Development and validation of the San Diego Early Test Score to predict acute and early HIV infection risk in men who have sex with men.

dc.contributor.author

Hoenigl, Martin

dc.contributor.author

Weibel, Nadir

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Mehta, Sanjay R

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Anderson, Christy M

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Jenks, Jeffrey

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Green, Nella

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Gianella, Sara

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Smith, Davey M

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Little, Susan J

dc.date.accessioned

2023-08-01T18:02:45Z

dc.date.available

2023-08-01T18:02:45Z

dc.date.issued

2015-08

dc.date.updated

2023-08-01T18:02:44Z

dc.description.abstract

Background

Although men who have sex with men (MSM) represent a dominant risk group for human immunodeficiency virus (HIV), the risk of HIV infection within this population is not uniform. The objective of this study was to develop and validate a score to estimate incident HIV infection risk.

Methods

Adult MSM who were tested for acute and early HIV (AEH) between 2008 and 2014 were retrospectively randomized 2:1 to a derivation and validation dataset, respectively. Using the derivation dataset, each predictor associated with an AEH outcome in the multivariate prediction model was assigned a point value that corresponded to its odds ratio. The score was validated on the validation dataset using C-statistics.

Results

Data collected at a single HIV testing encounter from 8326 unique MSM were analyzed, including 200 with AEH (2.4%). Four risk behavior variables were significantly associated with an AEH diagnosis (ie, incident infection) in multivariable analysis and were used to derive the San Diego Early Test (SDET) score: condomless receptive anal intercourse (CRAI) with an HIV-positive MSM (3 points), the combination of CRAI plus ≥5 male partners (3 points), ≥10 male partners (2 points), and diagnosis of bacterial sexually transmitted infection (2 points)-all as reported for the prior 12 months. The C-statistic for this risk score was >0.7 in both data sets.

Conclusions

The SDET risk score may help to prioritize resources and target interventions, such as preexposure prophylaxis, to MSM at greatest risk of acquiring HIV infection. The SDET risk score is deployed as a freely available tool at http://sdet.ucsd.edu.
dc.identifier

civ335

dc.identifier.issn

1058-4838

dc.identifier.issn

1537-6591

dc.identifier.uri

https://hdl.handle.net/10161/28637

dc.language

eng

dc.publisher

Oxford University Press (OUP)

dc.relation.ispartof

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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10.1093/cid/civ335

dc.subject

Humans

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HIV Infections

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Risk Assessment

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Retrospective Studies

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Random Allocation

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Reproducibility of Results

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Homosexuality, Male

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Adult

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Male

dc.title

Development and validation of the San Diego Early Test Score to predict acute and early HIV infection risk in men who have sex with men.

dc.type

Journal article

duke.contributor.orcid

Jenks, Jeffrey|0000-0001-6632-9587

pubs.begin-page

468

pubs.end-page

475

pubs.issue

3

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Medicine

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Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

61

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