Table 3.
Performance of full and simpler HIV risk prediction models among patients with high or very high risk scores in the validation dataset – Kaiser Permanente Northern California, 2015-2017 (N=606,701)
| Sensitivity (% of incident HIV cases identified) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| HIV risk prediction model | N of patients flagged |
Overall (n=83) |
Male (n=69) |
Female (n=14) |
Black (n=20) |
White (n=20) |
Sensitivity for incident PrEP users, % (n=640) |
Specificity, % | PPV, % | NPV, % |
| Full LASSO model | 13,463 | 38·6 | 46·4 | 0 | 25·0 | 25·0 | 59·1 | 97·8 | 0·24 | >99·9 |
| MSM status and STI positivity, testing, and treatment | 4617 | 28·9 | 34·8 | 0 | 15·0 | 35·0 | 42·7 | 99·2 | 0·52 | >99·9 |
| STI positivity, testing, and treatment | 1458 | 20·5 | 24·6 | 0 | 10·0 | 15·0 | 16·2 | 99·8 | 1·17 | >99·9 |
| MSM status and STI positivity | 3849 | 25·3 | 30·4 | 0 | 10·0 | 30·0 | 38·8 | 99·4 | 0·55 | >99·9 |
| MSM status | 3790 | 25·3 | 30·4 | 0 | 10·0 | 30·0 | 38·1 | 99·4 | 0·55 | >99·9 |
| STI positivity | 1016 | 6·0 | 7·2 | 0 | 10·0 | 0 | 6·4 | 99·8 | 0·49 | >99·9 |
LASSO, least absolute shrinkage and selection operator; STI, sexually transmitted infection; MSM, men who have sex with men; PrEP, preexposure prophylaxis; PPV, positive predictive value; NPV, negative predictive value. High risk scores were defined as a predicted probability of an incident HIV diagnosis within three years of 0·20-0·99%, and very high risk scores as a predicted probability of ≥1·0%.