CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

THURSDAY, FEBRUARY 26, 2015 Session P-S1 Poster Session

Poster Hall

2:30 pm– 4:00 pm Access and Engagement 850 Trends in Healthcare Access and HIV Risk Behaviors—African AmericanWomen, 2006-2013 Wade Ivy ; Gabriela Paz-Bailey US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US

Background: In 2010, African American women accounted for 29% of the estimated new HIV infections among adult and adolescent African Americans in the US, a 21% decrease since 2008. The factors that contributed to this decrease are unknown; however, we hypothesized that improvements in healthcare access and socioeconomic factors may have contributed to this reduction. Methods: We analyzed data from three cycles of the National HIV Behavioral Surveillance system (2006, 2010, and 2013). Heterosexuals of low socioeconomic status or who were residents of census tracts with high rates of poverty were surveyed from over 20 US cities with high prevalence of AIDS using respondent-driven sampling and venue-based sampling, and asked to complete an HIV test. We analyzed data from African American women living at or below the poverty threshold using GEE to determine differences in access to healthcare and risk behaviors over time, controlling for education and city of residence. Models were run separately using each of the variables under investigation as outcomes. Results: Data from 11,065 African American women were analyzed. Significant increases were found in the percentage of women who reported ever having an HIV test (78%, 84% and 89%, in 2006, 2010 and 2013, respectively; p<0.001), having current health insurance (60%, 65% and 74%, respectively; p<0.001), and recently (past 12 months) visiting a healthcare provider (74%, 77% and 84%, respectively; p<0.001). The percentage of women who reported being unemployed decreased (47%, 47% to 41%, respectively, p<0.001), as did those reporting an annual income of less than $10,000 (73%, 75% and 63%, respectively, p<0.001), and those reporting recent injection drug use (6%, 3% and 3%; p<0.001). However, behaviors that facilitate HIV transmission increased from 2006 to 2013. The percentage of women who reported condomless vaginal sex at last sex (78%, 81% and 83%; p<0.001), condomless anal sex at last sex (8%, 13% and 32%; p<0.001), or 3 or more sex partners in the past 12 months (41%, 46% and 46%; p<0.001) increased significantly over time. Conclusions: From 2006 to 2013, improvements in access to healthcare, HIV testing, and socioeconomic factors and reductions in injection drug use were reported by African American women. However, the percentage of women reporting high-risk sexual behaviors increased over time. More research is needed to understand the factors that contribute to the recent decline in new HIV infections among African American women. 851 Engagement in the HIV Care Continuum Among Female Sex Workers in Lilongwe, Malawi Kathryn E. Lancaster 1 ;Thandie Lungu 3 ; Mina C. Hosseinipour 3 ; Katy Chadwick 2 ; Zoe Dibb 2 ;Vivian F. Go 1 ; BrianW. Pence 1 ; Kimberly A. Powers 1 ; Irving F. Hoffman 1 ;William C. Miller 1 1 University of North Carolina, Chapel Hill, NC, US; 2 Theatre for a Change, Lilongwe, Malawi; 3 University of North Carolina Project–Malawi, Lilongwe, Malawi Background: Female sex workers (FSW) are a key population at great risk for HIV acquisition and transmission within the generalized epidemics of sub-Saharan Africa. This study documents FSW engagement in the HIV care continuum in Lilongwe, Malawi, where the HIV prevalence among FSW is among the highest globally. Methods: In July and August 2014, we recruited 200 FSW in Lilongwe, Malawi using venue-based sampling. FSWwho were ≥ 18 years and reported receiving money in exchange for sex in the past 12 months participated in a biological and behavioral survey to assess their engagement in the HIV care continuum. Seropositive FSW, identified using HIV rapid testing, received PIMA CD4 counts and HIV-1 RNA levels using dried blood spots. We estimated proportions for HV seroprevalence, previous HIV diagnosis (self-report), linkage to HIV care (self-report of ever having seen an HIV care provider), current ART status (self-report), and viral load suppression ( ≤ 5000 copies/ml). Results: HIV seroprevalence was 69% (n=138). Of all the HIV-infected FSW, 20% (Figure 1) were newly diagnosed (n=20 (15%) previously tested negative; n=7 (5%) never tested or never received results). Among newly diagnosed FSW that previously tested negative, the median time since last HIV test was 11 months (IQR: 3-17). The median CD4 among all newly diagnosed FSWwas 464 cells/mm 3 (IQR: 276-632). 85% of previously HIV-diagnosed FSW reported linkage to care, representing 68% of all HIV-infected FSW. Among all HIV-infected FSW, 49%were not on ART with a median CD4 of 478 cells/mm 3 (IQR: 321-656). 74% of previously diagnosed and linked to care FSWwere currently receiving ART, representing 51% of all HIV-infected FSW. Among the 51% of all HIV-infected FSW on ART, 86% (n=60) were virally suppressed and 67% (n=48) reported never skipping pills within the prior month.

Poster Abstracts

514

CROI 2015