio, Carlos del
Magnus, Manya
Mannheimer, Sharon
Fields, Sheldon
Tieu, Hong van
Kuo, Irene
Shoptaw, Steve
Grinsztejn, Beatriz
Sanchez, Jorge
Wakefield, Steven
Fuchs, Jonathan D.
Wheeler, Darrell
Mayer, Kenneth H.
Koblin, Beryl A.
Buchbinder, Susan
Affilliation
San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.
University of California. San Francisco, CA, USA.
Johns Hopkins School of Medicine. Baltimore, MD, USA.
San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.
Yale School of Nursing. New Haven, CT, USA.
Emory University. Atlanta, GA, USA.
George Washington University. Washington, DC, USA.
Columbia University. New York, NY, USA.
New York Institute of Technology. Old Westbury, NY, USA.
New York Blood Center. New York, NY, USA.
George Washington University. Washington, DC, USA.
University of California, Los Angeles, CA, USA
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Asociacion Civil Impacta Salud y Educacion. Lima, Peru.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA.
San Francisco Department of Public Health. Center for Learning Innovation. San Francisco, CA, USA.
University at Albany. Albany, NY, USA.
Fenway Health. Boston, MA, USA.
New York Blood Center. New York, NY, USA.
San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.
University of California. San Francisco, CA, USA.
Johns Hopkins School of Medicine. Baltimore, MD, USA.
San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.
Yale School of Nursing. New Haven, CT, USA.
Emory University. Atlanta, GA, USA.
George Washington University. Washington, DC, USA.
Columbia University. New York, NY, USA.
New York Institute of Technology. Old Westbury, NY, USA.
New York Blood Center. New York, NY, USA.
George Washington University. Washington, DC, USA.
University of California, Los Angeles, CA, USA
Fundação Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Asociacion Civil Impacta Salud y Educacion. Lima, Peru.
Fred Hutchinson Cancer Research Center. Seattle, WA, USA.
San Francisco Department of Public Health. Center for Learning Innovation. San Francisco, CA, USA.
University at Albany. Albany, NY, USA.
Fenway Health. Boston, MA, USA.
New York Blood Center. New York, NY, USA.
San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.
Abstract
Accurate HIV risk assessment among men who have sex with men (MSM) is important to help providers assess risk, and target HIV prevention interventions. We sought to develop an evidence-based HIV risk assessment tool for US MSM that is inclusive of Black MSM. Data from four large longitudinal cohorts of MSM were used to develop (EXPLORE), and validate (VAX004, HPTN061, and HVTN505). These data included visits in which participants self-reported HIV risk behavior and underwent HIV testing. We developed a pooled logistic model for incident HIV infection based on self-reported risk behaviors during the 6 months before each study visit. A total of 4069 MSM were used for the development cohort, and 8047 MSM in the three validation cohorts through 2013. The final model includes age (< 35, ≥ 35); Black race and Latino ethnicity; numbers of HIV-negative anal sex partners; number of insertive or receptive anal intercourse episodes; having 1 HIV-negative partner only; self-reported substance use; and bacterial sexually transmitted infection diagnosis. The model showed good discrimination in internal validation (C-statistic = 79.5). The external validation cohorts also showed good discrimination, with C-statistics of 73.1, 71.0, 71.9 in VAX004, HPTN061, and HVTN505 respectively, and acceptable calibration. We developed and validated an HIV risk assessment tool for MSM, which showed good predictive ability, including among the largest cohort of HIV-uninfected Black MSM in the US. This tool is available online (mysexpro.org) and can be used by providers to support targeting of HIV prevention interventions such as pre-exposure prophylaxis for MSM.
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