{"doi":"10.1093/cid/ciae211","title":"A Human Immunodeficiency Virus Type 1 Risk Assessment Tool for Women Aged 15–49 Years in African Countries: A Pooled Analysis Across 15 Nationally Representative Surveys","abstract":"BACKGROUND: Women in Africa disproportionately acquire human immunodeficiency virus type 1 (HIV-1). Understanding which women are most likely to acquire HIV-1 can guide focused prevention with preexposure prophylaxis (PrEP). Our objective was to identify women at the highest risk of HIV-1 and estimate PrEP efficiency at different sensitivity levels. METHODS: Nationally representative data were collected from 2015 through 2019 from 15 population-based household surveys. This analysis included women aged 15-49 who tested HIV-1 seronegative or had recent HIV-1. Least absolute shrinkage and selection operator regression models were fit with 28 variables to predict recent HIV-1. Models were trained on the full population and internally cross-validated. Performance was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, and number needed to treat (NNT) with PrEP to avert 1 infection. RESULTS: Among 209 012 participants, 248 had recent HIV-1 infection, representing 118 million women and 402 000 (95% confidence interval [CI], 309 000-495 000) annual infections. Two variables were retained: living in a subnational area with high HIV-1 viremia and having a sexual partner living outside the home. The full-population AUC was 0.80 (95% CI, .76-.84); cross-validated AUC was 0.79 (95% CI, .75-.84). At 33% sensitivity, 130 000 cases could be averted if 7.9 million women were perfectly adherent to PrEP; NNT would be 61. At 67% sensitivity, 260 000 cases could be averted if 25.1 million women were perfectly adherent; NNT would be 96. CONCLUSIONS: This risk assessment tool was generalizable, predictive, and parsimonious with trade-offs between reach and efficiency.","journal":"Clinical Infectious Diseases","year":2024,"id":436587,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9611,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":334760,"name":"Bonnie E. Shook‐Sa","orcid":"0000-0001-9506-4047","position":1,"is_corresponding":false},{"id":1157356,"name":"Amber Young","orcid":"0000-0001-7042-6961","position":2,"is_corresponding":false},{"id":1244964,"name":"Yating Zou","orcid":"0009-0000-2506-8907","position":3,"is_corresponding":false},{"id":299059,"name":"Lynda Stranix‐Chibanda","orcid":"0000-0003-3566-1688","position":4,"is_corresponding":false},{"id":61432,"name":"Marcel Yotebieng","orcid":"0000-0003-2110-2631","position":5,"is_corresponding":false},{"id":264886,"name":"Nadia A. Sam‐Agudu","orcid":null,"position":6,"is_corresponding":false},{"id":361250,"name":"Sam Phiri","orcid":"0000-0002-9372-212X","position":7,"is_corresponding":false},{"id":375966,"name":"Wilbroad Mutale","orcid":"0000-0002-4891-6750","position":8,"is_corresponding":false},{"id":273592,"name":"Linda‐Gail Bekker","orcid":"0000-0002-0755-4386","position":9,"is_corresponding":false},{"id":367236,"name":"Manhattan Charurat","orcid":"0000-0002-1719-2796","position":10,"is_corresponding":false},{"id":252309,"name":"Sizulu Moyo","orcid":"0000-0002-5296-3242","position":11,"is_corresponding":false},{"id":1032311,"name":"Khangelani Zuma","orcid":"0000-0003-4492-5083","position":12,"is_corresponding":false},{"id":372476,"name":"Jessica Justman","orcid":"0000-0003-4704-3115","position":13,"is_corresponding":false},{"id":130929,"name":"Michael G. Hudgens","orcid":"0000-0002-9106-4194","position":14,"is_corresponding":false},{"id":401977,"name":"H. Benjamin","orcid":"0000-0002-1435-8455","position":15,"is_corresponding":false},{"id":312051,"name":"Nora E. Rosenberg","orcid":"0000-0002-9759-9966","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:00:16.989773Z","pmid":"38657086","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}