{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:53:16Z","timestamp":1791669196879,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T00:00:00Z","timestamp":1641686400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV\u2010002606"],"award-info":[{"award-number":["INV\u2010002606"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1164897"],"award-info":[{"award-number":["OPP1164897"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1190661"],"award-info":[{"award-number":["OPP1190661"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018734","name":"Joint United Nations Programme on HIV\/AIDS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018734","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Several HIV risk scores have been developed to identify individuals for prioritized HIV prevention in sub\u2010Saharan Africa. We systematically reviewed HIV risk scores to: (1) identify factors that consistently predicted incident HIV infection, (2) review inclusion of community\u2010level HIV risk in predictive models and (3) examine predictive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched nine databases from inception until 15 February 2021 for studies developing and\/or validating HIV risk scores among the heterosexual adult population in sub\u2010Saharan Africa. Studies not prospectively observing seroconversion or recruiting only key populations were excluded. Record screening, data extraction and critical appraisal were conducted in duplicate. We used random\u2010effects meta\u2010analysis to summarize hazard ratios and the area under the receiver\u2010operating characteristic curve (AUC\u2010ROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 1563 initial search records, we identified 14 risk scores in 13 studies. Seven studies were among sexually active women using contraceptives enrolled in randomized\u2010controlled trials, three among adolescent girls and young women (AGYW) and three among cohorts enrolling both men and women. Consistently identified HIV prognostic factors among women were younger age (pooled adjusted hazard ratio: 1.62 [95% confidence interval: 1.17, 2.23], compared to above 25), single\/not cohabiting with primary partners (2.33 [1.73, 3.13]) and having sexually transmitted infections (STIs) at baseline (HSV\u20102: 1.67 [1.34, 2.09]; curable STIs: 1.45 [1.17; 1.79]). Among AGYW, only STIs were consistently associated with higher incidence, but studies were limited (\n                      <jats:italic>n<\/jats:italic>\n                      = 3). Community\u2010level HIV prevalence or unsuppressed viral load strongly predicted incidence but was only considered in 3 of 11 multi\u2010site studies. The AUC\u2010ROC ranged from 0.56 to 0.79 on the model development sets. Only the VOICE score was externally validated by multiple studies, with pooled AUC\u2010ROC 0.626 [0.588, 0.663] (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : 64.02%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Younger age, non\u2010cohabiting and recent STIs were consistently identified as predicting future HIV infection. Both community HIV burden and individual factors should be considered to quantify HIV risk. However, HIV risk scores had only low\u2010to\u2010moderate discriminatory ability and uncertain generalizability, limiting their programmatic utility. Further evidence on the relative value of specific risk factors, studies populations not restricted to \u201cat\u2010risk\u201d individuals and data outside South Africa will improve the evidence base for risk differentiation in HIV prevention programmes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Number<\/jats:title>\n                    <jats:p>CRD42021236367<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25861","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T00:43:41Z","timestamp":1641775421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Risk scores for predicting HIV incidence among adult heterosexual populations in sub\u2010Saharan Africa: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-2415","authenticated-orcid":false,"given":"Katherine M.","family":"Jia","sequence":"first","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-0548","authenticated-orcid":false,"given":"Hallie","family":"Eilerts","sequence":"additional","affiliation":[{"name":"Department of Population Health The London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-5171","authenticated-orcid":false,"given":"Olanrewaju","family":"Edun","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2977-0888","authenticated-orcid":false,"given":"Kevin","family":"Lam","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2386-4031","authenticated-orcid":false,"given":"Adam","family":"Howes","sequence":"additional","affiliation":[{"name":"Department of Mathematics Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-1936","authenticated-orcid":false,"given":"Matthew L.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Joint Centre for Excellence in Environmental Intelligence University of Exeter &amp; Met Office  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-728X","authenticated-orcid":false,"given":"Jeffrey W.","family":"Eaton","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,9]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"The Joint United Nations Programme on HIV\/AIDS (UNAIDS). 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