Patient selection: HIV-negative man who has sex with men
Outcome: HIV acquisition over the next 4 years
Parameters:
(1) history of STD (gonorrhea, chlamydia, syphilis)
(2) use of methamphetamines or inhaled nitrates (poppers) in the past 6 months
(3) unprotected anal intercourse during the past year with a partner positive for HIV or of unknown HIV status (known not HIV negative; sex of partner presumed male; receptive status not given)
(4) number of male sexual partners in the past year
|
Parameter
|
Finding
|
Points
|
|
history of STD
|
no
|
0
|
|
|
yes
|
4
|
|
methamphetamine or inhaled nitrate use
|
no
|
0
|
|
|
yes
|
11
|
|
unprotected anal intercourse
|
no
|
0
|
|
|
yes
|
1
|
|
number of male sexual partners
|
< 10
|
0
|
|
|
>= 10
|
3
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
• The higher the score the greater the risk of acquiring HIV over the next 4 years.
• Drug use is associated with the highest risk.
|
Score
|
Risk of HIV
|
|
0
|
< 5%
|
|
1 to 3
|
5 to 9%
|
|
4 to 11
|
10 to 14%
|
|
12 to 19
|
> 14%
|
Performance:
• The area under the ROC curve was 0.66 at 4 years.
