Table 1.
Factors associated with elevated risk of HIV acquisition among MSM in the Health in Men (HIM) study, Australia, 2001–2007, and their translation into eligibility criteria for PrEP
| Findings of the HIM study | Criteria to identify increased risk of HIV | |
|---|---|---|
| Risk factor | HIV incidence per 100 person years (95% confidence interval) | |
| All gay and bisexual men regardless of behavioural practices | 0.78 (0.59–1.02) | n/a |
| HIV risk factors: high risk | ||
| A regular sexual partner of an HIV-positive man with whom condoms were not consistently used in the last 6 months | 5.36 (2.78–10.25) | A regular sexual partner of an HIV-infected men (not on treatment and/or detectable viral load) with whom condoms were not consistently used in the last 3 months |
| At least one episode of receptive, unprotected anal intercourse with any casual HIV-infected male partner or a male partner of unknown HIV status during the last 6 months | 2.31 (1.48–3.63) | At least one episode of receptive condomless anal intercourse (CLAI) with any casual HIV-infected male partner or a male partner of unknown HIV status in the last 3 months |
| Rectal gonorrhoea diagnosis in last 6 months | 7.01 (2.26–21.74) | Rectal gonorrhoea, rectal chlamydia or infectious syphilis diagnosis in the last 3 months |
| Rectal chlamydia diagnosis in last 6 months | 3.57 (1.34–9.52) | |
| Methamphetamine use in last 6 months | 1.89 (1.25–2.84) | Methamphetamine use in last 3 months |
| HIV risk factors: medium HIV risk to be used in individual clinical assessment | ||
| More than one episode of anal intercourse during the last 3 months when proper condom use was not achieved (e.g. condoms slipped off or broke) | 1.30 (0.95–1.77) | More than one episode of anal intercourse during the last 3 months when proper condom use was not achieved (e.g. condoms slipped off or broke) |
| A regular sexual partner of CLAI or having at least one episode of insertive CLAI where the serostatus of partner is not known or is HIV-positive | 0.94 (0.35–2.52) | n/a |
| In uncircumcised men having at least one episode of insertive CLAI where the serostatus of partner is not known or is HIV-positive | 1.73 (0.43–6.90) | (If patient is uncircumcised) having in the last three months more than one episode of insertive CLAI where the serostatus of partner was not known or was HIV-positive and not on treatment |
| In circumcised men (comparison group, low risk, PrEP not recommended) | 0.65 (0.16–2.61) | n/a |