HIV Incidence Risk Index for MSM (HIRI-MSM)
Screening index identifying HIV-negative men who have sex with men at highest risk of HIV acquisition, derived in two US cohorts (VAX004 and EXPLORE). Score 0–47; a score of 10 or more (sensitivity 84%, specificity 45%) identifies men to evaluate for PrEP and intensive prevention.
Score interpretation
Below the published cut-off of 10.
→ HIV and STI testing every 6–12 months; safer sex counselling; condom promotion; advise on symptoms of acute HIV seroconversion; reassess risk annually or with change in behaviour
At or above the cut-off of 10 (sensitivity 84%, specificity 45% for incident HIV infection).
→ Offer HIV PrEP (tenofovir/emtricitabine daily or event-driven 2-1-1 regimen); confirm HIV-negative status before starting; baseline renal function, Hepatitis B serology; STI screen; 3-monthly HIV and STI testing on PrEP; condom use for STI prevention; assess adherence at every visit
Interpretation bands for the HIRI-MSM. Apply clinical judgement and local guidance.
References
- Smith DK, Pals SL, Herbst JH, Shinde S, Carey JW. Development of a clinical screening index predictive of incident HIV infection among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2012;60(4):421–427.
Related
Curated clinical cross-links plus same-class fallbacks.
- Propranolol (Migraine Prevention) · Beta-Blocker — Migraine Prophylaxis
- Aspirin (Low-Dose — Pre-eclampsia Prevention) · Antiplatelet — Pre-eclampsia Prophylaxis
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Ketoconazole (Adrenal Indication) · Adrenal Steroidogenesis Inhibitor (Antifungal with Adrenal Suppressing Properties)
- Doxycycline 100mg Capsules (Sinusitis — Penicillin Allergy) · Tetracycline antibiotic
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.