CROI 2015 Program and Abstracts

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Oral Abstracts

among Hispanics (49%), followed by Asians (48%), whites (47%), and blacks (42%), and lowest among American Indians/Alaska Native (30%). Retention in care was similar but viral suppression was lower among women who inject drugs (42%) compared with heterosexual women (46%). Conclusions: Almost half of women living with HIV were not in regular HIV care, and retention in care and viral suppression differed by race/ethnicity and age. Black-white differences in viral suppression among women are smaller than previously observed for men and women combined. Improvements in care and treatment outcomes are needed for all women, with particular focus on younger women.

101 Time Above 1500 Copies/ml: A Viral-Load Measure for Assessing Transmission Risk of HIV-Positive Patients in Care Lytt I. Gardner 1 ; Gary Marks 1 ; Charles Rose 1 ; Meg Sullivan 2 ; Susan Holman 3 ; Jeanne Keruly 4 ; Anne Zinski 5 ; Allan Rodriguez 6 ;Thomas Giordano 7

1 Centers for Disease Control and Prevention, Atlanta, GA, US; 2 Boston University School of Medicine, Boston, MA, US; 3 Colleges of Medicine and Nursing, SUNY Downstate Medical Center, Brooklyn, NY, US; 4 Johns Hopkins University School of Medicine, Baltimore, MD, US; 5 University of Alabama at Birmingham, Birmingham, AL, US; 6 Miller School of Medicine, University of Miami, Miami, FL, US; 7 Baylor College of Medicine, Houston, TX, US Background: HIV-positive persons aware of their serostatus account for about 50% of HIV transmissions. As entry and retention in care improves, proportionally more of these transmissions will come from HIV patients in care. We assessed the HIV transmission potential of patients in care by examining the amount of person-time (PT) they spend above a viral load (VL) threshold that increases risk for transmission. Methods: The analysis included 14,532 HIV patients in six HIV clinics in the U.S. from April 1, 2009 to March 31, 2013. We examined HIV transmission potential by using longitudinal cohort data on VLs and amount of PT spent above a VL threshold (1500 copies/ml) that increases risk for transmission. Eligible patients had to have ≥ 30 days between their first and last VL test (total observation time). Consecutive VLs and the duration between themwere used to generate PT: when two consecutive results were ≤ 1500 copies, then all PT was below the threshold; when two consecutive results were >1500 copies, then all PT was above the threshold; when one result was above and the other one below the threshold, then PT was estimated based on the magnitude of the difference in the two VLs and the extent to which the larger VL exceeded the 1500 copies/ml threshold. Poisson regression with robust standard errors was used to estimate the rate (percent) of PT above the threshold. A multivariable model of time above the 1500 copies threshold controlled for demographic and clinical predictors. Results: Overall, the HIV VL exceeded 1500 copies/ml during 23% of patients’ observation time (average, 84 days per person, per year); 54% of the patients had one or more VLs above 1500. In the multivariable model, the percentage of PT above the 1500 threshold was significantly higher among: patients aged 16 to 39 (32%) and 40 to 49 (23%) vs. 50+ years (16%) ; black (26%) vs. white (16%) patients; those who injected drugs (26%) vs. those who did not (23%); patients with an initial VL >1500 copies/ml (51%) vs. <1500

Oral Abstracts

copies/ml (10%); and heterosexual men (24%) and women (25%) vs. MSM (20%).

Conclusions: Several subgroups of HIV-positive patients in care spent a quarter or more of their time with VLs above 1500 copies/ml, putting them above the threshold for potentially transmitting HIV to others. Efforts by HIV clinicians and patients to maximize the duration of time with VL below 1500 copies/ml will reduce the risk of HIV transmission. 102 Incidence and Risk Factors for Sexual Assault Among MSM and YoungWomen in Coastal Kenya Adrian D. Smith 1 ; Sam Rogers 1 ; ElizabethWahome 2 ; Marianne Darwinkel 2 ; Susan M. Graham 3 ; Eduard J. Sanders 2 1 Nuffield Department of Population Health, Oxford, United Kingdom; 2 Centre for Geographic Medicine Research – Coast, Kilifi, Kenya; 3 University of Washington, Seattle, WA, US Background: Experience of rape presents direct and indirect risks for HIV transmission. Sex workers and men who have sex with men (MSM) in Africa are widely criminalized and may experience discrimination in interactions with public and organised society. Methods: Data were from cohorts of HIV-negative and HIV-positive adults in Coastal Kenya since 2005. Follow-up included periodic risk behaviour assessment, including occurance of rape in the prior 3 months. Incidence of first rape was estimated for male and female participants separately. We estimated adjusted odds ratios (AOR) of rape for

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CROI 2015