WP 60 Identifying STI Risk Profiles Among HIV+ Military Cohort Members Using Multidimensional Scaling Profile Analysis

Wednesday, September 21, 2016
Galleria Exhibit Hall
Grace Macalino, PhD, Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University, Rockville, MD, Morgan Byrne, M.P.H, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Science, Bethesda, MD, Robert Deiss, MD, Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, CA, Anuradha Ganesan, MD, Infectious Disease Clinic, Walter Reed National Military Medical Center, Bethesda, MD, Tahaniyat Lalani, MD, Naval Medical Center Portsmouth, Portsmouth, VA, Christina Schofield, MD, Madigan Army Medical Center, Tacoma, WA, Brian Agan, MD, Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biometrics, Uniformed Services University, Rockville, MD and Jason Okulicz, MD, Infectious Disease Clinical Research Program, San Antonio Military Medical Center, Fort Sam Houston, TX

Background: We were interested in identifying profiles of risk among HIV seropositive DoD beneficiaries using multidimensional scaling profile analysis (MDS), as risk behaviors are often co-occurring. 

Methods:  All risk behavior data were used from surveys between 9/14-2/15. MDS was used to identify the dimensionality of “typical” risk behavior profiles and “atypical” participants. We chose STI risk behaviors a priori to develop profiles. MDS analyses require complete data on relevant variables. Regression analysis was conducted to investigate the effects of atypical individuals vs. prototypical risk groups on incident STIs as well as self-Perceived STI risk. 

Results:  1349 participants completed surveys, 369 participants had complete data for all essential variables (representative of at-risk population), >90% reported MSM behavior. 44% had an incident STI within one year, 36.2% with incident syphilis. Two risk behavior typical profiles were derived from the data—Profile 1 represented participants that engaged in anal sex without a condom, binge drinking, or at-risk drinking in a typical day, while Profile 2 represents no condom use Profile 1 was associated with incident syphilis (OR 2.5 (95% CI (1.2, 4.8)) compared to atypical participants. Compared to atypical participants, Profile 1 participants were less likely to be African American than Caucasian and more likely to be in the Army compared to the Navy. Compared to Atypical participants, Type 2 participants were more likely to be service members in the Marines, Navy, and Other military branch than the Air Force. Profile 1 consistently reported higher rates of medium/high risk (OR 12.5 (95% CI 4.1-37.5)) (OR 17.7 95%CI (4.745-65.94)) compared to both Profile 2 and atypical respectively.

Conclusions:  2 risk profiles were identified, while only 1 was associated with incident syphilis. Additional analyses include identifying other predictive behaviors of STIs and impact of race. Comprehensive profiles can assist in the development of prevention efforts that can target specific populations.