| Title: |
A Risk Assessment Tool for Identifying Pregnant and Postpartum Women Who May Benefit From Preexposure Prophylaxis. |
| Authors: |
Pintye, J; Drake, AL; Kinuthia, J; Unger, JA; Matemo, D; Heffron, RA; Barnabas, RV; Kohler, P; McClelland, RS; John-Stewart, G |
| Publisher Information: |
University of Nairobi |
| Publication Year: |
2017 |
| Subject Terms: |
HIV; PrEP; postpartum; preexposure prophylaxis; pregnancy; risk score; demo; psy |
| Description: |
Background: A human immunodeficiency virus (HIV) risk assessment tool for pregnant women could identify women who would most benefit from preexposure prophylaxis (PrEP) while minimizing unnecessary PrEP exposure. Methods: Data from a prospective study of incident HIV among pregnant/postpartum women in Kenya were randomly divided into derivation (n = 654) and validation (n = 650) cohorts. A risk score was derived using multivariate Cox proportional hazards models and standard clinical prediction rules. Ability of the tool to predict maternal HIV acquisition was assessed using the area under the curve (AUC) and Brier score. Results: The final risk score included the following predictors: having a male partner with unknown HIV status, number of lifetime sexual partners, syphilis, bacterial vaginosis (BV), and vaginal candidiasis. In the derivation cohort, AUC was 0.84 (95% confidence interval [CI], .72-.95) and each point increment in score was associated with a 52% (hazard ratio [HR], 1.52 [95% CI, 1.32-1.76]; P 6 than with scores ≤6 (7.3 vs 1.1 per 100 person-years, respectively; P 6 accounted for 16% of the population but 56% of HIV acquisitions. Conclusions: A combination of indicators routinely assessed in antenatal clinics was predictive of HIV risk and could be used to prioritize pregnant women for PrEP. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://hdl.handle.net/11295/100948 |
| Availability: |
http://hdl.handle.net/11295/100948 |
| Rights: |
undefined |
| Accession Number: |
edsbas.1D832FEA |
| Database: |
BASE |