Hoenigl et al reported the San Diego Early Test score to identify a male who has sex with men with increased risk for acute and early HIV infection. This can help to target a person at increased risk who may benefit from an intervention. The authors are from the University of California at San Diego, the Medical University at Graz and the Veterans Affairs Healthcare System in San Diego.
Patient selection: men who have sex with men
Outcome: acute and early HIV infection
Parameters:
(1) number of male partners
(2) condomless receptive anal intercourse (CRAI)
(3) HIV-infected partner
(4) bacterial sexually-transmitted infection (STI; syphilis, gonorrhea, chlamydia)
|
Parameter
|
Finding
|
Points
|
|
number of male partners
|
0 to 9
|
0
|
|
|
>= 10
|
2
|
|
CRAI and number of male partners
|
no CRAI
|
0
|
|
|
CRAI and number 0 to 4
|
0
|
|
|
CRAI and number >= 5
|
3
|
|
CRAI and HIV infected partner
|
no CRAI
|
0
|
|
|
no HIV infected partners
|
0
|
|
|
CRAI and HIV infected partner
|
3
|
|
bacterial STI
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk for acute and early HIV infection.
• A score >=3 had a diagnostic odds ratio of 4,
• A score >= 5 had a diagnostic odds ratio of 5.
|
Score
|
Prevalence of Incident Infection in Derivation Cohort
|
|
0, 1 or 2
|
1.1%
|
|
3 or 4
|
2.9%
|
|
5
|
4%
|
|
6 or 7
|
6.7%
|
|
8, 9 or 10
|
12.5%
|
Performance:
• The area under the ROC curve ranged from 0.70 to 0.74 in various groups.
