{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:39:37Z","timestamp":1790800777270,"version":"4.1.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R03AI140922"],"award-info":[{"award-number":["R03AI140922"]}],"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":["K01AI116298"],"award-info":[{"award-number":["K01AI116298"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007813","name":"Center for AIDS Research, University of Washington","doi-asserted-by":"publisher","award":["P30 AI027757"],"award-info":[{"award-number":["P30 AI027757"]}],"id":[{"id":"10.13039\/100007813","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["F31HD097841"],"award-info":[{"award-number":["F31HD097841"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["F31HD105513"],"award-info":[{"award-number":["F31HD105513"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Clinical risk score tools require validation in diverse settings and populations before they are widely implemented. We aimed to externally validate an HIV risk assessment tool for predicting HIV acquisition among pregnant and postpartum women. In the context of prevention of mother-to-child transmission programs, risk score tools could be used to prioritize retesting efforts and delivery of pre-exposure prophylaxis (PrEP) to pregnant and postpartum women most at risk for HIV acquisition while minimizing unnecessary perinatal exposure.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Data from women enrolled in a cross-sectional study of programmatic HIV retesting and\/or receiving maternal and child health care services at five facilities in Western Kenya were used to validate the predictive ability of a simplified risk score previously developed for pregnant\/postpartum women. Incident HIV infections were defined as new HIV diagnoses following confirmed negative or unknown status during pregnancy. Predictive performance was assessed using the area under the receiver operating characteristic curve (AUC) and Brier score.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Among 1266 women with 35 incident HIV infections, we found an AUC for predicting HIV acquisition of 0.60 (95% CI, 0.51, 0.69), with a Brier score of 0.27. A risk score &gt;6 was associated with a 2.9-fold increase in the odds of HIV acquisition (95% CI, 1.48, 5.70; p = 0.002) vs scores \u22646. Women with risk scores &gt;6 were 27% (346\/1266) of the population but accounted for 52% of HIV acquisitions. Syphilis, age at sexual debut, and unknown partner HIV status were significantly associated with increased risk of HIV in this cohort.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>The simplified risk score performed moderately at predicting risk of HIV acquisition in this population of pregnant and postpartum women and may be useful to guide PrEP use or counseling.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0306992","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T17:36:42Z","timestamp":1720633002000},"page":"e0306992","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating the performance of a risk assessment score tool to predict HIV acquisition among pregnant and postpartum women in Kenya"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-3839","authenticated-orcid":true,"given":"Nok","family":"Chhun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire W.","family":"Rothschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monalisa","family":"Penumetsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Matemo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peninah","family":"Kithao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbra A.","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"John-Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kinuthia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-7706","authenticated-orcid":true,"given":"Alison L.","family":"Drake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"issue":"3","key":"pone.0306992.ref001","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/QAI.0000000000000974","article-title":"An Empiric HIV Risk Scoring Tool to Predict HIV-1 Acquisition in African Women.","volume":"72","author":"JE Balkus","year":"2016","journal-title":"J Acquir Immune Defic Syndr."},{"issue":"3","key":"pone.0306992.ref002","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/QAI.0b013e31827e622d","article-title":"An empiric risk scoring tool for identifying high-risk heterosexual HIV-1-serodiscordant couples for targeted HIV-1 prevention.","volume":"62","author":"EM Kahle","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"9","key":"pone.0306992.ref003","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1097\/OLQ.0b013e3181a9cc41","article-title":"Prediction of HIV acquisition among men who have sex with men.","volume":"36","author":"TW Menza","year":"2009","journal-title":"Sex Transm Dis."},{"issue":"4","key":"pone.0306992.ref004","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/QAI.0b013e318256b2f6","article-title":"Development of a clinical screening index predictive of incident HIV infection among men who have sex with men in the United States","volume":"60","author":"DK 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