Sexual Behavior During Acute HIV Infection Among Men Who Have Sex With Men, in Los Angeles, California: Table 1.

Davey, Dvora Joseph; Beymer, Matt R; Roberts, Chelsea; Bolan, Robert; Klausner, Jeffrey D.

doi:10.1093/infdis/jiw112

Cited by 6 publications

(10 citation statements)

References 6 publications

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“…It is well established that CLAI is the main transmission route for acquiring HIV-1 among MSM [39] and not reporting CLAI could be due to social desirability bias, again potentially lowering the performance of the risk score. Similar rates of CLAI were described for AHI patients in a recent prospective study from the USA among MSM [40] and the data collected in both cohorts are likely consistent with clinical settings in which the risk score could be implemented as a screening tool, using clients’ self-reported behavior.…”

Section: Discussionsupporting

confidence: 78%

Development and validation of a risk score to assist screening for acute HIV-1 infection among men who have sex with men

et al. 2017

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BackgroundEarly treatment of acute HIV-1 infection (AHI) is beneficial for patients and could reduce onward transmission. However, guidelines on whom to test for AHI with HIV-1 RNA testing are lacking.MethodsA risk score for possible AHI based on literature and expert opinion – including symptoms associated with AHI and early HIV-1 – was evaluated using data from the Amsterdam Cohort Studies among men who have sex with men (MSM). Subsequently, we optimized the risk score by constructing two multivariable logistic regression models: one including only symptoms and one combining symptoms with known risk factors for HIV-1 seroconversion, using generalized estimating equations. Several risk scores were generated from these models and the optimal risk score was validated using data from the Multicenter AIDS Cohort Study.ResultsUsing data from 1562 MSM with 175 HIV-1 seroconversion visits and 17,271 seronegative visits in the Amsterdam Cohort Studies, the optimal risk score included four symptoms (oral thrush, fever, lymphadenopathy, weight loss) and three risk factors (self-reported gonorrhea, receptive condomless anal intercourse, more than five sexual partners, all in the preceding six months) and yielded an AUC of 0.82. Sensitivity was 76.3% and specificity 76.3%. Validation in the Multicenter AIDS Cohort Study resulted in an AUC of 0.78, sensitivity of 56.2% and specificity of 88.8%.ConclusionsThe optimal risk score had good overall performance in the Amsterdam Cohort Studies and performed comparable (but showed lower sensitivity) in the validation study. Screening for AHI with four symptoms and three risk factors would increase the efficiency of AHI testing and potentially enhance early diagnosis and immediate treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2508-4) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 78%

Development and validation of a risk score to assist screening for acute HIV-1 infection among men who have sex with men

et al. 2017

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“…Joseph Davey et al . [ 12 ] also found that men with acute infections reported on average twice the number of sexual partners in the previous month compared to men with nonacute infections ( Table 1 ). The effect was strong enough to persist even when averaged over the previous 3 months.…”

Section: Our Hypothesis and Supporting Datamentioning

confidence: 92%

“…Joseph Davey et al . [ 12 ] found that at their time of HIV+ diagnosis, homosexual men with acute infections reported an average of 4.2 sexual partners during the previous month (−1 M) and an average of 2.85 sexual partners per month in the two antecedent months (−3 M and −2 M). Since the acute stage lasts ∼24 days following infection, at most a fraction of the previous month was spent infected for almost all acute stage individuals [ 4 ].…”

Section: Our Hypothesis and Supporting Datamentioning

confidence: 99%

“…In agreement with Joseph Davey et al . [ 12 ], Braun et al . [ 13 ] report that diagnosis with an acute ( n = 169) compared with nonacute ( n = 5015) HIV infection in homosexual men was associated with 5-fold higher odds for future risky sexual behavior, which they defined as condomless sex with an occasional partner (adjusted odds ratio [OR], 5.58).…”

Section: Our Hypothesis and Supporting Datamentioning

confidence: 99%

“…Consistent with the findings presented by Joseph Davey et al . [ 12 ], this suggests that the virus preferentially increases sexual behavior when the host is most infectious, which is in the early stages of infection [ 16 ]. This accords with the finding that about half of all HIV transmission occurs from an individual in the acute phase [ 4 ].…”

Section: Our Hypothesis and Supporting Datamentioning

confidence: 99%

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Does HIV infection increase male sexual behavior?

Starks

Kelsey

Rosania

et al. 2020

Evolution, Medicine, and Public Health

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After 40 years of intense study on HIV/AIDS, scientists have identified, amongst other things, at risk populations, stages of disease progression, and treatment strategies. What has received less attention is the possibility that infection might elicit an increase in sexual behavior in humans. In 2000, Starks and colleagues speculated that HIV infection could alter host behavior in a manner that facilitated the spread of the virus. Retrospective and self-report data from five studies now support this hypothesis. Individuals with acute – versus nonacute – stage infections report more sexual partners and more frequent risky sex. Additionally, male sexual behavior increases non-linearly with HIV viral load, and data suggest a potential threshold viral level above which individuals are more likely to engage in risky sexual behavior. Taken together, these data suggest that HIV infection influences male sexual behavior in a manner beneficial to the virus. Here, we present these findings, highlight their limitations, and discuss alternative perspectives. We argue for increased testing of this hypothesis and advocate for increased public health measures to mitigate the putative impact on male sexual behavior. Lay Summary In 2000, Starks and colleagues speculated that HIV infection could alter host behavior in a manner that facilitated the spread of the virus. Retrospective and self-report data from five studies now support this hypothesis. We argue for increased testing of this hypothesis and advocate for increased public health measures to mitigate the putative impact on male sexual behavior.

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Reply to Davey et al

Suthar

Williams

2016

J Infect Dis.

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Sexual Behavior During Acute HIV Infection Among Men Who Have Sex With Men, in Los Angeles, California: Table 1.

Cited by 6 publications

References 6 publications

Development and validation of a risk score to assist screening for acute HIV-1 infection among men who have sex with men

Development and validation of a risk score to assist screening for acute HIV-1 infection among men who have sex with men

Does HIV infection increase male sexual behavior?

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