CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Surveillance data indicate that the time from HIV infection to ART initiation has been substantially reduced among newly diagnosed NYC PWH. Slower improvements in the median CD4 at diagnosis relative to that at ART initiation highlight the need for additional progress in earlier HIV diagnosis and care linkage. Use of CD4 as a time-sensitive metric can complement the HIV care continuum and help target and evaluate efforts aimed at earlier diagnosis and ART initiation. 1002 Return to HIV-Related Medical Care After a Hiatus of ≥ 1 Year, New York State, 2013 Carol-Ann Swain 4 ; Daniel Gordon 4 ; Jessica L. Simpson 3 ; Bridget J. Anderson 4 ; Bruce D. Agins 1 ; Lou C. Smith 2 1 Office of the Medical Director, New York State Department of Health, New York, NY, US; 2 US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US; 3 Division of Epidemiology, Evaluation and Research, New York State Department of Health, Albany, NY, US; 4 New York State Department of Health, Albany, NY, US Background: Engagement in HIV medical care results in greater access to antiretroviral therapy, faster HIV viral suppression and better health outcomes among HIV positive persons. In New York State (NYS) one third of HIV-diagnosed persons had no evidence of care in 2012. The study goal was to identify factors associated with receipt of HIV-related medical care in 2013 among a cohort of persons with no laboratory indication of care in 2012. Methods: NYS HIV surveillance data as of April 2014 were restricted to persons aged ≥ 13 years, diagnosed 2006-2010 in NYS, linked to care within one year of diagnosis and living as of December 2013. Out of care status was defined as having no reported HIV-related test in 2012; return to care was defined as having an HIV-related test in 2013. Risk ratios (RR) and 95% confidence intervals (CI) for return to care were calculated using a log binomial multivariate model adjusted for: viral load at last test, race/ethnicity, age, HIV transmission risk, year of diagnosis, year of last reported test and country of birth. Results: 15,261 persons met the inclusion criteria; 2,997 (20%) had no care in 2012. The no-care group was predominately male (75%), non-Hispanic black (47%), and had MSM (men who have sex with men) transmission risk (45%). 55% of the no-care group had had a test in 2010 or 2011, but 11% had no test after 2007. 13%met the CDC AIDS case definition (CD4 count <200 cells/mm3) at last test before reengagement (Figure) and 62%were not virally suppressed (>200 copies of HIV/ml). 535 (18%) persons returned to care in 2013. In multivariate analysis, the likelihood of returning to care was higher among US-born persons (RR 1.61 (95% CI: 1.29-2.01)) and significantly lower for persons whose last test occurred in earlier years (e.g., compared to 2011, 2010 RR 0.5 (95% CI: 0.41-0.62), 2009 RR 0.39 (95% CI:0.30-0.52), 2008 RR 0.22 (95% CI:0.15-0.32)).

Poster Abstracts

Conclusions: A substantial proportion of persons diagnosed 2006-2010 were out of care in 2012. One third had a CD4 count <350 at last test, yet few had evidence of re- engagement in 2013. Strategies to address attrition from care as well as re-engagement are needed. Persons with recent care may be particularly open to re-engagement efforts, suggesting the benefit of prompt action to return them to care.

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CROI 2015