Development and Validation of an HIV Risk Assessment Tool for African Women

 描述：妇女占全球新增艾滋病毒感染人数的一半以上，其中非洲妇女的发病率最高。最近完成的几项妇女艾滋病毒生物医学预防试验报告了高发病率，尽管在试验期间提供了全面的艾滋病毒风险降低服务，但在一些研究地点，发病率高达10%。迫切需要加强我们对非洲妇女感染艾滋病毒的预测因素的了解，以便在风险最高的妇女分组中确定干预机会，并扩大有针对性的艾滋病毒预防活动。最近已经为几个人群制定了经验艾滋病毒风险评分，包括非洲艾滋病毒血清不一致的夫妇和在美国与男性发生性行为的男性。这些工具不仅有助于确定那些感染艾滋病毒风险最大的人，而且还被用来指导在这些人群中实施新的艾滋病毒预防活动。还没有为感染艾滋病毒的非洲妇女开发类似的工具。这项提议的目标是利用已完成的大规模妇女艾滋病毒预防试验积累的高质量数据库，包括VOICE(MTN-003)、HPTN 035、MDP301、FE-PrEP和ASPIRE(MTN-020)，为生活在非洲的妇女开发和验证艾滋病毒风险评估工具，以确定那些在明年感染艾滋病毒风险最大的人。由此得出的结论是 高度杠杆化的提案可以在艾滋病毒预防科学领域产生重大影响，为卫生工作者、政策制定者和艾滋病毒预防研究人员提供一种工具，以确定感染艾滋病毒风险最大的人群，从而有机会向这些高危妇女提供有针对性的密集预防服务。

 DESCRIPTION: Women account for more than half of all new HIV infections globally, with the greatest incidence occurring in African women. Several recently completed biomedical HIV prevention trials in women have reported high incidence rates, as great as 10% at some study sites, despite the provision of comprehensive HIV risk reduction services during the trial. Improving our understanding of predictors of HIV acquisition in African women is urgently needed in order to identify opportunities for intervention among sub-groups of women at greatest risk and inform the scale-up of targeted HIV prevention activities. Empiric HIV risk scores have recently been developed for several populations, including African HIV serodiscordant couples and men who have sex with men in the United States. These tools not only help to identity those at greatest risk of acquiring HIV, they are also being used to guide th implementation of novel HIV prevention activities in these populations. A similar tool has not been developed for African women at risk for HIV. The goal of this proposal is to utilize the accumulated, high-quality databases from completed large-scale HIV prevention trials in women, including VOICE (MTN-003), HPTN 035, MDP301, FEM-PrEP, and ASPIRE (MTN-020), to develop and validate an HIV risk assessment tool for women living in Africa that identifies those who are at greatest risk of acquiring HIV in the next year. The findings from this highly leveraged proposal could have a major impact in the field of HIV prevention science by providing health workers, policy makers and HIV prevention researchers with a tool to identify populations at greatest risk of acquiring HIV, allowing for the opportunity to provide targeted, intensive prevention services to these high-risk women.