Estimated HIV acquisition risk if source is viraemic, by population group
| Table 6. Risk of HIV acquisition by exposure event with an HIV viraemic source: Australian-born heterosexual population who do not inject drugs | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Exposure event | |||||||||
| SOURCE: HIV infection and viraemia rate per 1000 | RAI ejaculate | RAI no ejaculate or withdrawal | IAI uncircumcised | IAI circumcised | RVI | IVI | Shared injecting equipment | Mucous membrane /non intact skin | Occupational needle stick injury |
| Heterosexual male: 0.35 | 1:200,000 | 1:400,000 | 1:3,000,000 | 1:2,000,000 | 1:1,000,000 | ||||
| Heterosexual female: 0.04 | 1:4,000,000 | 1:20,000,000 | 1:60,000,000 | 1:25,000,000 | 1:11,000,000 | ||||
IAI: insertive anal intercourse
IVI: insertive vaginal intercourse
RAI: receptive anal intercourse
RVI: receptive vaginal intercourse
| Table 7. Risk of HIV acquisition by exposure event with an HIV viraemic source: non-Australian heterosexual population who do not inject drugs | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Exposure event | |||||||||
| SOURCE: HIV infection and viraemia rate/1000 | RAI ejaculate | RAI no ejaculate/ withdrawal | IAI uncircumcised | IAI circumcised | RVI | IVI | Shared injecting equipment | Mucous membrane /non intact skin | Occupational needle stick injury |
| Latin American male: 1.22 | 1:50,000 | 1:100,000 | 1:1,000,000 | 1:800,000 | 1:300,000 |
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| Latin American female: 1.22 | 1:100,000 | 1:700,000 | 1:2,000,000 | 1:800,000 | 1:300,000 | ||||
| Sub-Saharan male: 1.0 | 1:70,000 | 1:100,000 | 1:1,000,000 | 1:1,000,000 | 1:400,000 | ||||
| Sub-Saharan female: 1.0 | 1:100,000 | 1:900,000 | 1:2,000,000 | 1:1,000,000 | 1:400,000 | ||||
| South-East Asian male: 1.05 | 1:60,000 | 1:100,000 | 1:1,100,000 | 1:1,000,000 | 1:400,000 | ||||
| South-East Asian female: 1.05 | 1:100,000 | 1:900,000 | 1:2,000,000 | 1:1,000,000 | 1:400,000 | ||||
| Table 8. Risk of HIV acquisition by exposure event with an HIV viraemic source: heterosexual people who inject drugs population | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Exposure event | |||||||||
| SOURCE: HIV infection and viraemia rate per 1000 | RAI ejaculate | RAI no ejaculate/ withdrawal | IAI uncircumcised | IAI circumcised | RVI | IVI | Shared injecting equipment | Mucous membrane /non intact skin | Occupational needle stick injury |
| Male: 2.45 | 1:20,000 | 1:60,000 | 1:500,000 | 1:50,000 | 1:400,000 | 1:170,000 |
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| Female: 2.45 | 1:60,000 | 1:300,000 | 1:1,000,000 | 1:50,000 | 1:400,000 | 1:170,000 |
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| Table 9. Risk of HIV acquisition by exposure event with an HIV viraemic source: population who do not inject drugs and MSM who inject drugs | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Exposure event | |||||||||
| SOURCE: HIV infection and viraemia rate/1000 | RAI ejaculate | RAI no ejaculate/ withdrawal | IAI uncircumcised | IAI circumcised | RVI | IVI | Shared injecting equipment | Mucous membrane /non intact skin | Occupational needle stick injury |
| MSM: 11.68 | 1:5,000 | 1:10,000 | 1:13,000 | 1:70,000 | 1:100,000 | 1:80,000 | 1:30,000 | ||
| MSM PWID: 156.45 | 1:400 | 1:900 | 1:1,000 | 1:5,000 | 1:7,000 | 1:700 | 1:6000 | 1:2,000 | |
A viraemic person is defined as a person with HIV with a viral load of 200 copies/mL or above
Ejaculate is defined as ejaculation inside vagina or anus of the person presenting for PEP
Withdrawal is defined as the withdrawal of penis before ejaculation inside vagina or anus of the person presenting for PEP
Uncircumcised or circumcised refers to the circumcision status of the person presenting for PEP.
Note:
The viraemia rate per 1000 for Australian MSM who inject drugs was calculated as follows:
- Estimated MSM population = 132,203 48
- Estimated MSM population who inject drugs = 6,21349
- HIV seroprevalence in MSM PWID is 44.7% = 2,777 49
- 79% (2193) of MSM PWID who have HIV are virally suppressed = 584 not virally suppressed 49
- 14% MSM who inject drugs are undiagnosed and therefore viraemic = 388
- Total number of MSM who inject drugs who have HIV infection and are viraemic = 584 (diagnosed but not virally suppressed) + 388 (undiagnosed and therefore viraemic) = 972
- 972 not virally suppressed/total population of 6213 MSM who inject drugs = 972/6213 X 1000 = viraemic rate of 156.44 per 1000 Australian MSM who inject drugs
