{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:21:19Z","timestamp":1774398079955,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"India-Canada Centre for Innovative Multidisciplinary Partnerships to Accelerate Community Transformation and Sustainability","award":["3072"],"award-info":[{"award-number":["3072"]}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["252845"],"award-info":[{"award-number":["252845"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["324154"],"award-info":[{"award-number":["324154"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT153149"],"award-info":[{"award-number":["PJT153149"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,4,13]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Across Canada, in the last decade, incidence rates of sexually transmitted and blood-borne infections (STBBI) have peaked (syphilis) or plateaued (hepatitis C virus (HCV) and HIV). Key populations (gay, bisexual and other men who have sex with men, trans and gender-diverse people, and people who use injection drugs) are at greater risk for these STBBIs, so correctly predicting risk before screening potentially infected individuals is crucial. We developed and validated a diagnostic clinical risk prediction model (CRPM) estimating HIV, HCV and syphilis risk for two key populations in two Canadian provinces.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used 20 variables and STBBI test results from a cross-sectional study evaluating multiplexed testing (detection of coinfections) in New Brunswick and Quebec (n=400) to develop our CRPM. We randomly split the data into development (n=300) and validation (n=100) datasets using clinic-stratified sampling. We used Bayesian predictive projection with development data to select ranked STBBI predictors. We obtained the ORs of the highest performing submodel measured as area under the receiver operating curve (AUC), sensitivity and specificity with 89% credible intervals (89% CrI) using validation data. Analyses were performed in R (\u2265V.4.2.3).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Out of 400 participants, 73 were infected with HIV (n=16), HCV (n=60), and\/or syphilis (n=5). An internally validated submodel with two predictors (<jats:italic>past drug injection<\/jats:italic>, <jats:italic>type of past sexually transmitted infection<\/jats:italic>) displayed the highest AUC (0.79; 89% CrI 0.66 to 0.79), sensitivity (0.85; 89% CrI 0.79 to 0.91) and specificity (0.30; 89% CrI 0.15 to 0.50). The predictor contributing most to STBBI risk was <jats:italic>past drug injection<\/jats:italic> (OR=7.62; 89% CrI 4.41 to 13.07).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This Bayesian-based CRPM is the first to identify high-risk individuals for HIV, HCV and syphilis with an overall good performance that minimises case missing. After additional validation, it could serve as a promising novel tool for prescreening key populations and improve Canadian STBBI multiplexed screening strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056286","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T13:20:33Z","timestamp":1745500833000},"page":"467-473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Developing and validating a Bayesian clinical risk prediction model for three sexually transmitted infections in key populations from two Canadian provinces"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8575-436X","authenticated-orcid":false,"given":"Fiorella","family":"Vialard","sequence":"first","affiliation":[{"name":"School of Population and Global Health, McGill University, Montreal, Quebec, Canada"},{"name":"Centre for Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qihuang","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, McGill University, Montreal, Quebec, Canada"},{"name":"Quantitative Life Sciences, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan","family":"Webster","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Unit, Saint John Regional Hospital, Saint John, New Brunswick, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Materniak","sequence":"additional","affiliation":[{"name":"Infectious Disease Research Unit, Saint John Regional Hospital, Saint John, New Brunswick, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Dumont Blais","sequence":"additional","affiliation":[{"name":"R\u00c9ZO, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suma","family":"Nair","sequence":"additional","affiliation":[{"name":"School of Public Health, DY Patil University Deemed to be University, Navi Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Centre for Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada"},{"name":"Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4672-0500","authenticated-orcid":false,"given":"Nitika","family":"Pant Pai","sequence":"additional","affiliation":[{"name":"Centre for Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada"},{"name":"Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"2025101602151366000_101.7.467.1","unstructured":"Accelerating our response: government of Canada five-year action plan on sexually transmitted and blood-borne infections. 2019. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/reports-publications\/accelerating-our-response-five-year-action-plan-sexually-transmitted-blood-borne-infections.html"},{"key":"2025101602151366000_101.7.467.2","unstructured":"Estimates of HIV incidence, prevalence and Canada\u2019s progress on meeting the 90-90-90 hiv targets,2020. 2022. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/estimates-hiv-incidence-prevalence-canada-meeting-90-90-90-targets-2020.html"},{"key":"2025101602151366000_101.7.467.3","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v44i02a05"},{"key":"2025101602151366000_101.7.467.4","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v48i23a01"},{"key":"2025101602151366000_101.7.467.5","unstructured":"HIV self-testing, 2023. Available: https:\/\/www.catie.ca\/hiv-self-testing-0"},{"key":"2025101602151366000_101.7.467.6","unstructured":"Harrigan M . Dried blood spot collection for hepatitis c and hiv testing in canada. 2021. Available: https:\/\/www.catie.ca\/prevention-in-focus\/dried-blood-spot-collection-for-hepatitis-c-and-hiv-testing-in-canada"},{"key":"2025101602151366000_101.7.467.7","doi-asserted-by":"crossref","first-page":"e303","DOI":"10.1016\/S2666-5247(21)00191-9","article-title":"Multiplexed rapid technologies for sexually transmitted infections: a systematic review","volume":"3","author":"Karellis","year":"2022","journal-title":"Lancet Microbe"},{"key":"2025101602151366000_101.7.467.8","unstructured":"Miller D . Research update: rapid hiv and syphilis test now approved for clinical use. 2023. Available: https:\/\/www.catie.ca\/prevention-in-focus\/research-update-rapid-hiv-and-syphilis-test-now-approved-for-clinical-use"},{"key":"2025101602151366000_101.7.467.9","doi-asserted-by":"crossref","DOI":"10.2196\/55075","article-title":"Feasibility, Preference, and Impact of a Rapid Multiplexed Point-of-Care Digital Innovation (AideSmart!) to Expedite Screening of Sexually Transmitted Blood-Borne Infections in At-Risk Populations in Canada: Cross-Sectional Study","volume":"26","author":"Karellis","year":"2024","journal-title":"J Med Internet Res"},{"key":"2025101602151366000_101.7.467.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0241-z"},{"key":"2025101602151366000_101.7.467.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-022-00601-5"},{"key":"2025101602151366000_101.7.467.12","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25861","article-title":"Risk scores for predicting HIV incidence among adult heterosexual populations in sub-Saharan Africa: a systematic review and meta-analysis","volume":"25","author":"Jia","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"2025101602151366000_101.7.467.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-023-02574-x"},{"key":"2025101602151366000_101.7.467.14","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000205"},{"key":"2025101602151366000_101.7.467.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.10577"},{"key":"2025101602151366000_101.7.467.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2023.105243"},{"key":"2025101602151366000_101.7.467.17","doi-asserted-by":"crossref","DOI":"10.2196\/37850","article-title":"Web-Based Risk Prediction Tool for an Individual\u2019s Risk of HIV and Sexually Transmitted Infections Using Machine Learning Algorithms: Development and External Validation Study","volume":"24","author":"Xu","year":"2022","journal-title":"J Med Internet Res"},{"key":"2025101602151366000_101.7.467.18","doi-asserted-by":"publisher","DOI":"10.1007\/s12551-018-0449-9"},{"key":"2025101602151366000_101.7.467.19","doi-asserted-by":"crossref","unstructured":"van de Schoot R , Depaoli S , King R , et al . Bayesian statistics and modelling. Nat Rev Methods Primers 2021;1. doi:10.1038\/s43586-020-00001-2","DOI":"10.1038\/s43586-020-00001-2"},{"key":"2025101602151366000_101.7.467.20","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003210"},{"key":"2025101602151366000_101.7.467.21","doi-asserted-by":"publisher","DOI":"10.1177\/09564624211031322"},{"key":"2025101602151366000_101.7.467.22","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001340"},{"key":"2025101602151366000_101.7.467.23","unstructured":"Canadian guidelines for sexually transmitted and blood-borne infections:guides for health professionals. 2024. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/infectious-diseases\/sexual-health-sexually-transmitted-infections\/canadian-guidelines.html"},{"key":"2025101602151366000_101.7.467.24","unstructured":"Buuren SV . Flexible imputation of missing data. 2nd edn. Chapman & Hall\/CRC Press, 2018."},{"key":"2025101602151366000_101.7.467.25","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1214\/20-EJS1711","article-title":"Projective inference in high-dimensional problems: Prediction and feature selection","volume":"14","author":"Piironen","year":"2020","journal-title":"Electron J Statist"},{"key":"2025101602151366000_101.7.467.26","unstructured":"Kruschke J . Doing bayesian data analysis: a tutorial introduction with r. 2014. Available: https:\/\/public.ebookcentral.proquest.com\/choice\/publicfullrecord.aspx?p=5754481"},{"key":"2025101602151366000_101.7.467.27","unstructured":"Team RC . R: a language and environment for statistical computing. 2021. 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