Identifying factors increasing the risk of acquiring HIV among Egyptians to construct a consensus web-based tool for HIV risk assessment

Abstract

Background

Accurate information on HIV transmission risk is required to construct evidence-based risk reduction practices for individuals and to direct the provision of prevention strategies at the population level. HIV transmission risk assessment will help in identifying individuals at high risk of HIV infection and directing the provision of post exposure prophylaxis (PEP).

Objective

To identify the common risk factors for HIV transmission in the Egyptian community in order to construct a web-based HIV risk assessment tool.

Methods

Following a systematic review and meta-analysis of published literature on HIV transmission and risk factors, we retrieved the key determinants of HIV exposure risk. In parallel, we conducted a case control study to identify the common risk factors for HIV transmission in the Egyptian community. The identified risk factors were incorporated in weighted risk scoring models to allow the quantification of the risk of HIV acquisition.

Results

There were 38 determinants associated with HIV seropositivity [people living with HIV (PLWH)] among Egyptians compared to 34 risk factors identified in our meta-analysis. All the derived scores showed high accuracy for predicting HIV infection status [sensitivity, specificity, PPV and NPV of greater than 90.0%, (AUC = 0.998–1.000; p < .001)].

Conclusion

Key drivers of HIV transmissions can be incorporated into a risk scoring model in order to quantify the risks of HIV acquisition. Such tools can facilitate the screening of PLWH and at-risk-individuals and direct interventions to halt HIV transmission.

Keywords:

• Meta-analysis
• HIV
• risk factor
• transmission
• risk assessment
• PLWH

Data availability statement

All data are fully available without restriction by the corresponding author at [email protected].

Transparency

Declaration of funding

No financial support or funding was received.

Declaration of financial/other relationships

Nothing to disclose.

Author contributions

AFK: Conducted the database search, data extraction, data curation, development of the data collection tools, recruitment of the study participants, data collection, statistical analysis and interpretation of data, contributed to writing of the manuscript, revised and approved final version of the manuscript.

HZS: Supervised the study implementation and data collection, development and validation of the data collection tools, revised and approved final version of the manuscript.

EWAW: Conceptualization, developed the theoretical framework and study design, conducted the data base search, data extraction, development and validation of the data collection tools, took the lead for overall direction and planning, supervised the study implementation, data curation, analysis and interpretation of data, major contribution to writing, revised and approved final version of the manuscript

Peer reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical approval

The study was approved by the institutional review board and the Ethics Committee of the High Institute of Public Health-Alexandria University (no. 522-2019). The research was conducted in accordance with the ethical guidelines of Helsinki’s Declaration (2013). Data sheets were coded with numbers to maintain the anonymity and confidentiality of patient’s data. This article does not contain any studies with animals performed by any of the authors.

Informed consent

All participants signed an informed written consent after explaining the aim and concerns of the study.