Smith et al developed a screening index for determining the risk for acquiring HIV in a male in the United States who engages in sex with men. The authors are from the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at CDC.
Patient selection: HIV-negative male in the United States who engages in sex with men
Parameters:
(1) current age in years
(2) number of male partners in past 6 months
(3) number of partners in the past 6 months who are HIV positive
(4) number of times in the past 6 months the receptive partner in anal intercourse AND partner did not use a condom
(5) number of times in past 6 months the inserting partner in anal intercourse AND partner HIV positive AND patient did not wear a condom
(6) methamphetamine use in past 6 months
|
Parameter |
Finding |
Points |
|
age in years |
< 18 years |
0 |
|
|
18 to 28 years |
8 |
|
|
29 to 40 years |
5 |
|
|
41 to 48 years |
2 |
|
|
>= 49 years |
0 |
|
number of male partners |
<= 5 |
0 |
|
|
6 to 10 |
4 |
|
|
>= 11 |
7 |
|
number of male partners HIV positive |
none |
0 |
|
|
1 |
4 |
|
|
>= 2 |
8 |
|
number of times receptive in anal intercourse without a condom |
0 |
0 |
|
|
>= 1 |
10 |
|
number of times insertive in anal intercourse without a condom and partner HIV+ |
0 |
0 |
|
|
>= 5 |
6 |
|
methamphetamine use in past 6 months |
no |
0 |
|
|
yes |
6 |
where:
• The maximum total score in the original paper was 47. In the CDC publication the maximum score was 45. Scoring 2 points for being insertive 1 to 4 times would explain the difference.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 45 or 47
• A score >= 10 indicates the need for intensive preventive measures incluing pre-exposure prophylaxis.
• A score < 10 indicates that standard HIV preventive measures are appropriate.
Specialty: Infectious Diseases
ICD-10: ,
