P3.099 Sex Work as an Emerging Risk Factor For HIV Seroconversion Among Injection Drug Users in the SurvUDI Network
Bibliographic record
Abstract
Background Previous analyses of SurvUDI data have shown an emerging positive association between sex work and HIV incidence among injection drug users (IDUs). Objective To characterise the association between sex work and HIV seroconversion among IDUs in the SurvUDI network between 2004 and 2010. Methods Participants who had injected in the past 6 months were recruited across the Province of Quebec and Ottawa, Canada, mainly in harm reduction programmes. They completed a questionnaire and provided saliva for HIV antibody testing. Multiple visits were linked through an encrypted identifying code. The association between sex work (defined as reporting at least one client sex partner in the last six months) and HIV seroconversion was tested with a Cox proportional hazards model. Time-dependent covariables tested as potential confounders were age (< 25 vs. ≥ 25 years), sex, cocaine as the most often injected drug, injection with strangers, injection with a needle previously used by someone else, and consistent condom use (defined as always using a condom for vaginal and anal sex with casual, client and paid sex partners, with no sex partners as reference category). Covariables were retained as confounders when they changed the adjusted hazard ratio (AHR) by > 10% when removed from the complete model. Results Sixty-four HIV seroconversions were observed during 3020 person-years of follow-up. In the final multivariate model, HIV incidence was significantly associated with sex work (AHR = 1.94, 95% CI: 1.09–3.46, p < 0.03) and injection with a needle previously used by someone else (AHR = 3.13, 95% CI: 1.88–5.22, p < 0.0001), adjusted for age. Sex did not modify the association with sex work. Conclusion Sex work is independently associated with HIV incidence among IDUs. Further studies are needed to understand whether this association is related to sexual transmission or if sex work is an intermediate variable between other unknown vulnerability factors and HIV transmission.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".