{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:00:41Z","timestamp":1790434841071,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T00:00:00Z","timestamp":1663545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006967","name":"Duke University Center for AIDS Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006967","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5P30 AI064518"],"award-info":[{"award-number":["5P30 AI064518"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["T32AI007392"],"award-info":[{"award-number":["T32AI007392"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI137121"],"award-info":[{"award-number":["K23AI137121"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R34 MH122291"],"award-info":[{"award-number":["R34 MH122291"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is underutilized in the southern United States. Rapid identification of individuals vulnerable to diagnosis of HIV using electronic health record (EHR)-based tools may augment PrEP uptake in the region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Using machine learning, we developed EHR-based models to predict incident HIV diagnosis as a surrogate for PrEP candidacy. We included patients from a southern medical system with encounters between October 2014 and August 2016, training the model to predict incident HIV diagnosis between September 2016 and August 2018. We obtained 74 EHR variables as potential predictors. We compared Extreme Gradient Boosting (XGBoost) versus least absolute shrinkage selection operator (LASSO) logistic regression models, and assessed performance, overall and among women, using area under the receiver operating characteristic curve (AUROC) and area under precision recall curve (AUPRC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 998 787 eligible patients, 162 had an incident HIV diagnosis, of whom 49 were women. The XGBoost model outperformed the LASSO model for the total cohort, achieving an AUROC of 0.89 and AUPRC of 0.01. The female-only cohort XGBoost model resulted in an AUROC of 0.78 and AUPRC of 0.00025. The most predictive variables for the overall cohort were race, sex, and male partner. The strongest positive predictors for the female-only cohort were history of pelvic inflammatory disease, drug use, and tobacco use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our machine-learning models were able to effectively predict incident HIV diagnoses including among women. This study establishes feasibility of using these models to identify persons most suitable for PrEP in the South.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac775","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T04:47:45Z","timestamp":1663562865000},"page":"299-306","source":"Crossref","is-referenced-by-count":35,"title":["Development of a Human Immunodeficiency Virus Risk Prediction Model Using Electronic Health Record Data From an Academic Health System in the Southern United States"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4183-0532","authenticated-orcid":false,"given":"Charles M","family":"Burns","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Duke University Medical Center , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leland","family":"Pung","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University , Durham, North Carolina , USA"},{"name":"Duke Institute for Health Innovation , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Witt","sequence":"additional","affiliation":[{"name":"Duke Institute for Health Innovation , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gao","sequence":"additional","affiliation":[{"name":"Duke Institute for Health Innovation , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5828-4497","authenticated-orcid":false,"given":"Mark","family":"Sendak","sequence":"additional","affiliation":[{"name":"Duke Institute for Health Innovation , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh","family":"Balu","sequence":"additional","affiliation":[{"name":"Duke Institute for Health Innovation , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Krakower","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Beth Israel Deaconess Medical Center , Boston, Massachusetts , USA"},{"name":"Department of Population Medicine, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia L","family":"Marcus","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nwora Lance","family":"Okeke","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Duke University Medical Center , Durham, North Carolina , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith E","family":"Clement","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Louisiana State University Health Sciences Center , New Orleans, Louisiana , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"2023053015334371600_ciac775-B1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJMoa1108524","article-title":"Antiretroviral prophylaxis for HIV prevention in heterosexual men and women","volume":"367","author":"Baeten","year":"2012","journal-title":"N Engl J Med"},{"key":"2023053015334371600_ciac775-B2","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"Grant","year":"2010","journal-title":"N Engl J Med"},{"key":"2023053015334371600_ciac775-B3","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1016\/S0140-6736(22)00538-4","article-title":"Cabotegravir for the prevention 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