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Table 3 PAR of risk factors including UAI by sexual position

From: Using population attributable risk to choose HIV prevention strategies in men who have sex with men

Risk factor

PAR (95% CI)

Crude model

PAR (95% CI)

Adjusted model

Average annual

number of HIV cases

Average lifetime HIV costs

(range)(1)AUD$million, 2010 dollars

    

1% discounting

3% discounting

5% discounting

All risk factors

 

0.94 (0.82,0.98)

658

448 (416-487)

283 (257-314)

186 (165-212)

UAI by sexual position (2)

0.78 (0.69,0.89)

0.73 (0.66,0.85)

511

348 (323-378)

220 (200-244)

144 (128-165)

Insertive UAI only (strategic positioning)

0.12 (0.07,0.19)

0.04 (0.02,0.10)

28

19 (18-21)

12 (11-13)

8 (7-9)

Receptive UAI

0.66 (0.54,0.76)

0.69 (0.58,0.78)

483

329 (305-357)

208 (189-231)

136 (121-156)

Receptive with withdrawal

0.21 (0.16,0.28)

0.28 (0.20,0.37)

196

134 (124-145)

84 (77-94)

55 (49-63)

Receptive with ejaculation

0.45 (0.35,0.55)

0.41 (0.32,0.51)

287

196 (182-212)

123 (112-137)

81 (72-92)

Circumcision status (3)

      

Uncircumcision

0.08 (0.04,0.16)

0.07 (0.03,0.15)

49

33 (31-36)

21 (19-23)

14 (12-16)

Number of sexual partners

      

10+ casual sexual partners in the last 6 m

0.26 (0.18,0.36)

0.25 (0.14,0.42)

175

119 (111-129)

75 (68-84)

49 (44-56)

STIs (4)

      

Anal warts between study visits

0.14 (0.10,0.18)

0.12 (0.08,0.18)

84

57 (53-62)

36 (33-40)

24 (21-27)

Anal gonorrhoea at study visit

0.06 (0.04,0.07)

0.02 (0.01,0.03)

14

10 (9-10)

6 (5-7)

4 (4-5)

  1. CI = Confidence interval, PAR = population attributable risk, UAI = Unprotected anal intercourse, m = months
  2. 1. The average healthcare costs incurred from HIV seroconversions associated with specific risk factors were calculated by multiplying the PAR percent for each specific risk factor, by the 700 HIV infections associated with male homosexual exposure, by the average healthcare costs per HIV-infected person. We performed sensitivity analyses by rate of discounting and according to the bounds in delays in durations of time between infection and diagnoses and commencement of antiretroviral treatment but calculations were based on the best estimated PAR of the risk factors and not the 95% CI of the PAR.
  3. 2. Adapted from Jin et al [8]
  4. 3. Adapted from Templeton et al [9]
  5. 4. Adapted from Jin et al [21]