Table 3.
Comparison of risk of bias groupings on the effect of nonviral STI diagnosis on risk of HIV acquisition among female high-risk heterosexuals (k=66)
| Syphilis | Trichomoniasis | Gonorrhea | Chlamydia | Mycoplasma Genitalium | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| All Female Populations | ||||||||||
| Pooled RR (95% CI) | 1.67 (1.23, 2.27) | 1.54 (1.31, 1.82) | 2.81 (2.25, 3.50) | 1.49 (1.08, 2.04) | 3.10 (1.63, 5.92) | |||||
| I2, p value | 43.7%, 0.028 | 0.0%, 0.648 | 10.9%, 0.329 | 23.4%, 0.200 | 0.0%, 0.712 | |||||
| SA RR Range | 1.56–1.821 | 1.48–1.58 | 2.58–3.052 | 1.37, 1.693 | 2.94–4.084 | |||||
| k | 17 | 17 | 16 | 14 | 2 | |||||
| By Multivariate Adjustment | ||||||||||
| Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Pooled RR (95% CI) | 1.64 (1.01, 2.67) |
1.75 (1.12, 2.72) |
0.82 (0.47, 1.45) |
1.64 (1.38, 1.95) |
3.97 (1.86, 8.46) |
2.74 (2.14, 3.51) |
1.19 (0.65, 2.17) |
1.61 (1.11, 2.35) |
- | 3.10 (1.63, 5.92) |
| I2, p value | 40.8%, 0.119 | 50.0%, 0.035 | 0.0, 0.975 | 0.0%, 0.700 | 0.0%, 0.651 | 20.1%, 0.240 | 11.9%, 0.339 | 30.3%, 0.186 | 0.0%, 0.712 | |
| k | 7 | 10 | 6 | 11 | 3 | 13 | 6 | 8 | 0 | 2 |
| By Risk of Bias in Temporality | ||||||||||
| Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | |
| Pooled RR (95% CI) | 1.56 (0.76, 3.21) |
1.77 (1.23, 2.53) |
2.32 (1.55, 3.48) |
1.42 (1.18, 1.70) |
3.11 (2.00, 4.84) |
2.76 (2.10, 3.62) |
0.51 (0.19, 1.36) |
1.71 (1.31, 2.23) |
3.10 (1.63, 5.92) |
- |
| I2, p value | 62.1%, 0.032 | 38.0%, 0.088 | 0.0%, 0.731 | 0.0%, 0.837 | 0.0%, 0.421 | 21.9%, 0.241 | 0.0%, 0.400) | 0.0%, 0.471 | 0.0%, 0.712 | |
| k | 5 | 12 | 4 | 13 | 6 | 10 | 3 | 11 | 2 | 0 |
| Higher-Quality Data Only | ||||||||||
| Pooled RR (95% CI) | 1.49 (0.98, 2.26) | 1.51 (1.25, 1.84) | 2.64 (1.92, 3.63) | 1.90 (1.40, 2.56) | - | |||||
| I2, p value | 32.9%, 0.177 | 0.0%, 0.874 | 37.0%, 0.146 | 0.0%, 0.848 | ||||||
| SA RR Range | 1.19–1.835 | 1.48–1.576 | 2.33–2.877 | 1.77–2.068 | ||||||
| k | 7 | 7 | 7 | 6 | 0 | |||||
| High-Risk Occupation Only | ||||||||||
| Pooled RR (95% CI) | 1.59 (1.14, 2.20) | 1.50 (1.26, 1.78) | 2.84 (2.25, 3.58) | 1.49 (1.06, 2.10) | 3.10 (1.63, 5.92) | |||||
| I2, p value | 31.8%, 0.136 | 0.0%, 0.780 | 11.3%, 0.332 | 33.3%, 0.124 | 0.0%, 0.712 | |||||
| SA RR Range | 1.40–1.83 9 | 1.44–1.5310 | 2.60–3.1311 | 1.37–1.70 12 | 2.94–4.08 13 | |||||
| k | 12 | 14 | 13 | 12 | 2 | |||||
| By Multivariate Adjustment | ||||||||||
| Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Pooled RR (95% CI) | 2.11 (1.29, 3.46) |
1.39 (0.94, 2.04) |
0.79 (0.41, 1.53) |
1.57 (1.31, 1.88) |
3.72 (1.58, 8.77) |
2.81 (2.18, 3.62) |
1.24 (0.55, 2.82) |
1.61 (1.11, 2.35) |
- | 3.10 (1.63, 5.92) |
| I2, p value | 0.0%, 0.499 | 28.1%, 0.204 | 0.0%, 0.975 | 0.0%, 0.847 | 0.0%, 0.3.85 | 18.7%, 0.265 | 45.6%, 0.138 | 30.3%, 0.186 | 0.0%, 0.712 | |
| k | 4 | 8 | 4 | 10 | 2 | 11 | 4 | 8 | 0 | 2 |
| By Risk of Bias in Temporality | ||||||||||
| Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | Higher Risk | Lower Risk | |
| Pooled RR (95% CI) | 0.92 (0.40, 2.13) |
1.75 (1.21, 2.55) |
2.13 (1.23, 3.69) |
1.44 (1.20, 1.73) |
3.80 (2.20, 6.56) |
2.72 (2.04, 3.62) |
0.51 (0.19, 1.38) |
1.73 (1.29, 2.31) |
- | 3.10 (1.63, 5.92) |
| I2, p value | 0.0%. 0.541 | 40.0%, 0.091 | 0.0%, 0.582 | 0.0%, 0.809 | 0.0%, 0.770 | 26.8%, 0.205 | 0.0%, 0.400 | 11.4%, 0.340 | 0.0%, 0.712 | |
| k | 2 | 10 | 3 | 11 | 4 | 9 | 3 | 9 | 0 | 2 |
| Higher-Quality Data Only | ||||||||||
| Pooled RR (95% CI) | 1.49 (0.98, 2.26) | 1.51 (1.25, 1.84) | 2.64 (1.92, 3.63) | 1.90 (1.40, 2.56) | - | |||||
| I2, p value | 32.9%, 0.177 | 0.0%, 0.874 | 37.0%, 0.146 | 0.0%, 0.848 | ||||||
| SA RR Range | 1.19–1.8314 | 1.48–1.5715 | 2.33–2.8716 | 1.30–2.5617 | ||||||
| k | 7 | 7 | 7 | 6 | 0 | |||||
k = Number of effect size estimates included; RR = Risk ratio; SA = Sensitivity analysis; SA RR range = Range when one study removed from analysis
Where studies reported multiple effect sizes for the same population-pathogen pairing, estimates and SA RR ranges above reflect better-quality data (i.e., multivariate-adjusted vs unadjusted and/or shorter duration of follow-up). SA RR ranges for lower-quality data are reported in footnotes.
RR when each study removed from analysis, where RR changed by >0.05: Auvert 2011: 1.74 (1.27, 2.39); Braunstein 2011: 1.58 (1.18, 2.13); Ghys 2001: 1.73 (1.25, 2.39); Hanson 2005: 1.56 (1.17, 2.07); Metha 2006: 1.61 (1.18, 2.20); Plummer 1991: 1.81 (1.29, 2.54); Su 2016: 1.57 (1.16, 2.13); Wall 2017: 1.82 (1.30, 2.54); Watson-Jones 2009: 1.75 (1.28, 2.40). RR when lower-quality effect size was substituted for Braunstein 2011 was 1.58 (1.19, 2.10).
RR when each study removed from analysis: Ghys 2001: 2.69 (2.16, 3.35); Kaul 2004: 2.74 (2.19, 3.43); Laga 1993: 2.71 (2.12, 3.46); Martin 1998: 2.94 (2.36, 3.67); Masese 2015: 3.05 (2.42, 3.84); Ramjee 2005: 2.89 (2.29, 3.65); Vandepitte 2013: 2.58 (2.1, 3.18). RR when lower-quality effect size was substituted from Vandepitte 2013 was 2.62 (2.15, 3.19).
RR when each study removed from analysis: Auvert 2011: 1.68 (1.29, 2.17); Kaul 2004: 1.41 (1.02, 1.95); Laga 1993: 1.37 (0.97, 1.94); Nagot 2005: 1.69 (1.28, 2.22); Plummer 1991: 1.43 (0.98, 2.08); Vandepitte 2013: 1.42 (1.00, 2.02); Watson-Jones 2009: 1.39 (0.99, 1.94). RR when lower-quality effect size was substituted from Kapiga 2007 was 1.60 (1.12, 2.29).
RR when each study removed from analysis: Mlisana 2012: 2.94 (1.45, 5.96), Vandepitte 2013: 4.08 (0.83, 20.06). RR when lower-quality effect size was substituted from Vandepitte 2013 was 2.41 (1.29, 4.50).
RR when each study removed from analysis: Braunstein 2011: 1.19 (0.96, 1.49); Plummer 1991: 1.83 (1.13, 2.98); Riedner 2006: 1.33 (0.87, 2.04); Watson-Jones 2009: 1.65 (1.04, 2.61).
RR when Martin 1998 removed from analysis: 1.57 (1.27, 1.93).
RR when each study removed from analysis: Laga 1993: 2.46 (1.71, 3.53); Martin 1998: 2.86 (2.01, 4.06); Masese 2015: 2.87 (1.96, 4.19); Ramjee 2005: 2.75 (1.92, 3.94); Vandepitte 2013: 2.33 (1.81, 2.98).
RR when each study removed from analysis: Laga 1993: 1.77 (1.24, 2.53); Martin 1998: 1.98 (1.44, 2.71); Plummer 1991: 2.06 (1.43, 2.95); Watson-Jones 2009: 1.79 (1.29, 2.48).
RR when each study removed from analysis: Auvert 2011: 1.67 (1.19, 2.34); Braunstein 2011: 1.45 (1.09, 1.94); Ghys 2001: 1.65 (1.15, 2.37); Plummer 1991: 1.83 (1.32, 2.56); Riedner 2006: 1.52 (1.07, 2.15); Su 2016: 1.40 (1.05, 1.87); Watson-Jones 2009: 1.68 (1.20, 2.36). RR when lower-quality effect size was substituted from Braunstein 2011 was 1.42 (1.09, 1.84); when substituted from Vandepitte 2013 was 1.54 (1.16, 2.06)
RR when lower-quality effect size was substituted from Braunstein 2011 was 1.44 (1.21, 1.72).
RR when each study removed from analysis: Ghys 2001: 2.71 (2.16, 3.41); Kaul 2004: 2.77 (2.19, 3.51); Laga 1993: 2.75 (2.12, 3.56); Martin 1998: 2.97 (2.37, 3.72); Masese 2015: 3.13 (2.45, 4.00); Ramjee 2005: 2.94 (2.30, 3.76); Vandepitte 2013: 2.60 (2.09, 3.23). RR when lower-quality effect size was substituted from Vandepitte 2013 was 2.61 (2.11, 3.24).
RR when each study removed from analysis: Auvert 2011 1.70 (1.31, 2.21); Kaul 2004: 1.40 (0.98, 2.00); Laga 1993: 1.37 (0.94, 2.02); Nagot 2005: 1.69 (1.24, 2.29); Plummer 1991: 1.44 (0.95, 2.17); Vandepitte 2013: 1.43 (0.97, 2.1); Watson-Jones 2009: 1.38 (0.96, 2.00).
RR when each study removed from analysis: Mlisana 2012: 2.94 (1.45, 5.96), Vandepitte 2013: 4.08 (0.83, 20.06). R when lower-quality effect size was substituted from Vandepitte 2013 was 2.41 (1.29, 4.50).
RR when each study removed from analysis: Braunstein 2011: 1.19 (0.96, 1.49); Plummer 1991: 1.83 (1.13, 2.98); Riedner 2006: 1.33 (0.87, 2.04); Watson-Jones 2009: 1.65 (1.04, 2.61).
RR when Martin 1998 removed from analysis: 1.57 (1.27, 1.93).
RR when each study removed from analysis: Laga 1993: 2.46 (1.71, 3.53); Martin 1998: 2.86 (2.01, 4.06); Masese 2015: 2.87 (1.96, 4.19); Ramjee 2005: 2.75 (1.92, 3.94); Vandepitte 2013: 2.33 (1.81, 2.98).
RR when each study removed from analysis: Martin 1998: 1.3 (0.5, 3.38); Priddy 2011: 1.46 (0.08, 26.64); Plummer 1991: 1.58 (0.92, 2.71); Laga 1993: 2.23 (1.28, 3.88); Watson-Jones 2009: 2.56 (1.21, 5.42).