Identifying Adolescent Girls and Young Women at High Risk for HIV Acquisition: A Risk Assessment Tool From the Girl Power-Malawi Study

被引:9
|
作者
Rosenberg, Nora E. [1 ,2 ]
Kudowa, Evaristar [1 ]
Price, Joan T. [3 ]
Pettifor, Audrey [4 ]
Bekker, Linda-Gail [5 ]
Hosseinipour, Mina C. [1 ,6 ]
Chagomerana, Maganizo [1 ,6 ]
机构
[1] Univ North Carolina Project, Lilongwe, Malawi
[2] Univ N Carolina, Dept Hlth Behav, Chapel Hill, NC 27515 USA
[3] Univ N Carolina, Sch Med, Dept Obstet, Gynecol, Chapel Hill, NC 27515 USA
[4] Univ N Carolina, Sch Med, Dept Epidemiol, Chapel Hill, NC 27515 USA
[5] Univ Cape Town, Desmond Tutu HIV Fdn, Cape Town, South Africa
[6] Univ N Carolina, Sch Med, Dept Med, Chapel Hill, NC 27515 USA
基金
美国国家卫生研究院;
关键词
SCORING TOOL; INFECTION; VALIDATION; AIDS;
D O I
10.1097/OLQ.0000000000001242
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background Prioritizing HIV prevention for adolescent girls and young women (AGYW) at high risk for HIV acquisition in sub-Saharan Africa (typically considered >= 3 per 100 person-years [PYs]) is urgently needed, but identifying these AGYW is challenging. We sought to assess and, if needed, enhance a risk assessment tool from the VOICE trial for identifying AGYW at high risk for HIV in Lilongwe, Malawi. Methods A multisite prospective cohort study was conducted among sexually active AGYW 15 to 24 years old at 4 health centers in 2016 to 2017. The VOICE tool was first applied and then updated by excluding variables that were not predictive and adding variables that were. Incidence rates (IRs), incidence rate ratios, 95% confidence intervals (CIs), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated. Results Seven hundred ninety-five participants experienced 14 seroconversions for 672 PYs (IR, 2.08 per 100 PYs; 95% CI, 1.23-3.52). The VOICE tool had moderate predictive ability (AUC, 0.64; 95% CI, 0.52-0.75). Maintaining 2 variables (genital ulcers and vaginal discharge), removing 5 sociodemographic variables, and adding 2 variables (ever pregnant and >5-year male-female age gap) enhanced performance (AUC, 0.79; 95% CI, 0.69-0.89). Thirty-five percent had a score of 0, 41% had a score of 1 to 2, and 24% had a score >3. A score >1 resulted in 100% sensitivity, 35.9% specificity, and an IR of 3.25 per 100 PYs. A score >3 resulted in 64.3% sensitivity, 76.8% specificity, and an IR of 5.89 per 100 PYs. Conclusions A simple risk assessment tool identified a subset of AGYW in Malawi at high risk for HIV acquisition who may benefit from biomedical HIV prevention.
引用
收藏
页码:760 / 766
页数:7
相关论文
共 50 条
  • [1] Intimate Partner Violence and Contraception among Adolescent Girls and Young Women: A Longitudinal Analysis of the Girl Power-Malawi Cohort
    Grundy, Sara J.
    Maman, Suzanne
    Graybill, Lauren
    Phanga, Twambilile
    Vansia, Dhrutika
    Nthani, Tiyamike
    Tang, Jennifer H.
    Bekker, Linda-Gail
    Pettifor, Audrey
    Rosenberg, Nora E.
    [J]. JOURNAL OF PEDIATRIC AND ADOLESCENT GYNECOLOGY, 2022, 35 (06) : 662 - 668
  • [2] Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi
    Price, Joan T.
    Rosenberg, Nora E.
    Vansia, Dhrutika
    Phanga, Twambilile
    Bhushan, Nivedita L.
    Maseko, Bertha
    Brar, Savvy K.
    Hosseinipour, Mina C.
    Tang, Jennifer H.
    Bekker, Linda-Gail
    Pettifor, Audrey
    [J]. JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2018, 77 (01) : 53 - 63
  • [3] Understanding HIV prevention from the perspective of adolescent girls and young women at high risk of HIV infection
    Malone, S.
    Gomez, A.
    Prasad, R.
    Gangaramany, A.
    Croucamp, Y.
    Kramer, P.
    Mulhausen, J.
    Noble-Campbell, P.
    [J]. JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, 2021, 24
  • [4] HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade
    Hill, Lauren M.
    Maseko, Bertha
    Chagomerana, Maganizo
    Hosseinipour, Mina C.
    Bekker, Linda-Gail
    Pettifor, Audrey
    Rosenberg, Nora E.
    [J]. JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, 2020, 23
  • [5] INTRA-VAGINAL PRACTICES AMONG ADOLESCENT GIRLS AND YOUNG WOMEN IN SOUTH AFRICA: RISK FOR HIV ACQUISITION
    Maje, Lorato
    Kaida, Angela
    Venners, Scott
    Bekinska, Mags
    Hornschuh, Stefanie
    Smith, Patricia
    Brockman, Mark
    Ndung'U, Thumbi
    Gray, Glenda
    Smit, Jenni
    Dietrich, Janan
    [J]. SEXUALLY TRANSMITTED INFECTIONS, 2019, 95 : A193 - A194
  • [6] How Does Relationship Power Influence HIV Risk Among Adolescent Girls and Young Women in Kenya?
    Pulerwitz, Julie
    Mathur, Sanyukta
    Woznica, Daniel
    [J]. AIDS RESEARCH AND HUMAN RETROVIRUSES, 2018, 34 : 102 - 102
  • [7] Role of Male Sex Partners in HIV Risk of Adolescent Girls and Young Women in Mozambique
    Chapman, Jenifer
    do Nascimento, Nena
    Mandal, Mahua
    [J]. GLOBAL HEALTH-SCIENCE AND PRACTICE, 2019, 7 (03): : 435 - 446
  • [8] Defining characteristics of genital health in South African adolescent girls and young women at high risk for HIV infection
    Dabee, Smritee
    Barnabas, Shaun L.
    Lennard, Katie S.
    Jaumdally, Shameem Z.
    Gamieldien, Hoyam
    Balle, Christina
    Happel, Anna-Ursula
    Murugan, Brandon D.
    Williamson, Anna-Lise
    Mkhize, Nonhlanhla
    Dietrich, Janan
    Lewis, David A.
    Chiodi, Francesca
    Hope, Thomas J.
    Shattock, Robin
    Gray, Glenda
    Bekker, Linda-Gail
    Jaspan, Heather B.
    Passmore, Jo-Ann S.
    [J]. PLOS ONE, 2019, 14 (04):
  • [9] POPULATION ESTIMATES OF HIV RISK FACTORS TO INFORM HIV PREVENTION PROGRAMMING FOR ADOLESCENT GIRLS AND YOUNG WOMEN
    Howard, Ashleigh L.
    Chiang, Laura
    Picchetti, Viani
    Zhu, Liping
    Hegle, Jennifer
    Patel, Pragna
    Saul, Janet
    Wasula, Lydia
    Nantume, Sophie
    Coomer, Rachel
    Kamuingona, Rahimisa
    Oluoch, Rose Patricia
    Mharadze, Tendayi
    Duffy, Meghan
    Kambona, Caroline A.
    Ramphalla, Puleng
    Fathim, Kamagate Maman
    Massetti, Greta M.
    [J]. AIDS EDUCATION AND PREVENTION, 2023, 35 : 20 - 38
  • [10] Intersections of financial agency, gender dynamics, and HIV risk: A qualitative study with adolescent girls and young women in Zambia
    Bermudez, Laura Gauer
    Mulenga, Drosin
    Musheke, Maurice
    Mathur, Sanyukta
    [J]. GLOBAL PUBLIC HEALTH, 2022, 17 (08) : 1638 - 1651