{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:52:09Z","timestamp":1767178329451,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pcbi.1010559","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000}}],"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["201369"],"award-info":[{"award-number":["201369"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["324730_179567"],"award-info":[{"award-number":["324730_179567"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010474","name":"Swiss HIV Cohort Research Foundation","doi-asserted-by":"publisher","award":["823"],"award-info":[{"award-number":["823"]}],"id":[{"id":"10.13039\/501100010474","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["BSSGI0_155851"],"award-info":[{"award-number":["BSSGI0_155851"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["BSSGI0_155851"],"award-info":[{"award-number":["BSSGI0_155851"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>Machine learning is increasingly introduced into medical fields, yet there is limited evidence for its benefit over more commonly used statistical methods in epidemiological studies. We introduce an unsupervised machine learning framework for longitudinal features and evaluate it using sexual behaviour data from the last 20 years from over 3\u2019700 participants in the Swiss HIV Cohort Study (SHCS). We use hierarchical clustering to find subgroups of men who have sex with men in the SHCS with similar sexual behaviour up to May 2017, and apply regression to test whether these clusters enhance predictions of sexual behaviour or sexually transmitted diseases (STIs) after May 2017 beyond what can be predicted with conventional parameters. We find that behavioural clusters enhance model performance according to likelihood ratio test, Akaike information criterion and area under the receiver operator characteristic curve for all outcomes studied, and according to Bayesian information criterion for five out of ten outcomes, with particularly good performance for predicting future sexual behaviour and recurrent STIs. We thus assess a methodology that can be used as an alternative means for creating exposure categories from longitudinal data in epidemiological models, and can contribute to the understanding of time-varying risk factors.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1010559","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T14:04:50Z","timestamp":1666879490000},"page":"e1010559","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Unsupervised machine learning predicts future sexual behaviour and sexually transmitted infections among HIV-positive men who have sex with men"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7630-2617","authenticated-orcid":true,"given":"Sara","family":"Andresen","sequence":"first","affiliation":[]},{"given":"Suraj","family":"Balakrishna","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7966-3939","authenticated-orcid":true,"given":"Catrina","family":"Mugglin","sequence":"additional","affiliation":[]},{"given":"Axel J.","family":"Schmidt","sequence":"additional","affiliation":[]},{"given":"Dominique L.","family":"Braun","sequence":"additional","affiliation":[]},{"given":"Alex","family":"Marzel","sequence":"additional","affiliation":[]},{"given":"Thanh","family":"Doco Lecompte","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1449-3873","authenticated-orcid":true,"given":"Katharine EA","family":"Darling","sequence":"additional","affiliation":[]},{"given":"Jan A.","family":"Roth","sequence":"additional","affiliation":[]},{"given":"Patrick","family":"Schmid","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9724-8373","authenticated-orcid":true,"given":"Enos","family":"Bernasconi","sequence":"additional","affiliation":[]},{"given":"Huldrych F.","family":"G\u00fcnthard","sequence":"additional","affiliation":[]},{"given":"Andri","family":"Rauch","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9220-8348","authenticated-orcid":true,"given":"Roger D.","family":"Kouyos","sequence":"additional","affiliation":[]},{"given":"Luisa","family":"Salazar-Vizcaya","sequence":"additional","affiliation":[]},{"name":"the Swiss HIV Cohort Study","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"pcbi.1010559.ref001","first-page":"1","article-title":"Cohort-Derived Machine Learning Models for Individual Prediction of Chronic Kidney Disease in People Living With Human Immunodeficiency Virus: A Prospective Multicenter Cohort Study","volume":"(Xx Xxxx)","author":"JA Roth","year":"2020","journal-title":"J Infect Dis"},{"issue":"1","key":"pcbi.1010559.ref002","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41591-018-0300-7","article-title":"High-performance medicine: the convergence of human and artificial intelligence","volume":"25","author":"EJ Topol","year":"2019","journal-title":"Nat Med"},{"issue":"8","key":"pcbi.1010559.ref003","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1136\/sextrans-2017-053273","article-title":"100 Years of STIs in the UK: A review of national surveillance data","volume":"94","author":"H Mohammed","year":"2018","journal-title":"Sex Transm Infect"},{"key":"pcbi.1010559.ref004","first-page":"147","article-title":"The resurgence of syphilis in high-income countries in the 2000s: A focus on Europe","author":"G Spiteri","year":"2019","journal-title":"Epidemiol Infect"},{"issue":"8","key":"pcbi.1010559.ref005","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/QAD.0000000000001789","article-title":"Incidence of new hepatitis C virus infection is still increasing in French MSM living with HIV","volume":"32","author":"P Pradat","year":"2018","journal-title":"Aids"},{"issue":"10","key":"pcbi.1010559.ref006","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1093\/cid\/cis694","article-title":"Hepatitis C virus infections in the swiss HIV cohort study: A rapidly evolving epidemic","volume":"55","author":"G Wandeler","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"2","key":"pcbi.1010559.ref007","article-title":"Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals","volume":"96","author":"M Shilaih","year":"2017","journal-title":"Med (United States)"},{"issue":"S9","key":"pcbi.1010559.ref008","first-page":"19","article-title":"Modelling the syphilis epidemic among HIV-infected and uninfected MSM in Switzerland","volume":"20","author":"S Balakrishna","year":"2019","journal-title":"HIV Med"},{"issue":"1","key":"pcbi.1010559.ref009","first-page":"1","article-title":"Repeated syphilis episodes in HIV-infected men who have sex with men: A multicenter prospective cohort study on risk factors and the potential role of syphilis immunity","volume":"7","author":"JA Roth","year":"2020","journal-title":"Open Forum Infect Dis"},{"issue":"9","key":"pcbi.1010559.ref010","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph16091507","article-title":"Prevalence of active syphilis infection and risk factors among HIV-positive MSM in Zhejiang, China in 2015: A cross-sectional study","volume":"16","author":"L Chen","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"pcbi.1010559.ref011","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1093\/cid\/cix873","article-title":"High rates of subsequent asymptomatic sexually transmitted infections and risky sexual behavior in patients initially presenting with primary human immunodeficiency virus-1 infection","volume":"66","author":"DL Braun","year":"2018","journal-title":"Clin Infect Dis"},{"key":"pcbi.1010559.ref012","first-page":"2","author":"RD Kouyos","year":"2015","journal-title":"Increases in Condomless Sex in the Swiss HIV Cohort Study"},{"issue":"3","key":"pcbi.1010559.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/QAI.0000000000002025","article-title":"Trends in Number and Composition of Sex Partners among Men Who Have Sex with Men in the United States, National HIV Behavioral Surveillance, 2008\u20132014","volume":"81","author":"J Chapin-Bardales","year":"2019","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"12","key":"pcbi.1010559.ref014","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.annepidem.2018.09.006","article-title":"Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America, Western Europe, and Australia, 2000\u20132014","volume":"28","author":"J Chapin-Bardales","year":"2018","journal-title":"Ann Epidemiol"},{"issue":"7137","key":"pcbi.1010559.ref015","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1038\/446733a","article-title":"Capturing human behaviour","volume":"446","author":"N. Ferguson","year":"2007","journal-title":"Nature"},{"issue":"3","key":"pcbi.1010559.ref016","first-page":"416","article-title":"Clusters of sexual behavior in human immunodeficiency virus-positive men who have sex with men reveal highly dissimilar time trends","volume":"70","author":"L Salazar-Vizcaya","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pcbi.1010559.ref017","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1093\/ije\/dyp321","article-title":"Cohort profile: The Swiss HIV cohort study","volume":"39","author":"F Schoeni-Affolter","year":"2010","journal-title":"Int J Epidemiol"},{"issue":"18","key":"pcbi.1010559.ref018","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1097\/QAD.0000000000000878","article-title":"The HIV care cascade in Switzerland: Reaching the UNAIDS\/WHO targets for patients diagnosed with HIV","volume":"29","author":"P Kohler","year":"2015","journal-title":"Aids"},{"issue":"12","key":"pcbi.1010559.ref019","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1093\/cid\/cir725","article-title":"Characterization of human immunodeficiency virus type 1 (HIV-1) diversity and tropism in 145 patients with primary HIV-1 infection","volume":"53","author":"P Rieder","year":"2011","journal-title":"Clin Infect Dis"},{"key":"pcbi.1010559.ref020","author":"R Core Team","year":"2019","journal-title":"R: A Language and Environment for Statistical Computing. Vienna, Austria"},{"issue":"31","key":"pcbi.1010559.ref021","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1007\/s00357-014-9161-z","article-title":"Ward\u2019s Hierarchical Agglomerative Clustering Method: Which Algorithms Implement Ward\u2019s Criterion?","author":"F Murtagh","year":"2014","journal-title":"J Classif"},{"issue":"2","key":"pcbi.1010559.ref022","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/infdis\/jiz093","article-title":"A Systematic Phylogenetic Approach to Study the Interaction of HIV-1 with Coinfections, Noncommunicable Diseases, and Opportunistic Diseases","volume":"220","author":"K Kusejko","year":"2019","journal-title":"J Infect Dis"},{"key":"pcbi.1010559.ref023","first-page":"1","author":"L Salazar-vizcaya","year":"2022","journal-title":"An Approach to Quantifying the Interaction between Behavioral and Transmission Clusters"},{"issue":"6","key":"pcbi.1010559.ref024","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1002\/hep.28769","article-title":"Hepatitis C virus transmission among human immunodeficiency virus-infected men who have sex with men: Modeling the effect of behavioral and treatment interventions","volume":"64","author":"L Salazar-Vizcaya","year":"2016","journal-title":"Hepatology"},{"issue":"4 PART 1","key":"pcbi.1010559.ref025","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1017\/S0954579413000436","article-title":"Trajectories of multiple adolescent health risk behaviors in a low-income African American population","volume":"25","author":"B Mustanski","year":"2013","journal-title":"Dev Psychopathol"},{"issue":"November 2019","key":"pcbi.1010559.ref026","doi-asserted-by":"crossref","first-page":"107526","DOI":"10.1016\/j.drugalcdep.2019.06.028","article-title":"Sex, drugs, and sexually transmitted infections: A latent class analysis among men who have sex with men in Amsterdam and surrounding urban regions, the Netherlands","volume":"206","author":"RCA Achterbergh","year":"2020","journal-title":"Drug Alcohol Depend"},{"issue":"6","key":"pcbi.1010559.ref027","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1007\/s10508-020-01663-5","article-title":"Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older","volume":"49","author":"B Houle","year":"2020","journal-title":"Arch Sex Behav"},{"issue":"6","key":"pcbi.1010559.ref028","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/sextrans-2013-051334","article-title":"Sexual risk typologies and their relationship with early parenthood and STI outcomes among urban African-American emerging adults: A cross-sectional latent profile analysis","volume":"90","author":"SL Davies","year":"2014","journal-title":"Sex Transm Infect"},{"key":"pcbi.1010559.ref029","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.drugalcdep.2014.05.005","article-title":"Prevalence and patterns of smoking, alcohol use, and illicit drug use in young men who have sex with men","volume":"141","author":"ME Newcomb","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"pcbi.1010559.ref030","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.drugalcdep.2015.02.040","article-title":"Latent class analysis of substance use among men who have sex with men in Malaysia: Findings from the Asian Internet MSM Sex Survey","volume":"151","author":"SH Lim","year":"2015","journal-title":"Drug Alcohol Depend"},{"issue":"05","key":"pcbi.1010559.ref031","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4414\/bms.2008.13252","article-title":"Les personnes s\u00e9ropositives ne souffrant d\u2019aucune autre MST et suivant un traitement antir\u00e9troviral efficace ne transmettent pas le VIH par voie sexuelle","volume":"89","author":"P Vernazza","year":"2008","journal-title":"Bull des M\u00e9decins Suisses"},{"issue":"9","key":"pcbi.1010559.ref032","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral Therapy for the Prevention of HIV-1 Transmission","volume":"375","author":"MS Cohen","year":"2016","journal-title":"N Engl J Med"},{"issue":"2","key":"pcbi.1010559.ref033","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/jama.2016.5148","article-title":"Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy","volume":"316","author":"AJ Rodger","year":"2016","journal-title":"JAMA\u2014J Am Med Assoc"}],"updated-by":[{"DOI":"10.1371\/journal.pcbi.1010559","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000}}],"container-title":["PLOS Computational Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1010559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T13:59:22Z","timestamp":1667915962000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1010559"}},"subtitle":[],"editor":[{"given":"Joel O.","family":"Wertheim","sequence":"first","affiliation":[]}],"short-title":[],"issued":{"date-parts":[[2022,10,27]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pcbi.1010559","relation":{},"ISSN":["1553-7358"],"issn-type":[{"value":"1553-7358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,27]]}}}