CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Even with generous, ‘best-case scenario’ estimates, few Atlanta MSM will achieve protection from HIV with PrEP given the significant barriers described in the PrEP Care Continuum. Each step of the proposed continuum represents a critical intervention point. Novel strategies for PrEP delivery are needed to achieve the necessary effectiveness for MSM at risk of HIV. 974 Provider Prescription of Preexposure Prophylaxis (PrEP) for HIV Infection Shikha Garg ; JohnWeiser; Linda Beer; Jacek Skarbinski US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US Background: PrEP with daily oral fixed-dose combination tenofovir/emtricitabine is safe and effective in reducing the risk of HIV acquisition. While official PrEP guidelines were only released in 2014, interim guidance for use of PrEP in certain high-risk groups has been available since 2011. Data on provider uptake of interim PrEP guidance are lacking. Methods: U.S. care providers were surveyed during June 2013–January 2014 to estimate the weighted prevalence of ever prescribing PrEP and to describe patients for whom PrEP was prescribed. Physicians, nurse practitioners, or physician assistants who had completed training and who provided care to HIV-infected patients were eligible for the survey. We used prevalence ratios (aPR) estimated frommultivariable logistic regression to investigate the association between provider characteristics, including demographic factors and HIV care experience, and PrEP prescription. Analyses accounted for clustering, unequal selection probabilities, and non-response. Results: Surveys were completed by 1234 of 2023 eligible providers (adjusted response rate 64%). Among HIV care providers who responded to questions about PrEP prescription and who also reported providing care to HIV-infected and non-HIV-infected patients (n=935), 26% (95% confidence interval: 20–31) ever prescribed PrEP. Among providers prescribing PrEP, 74% prescribed to men who have sex with men, 23% to men who have sex with women, 30% to women who have sex with men, 23% to uninfected partners in serodiscordant couples trying to conceive, and 1% to injection drug users. Providing direct and continuous care to greater than 50 HIV-infected patients, male gender and gay/ lesbian/bisexual orientation were all provider characteristics independently associated with PrEP prescription (Table).

Poster Abstracts

Conclusions: PrEP is a powerful HIV prevention tool, yet at baseline, only one-fourth of U.S. providers who care for both HIV-infected and non-HIV-infected patients reported ever prescribing PrEP based on interim guidance. Although provider uptake may increase with the release of formal PrEP guidance in 2014, targeted efforts should be made to increase PrEP prescription by providers who care for few or no HIV-infected patients and who may have limited experience prescribing antiretroviral therapy.

TUESDAY, FEBRUARY 24, 2015 Session P-V4 Poster Session

Poster Hall

2:30 pm– 4:00 pm PrEP: Measures and Correlates of Adherence 975 Urine Assay for Tenofovir to Monitor Adherence to Tenofovir-Emtricitabine as PrEP

Helen C. Koenig 1 ; KaramMounzer 1 ; GiffinW. Daughtridge 1 ; Caroline E. Sloan 1 ; Linden Lalley-Chareczko 2 ; Ganesh Moorthy 3 ; S. Caitlin Conyngham 2 ; Elizabeth Ketner 1 ; Luis J. Montaner 4 ; PabloTebas 1 1 Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, US; 2 Philadelphia FIGHT, Philadelphia, PA, US; 3 The Children’s Hospital of Philadelphia, Philadelphia, PA, US; 4 Wistar Institute, Philadelphia, PA, US Background: Tenofovir-Emtricitabine (TDF/FTC) is approved for pre-exposure prophylaxis (PrEP) for HIV infection. Adherence is critical for the success of PrEP, but current adherence measurements (self-report) and plasma tenofovir (TFV) levels are inadequate tools for real time adherence monitoring. Our goal was to develop and validate a urine assay for the measurement of TFV levels to objectively monitor adherence to PrEP.

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CROI 2015