CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: We established a multivariate model for predicting risk of AEH infection in a cohort of mostly high-risk MSM undergoing HIV screening in central San Diego. We found that while URAI alone was associated with slightly increased AEH risk, the combination of URAI and number of male partners may be a more useful predictor of AEH. Such results may help to better focus and prioritize prevention resources in similar US metropolitan populations. 1022 Influence of Voluntary Repeat HIV Testing on Sexual Risk Behavior Among MSM Martin Hoenigl ; Davey M. Smith; Christy M. Anderson; Nella L. Green; Sanjay Mehta; Susan J. Little University of California San Diego, San Diego, CA, US Background: Currently, the CDC recommends that high-risk groups, like sexually active men who have sex with men (MSM), receive HIV testing and counseling every 3 to 6 months. We hypothesized that access to free and convenient HIV nucleic acid testing (NAT) may serve as a driver to increase high risk behaviors in HIV uninfected persons over time. Methods: We evaluated MSM individuals who enrolled in the “Early Test”, a community-based, confidential HIV screening program that includes NAT in San Diego, CA, between April 2008 and July 2014. We compared the baseline risk-taking behaviors in the 12 months prior to testing between repeat and once-only testers and then analyzed change in risk behaviors over time (i.e. dose response for testing) in repeat testers using McNemara test. Results: After exclusion of testers diagnosed with HIV at the first test, 8604 MSM were included in the analysis: 5402 (63%) single-testers and 3202 (37%) repeat-testers. At baseline, repeat-testers reported significantly more male partners and more unprotected receptive anal intercourse (URAI), when compared to single-testers (all p<0.001). In 2466 repeat-testers (median time between first and last test 723 days, IQR 410-1205; individuals with <183 days between tests were excluded) risk behaviors reported at the first and last test were compared; see table. Evaluating for a dose-response of risk behaviors by number of tests, MSM with 2-3 tests (n=1387, median time between first/last test 503 days) were compared to those with 4-5 tests (n=571, 844 days) and those with >5 tests (n=508, 1333 days). The reported risk increased proportional with number of tests: a. URAI with a HIV positive man (2-3 tests= +2.75% absolute [+69.1% relative]; 4-5 tests=+3.48% [+57.6%], >5 tests=+9.47% [+423%]), b. URAI and 10 or more male partners (2-3 tests=+2.38% [+9.8%], 4-5 tests +4.82% [+19.6%], >5 tests=+5.08% [+17.6%]), c. non-intravenous drug usage (2-3 tests=+6.7% [+29.1%], 4-5 tests=+5.95% [+25.4%], >5 tests=+13.19% [+69.8%]), and d. shared needles with drug use (2-3 tests=+1.87% [+170%], 4-5 tests=+1.52% [+79.2%], >5 tests=+3.23% [+734%]).

Poster Abstracts

Conclusions: San Diego MSM repeatedly screened for HIV with combined serologic and NAT, practice higher sexual risk behavior than once-only testers. These results support the hypothesis that testing may reinforce ongoing high-risk behaviors in the absence of negative feedback (i.e., positive HIV test). Future studies will be needed to assess causality between testing and change in risk behavior. 1023 HIV-Positive MSMWith Unsuppressed Viral Load Are More Likely to Engage in Risky Sex: Vancouver, Canada David Moore 1 ; Zishan Cui 1 ; Nathan J. Lachowsky 1 ; Henry F. Raymond 2 ; Eric Roth 3 ; Asheligh Rich 1 ; Paul Sereda 1 ; Julio Montaner 1 ; Mark Gilbert 4 ; Robert Hogg 1 1 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada; 2 San Francisco Department of Public Health, San Francisco, CA, US; 3 University of Victoria, Victoria, Canada; 4 BC Centre for Disease Control, Vancouver, Canada Background: Treatment as Prevention has been actively promoted in British Columbia (BC) as an approach to controlling the local HIV epidemic. We examined the prevalence and characteristics of HIV positive participants with unsuppressed viral load (VL) in a sample of MSM from Vancouver, BC. Methods: Participants were aged ≥ 16 years, male-identified, had sex with a man in the past six months and enrolled from February 25, 2012 – February 28, 2014. Individuals were recruited using respondent driven sampling (RDS) through referrals from peers who previously participated with multiple waves of recruitment to reach different social

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CROI 2015