CROI 2015 Program and Abstracts

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Poster Abstracts

networks. Seeds were recruited from community agencies and contacts or through advertisements on mobile smartphone applications or websites. Participants completed a self-administered computer-based survey and a nurse-administered point-of-care HIV test. We also conducted VL and CD4 cell counts for HIV positive participants. Risky sex was defined as condomless anal sex with a known HIV negative or unknown serostatus partner in the past 6 months. We performed multivariate logistic regression using RDS weighted variables to examine factors associated with having an unsuppressed VL ( ≥ 200 copies/mL). Results: We recruited 719 participants, of whom 119 (16.6%) were seeds. The median age was 33 years (IQR 26 - 47). With RDS adjustments, 67.9% identified as Caucasian, 10.9% as Aboriginal, 9.7% as Asian, 6.9% as Latin American and 4.6% as other ethnicities. 53.8% of the sample had a self-reported income of <$15,000 per year. The RDS adjusted HIV prevalence was 23.0%. A total of 36(18.6%) of 199 HIV-positive participants had an unsuppressed VL. Of these, 4 participants had previously undiagnosed HIV infection, 16 were not receiving ART and 16 were receiving ART but were not suppressed. Unsuppressed VL was independently associated with income <$15,000 (adjusted odds ratio [AOR] = 4.26; 95% Confidence Interval [CI] 1.44 – 12.6), use of methamphetamine in the past 6 months (AOR = 6.11; 95% CI 2.43-15.3), non-Caucasian ethnicity (AOR=5.21; 95% CI 2.02-13.3) and risky sex (AOR = 2.12; 95% CI 1.14-7.52). Conclusions: Despite a high prevalence of HIV, few individuals in our sample of MSM had unsuppressed VL. However, participants with unsuppressed VL were also more likely to report risky sex. Our data suggest a current leading edge of HIV transmission among low-income MSM in association with methamphetamine use. 1024 Substance Use, Mental Health, and HIV Risk Behavior Among MSM in Vancouver, Canada Nathan J. Lachowsky 1 ; Zishan Cui 2 ; Asheligh Rich 2 ; Paul Sereda 2 ;Thomas L. Patterson 3 ;Trevor Corneil 1 ; Mark Gilbert 4 ; Eric Roth 5 ; Robert Hogg 6 ; David Moore 1 1 University of British Columbia, Vancouver, Canada; 2 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada; 3 University of California San Diego, San Diego, CA, US; 4 Ontario HIV Treatment Network, Toronto, Canada; 5 University of Victoria, Victoria, Canada; 6 Simon Fraser University, Burnaby, Canada Background: Syndemic factors (e.g., substance use and mental health) are associated with HIV risk among MSM, but evidence examining both is mixed. The objectives of this study were to develop population-weighted estimates of self-reported substance use and doctor-diagnosed mental health conditions among MSM in Vancouver and to determine how these factors were associated with HIV risk. Methods: Participants were sexually active men aged ≥ 16 years recruited using Respondent-Driving Sampling (RDS). Participants completed a self-administered computer-based survey, including substance use in the past 6 months; problem drinking was assessed using Alcohol Use Disorders Identification Test (AUDIT) and depression and anxiety using Hospital Anxiety and Depression Scale (HADS). All analyses were weighted given use of RDS. Manual backward-stepwise multivariate logistic regression was used to examine independent associations with risky sex (defined as unprotected anal intercourse with a known serodiscordant or unknown serostatus partner in the past 6 months). Results: Of 719 participants, 23.0%were HIV-positive, 67.8%were White, and median age was 33 years (IQR 26-47). Over half (52.0%) of MSM reported any lifetime doctor- diagnosed mental health condition (of whom 46.1%were currently receiving treatment): depression 42.2%, anxiety 25.8%, bipolar disorder 5.8%, alcohol dependency 7.0% and other drug dependency 14.7%. Of all MSM, HADS depression scores were borderline for 67.1% and abnormal for 10.3%, HADS anxiety scores were borderline for 37.1% and abnormal for 47.8%, and AUDIT scores indicated harmful use for 5.5% and possible dependence for 7.8%. Substances used include: crystal meth weekly 5.8%, poppers weekly 6.4%, any viagra 16.7%, any LSD 5.5%. One-third of MSM (35.9%) reported risky sex, which was positively associated with greater HADS depression scores (adjusted odds ratio [AOR]= 1.23 [95% confidence interval 1.10-1.38]), weekly crystal meth use (AOR=3.24[1.31-8.05]), weekly poppers use (AOR=3.19[1.53-6.64]), any viagra use (AOR=2.86[1.79- 4.58]), Aboriginal (AOR=2.85[1.53-5.31]) or Latin American (AOR=7.94[3.97-15.89]) vs White ethnicity, and annual income >$30,000 (AOR=1.67[1.12-2.52]). Decreased odds of risky sex were associated with any LSD use (AOR=0.23[0.09-0.56]) and always asking partners their HIV status (AOR=0.33[0.20-0.54]). Conclusions: Mental health conditions were prevalent; depression and substance use were independently associated with risky sex alongside ethnic and income disparities. 1025 Electronic and Online Innovations in Respondent-Driven Sampling Methodology Nathan J. Lachowsky 1 ; Allan Lal 2 ; Zishan Cui 2 ; Asheligh Rich 2 ; Paul Sereda 2 ; Henry Fisher Raymond 3 ; Jamie I. Forrest 1 ; Eric Roth 4 ; Robert Hogg 2 ; David Moore 1 1 University of British Columbia, Vancouver, Canada; 2 British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada; 3 University of California San Francisco, San Francisco, CA, US; 4 University of Victoria, Victoria, Canada Background: HIV research has increasingly employed Respondent-Driven Sampling (RDS) to access and recruit “hidden” populations, such as MSM. Traditional RDS selects “seeds” (initial participants) in-person and provides participants with a limited number of paper coupons for onward recruitment. The objectives of this study were to explore the impact of online and electronic RDS innovations on differences between 1) MSM in recruitment chains of online VS offline seeds and 2) MSMwho redeemed electronic VS paper coupons. Methods: Participants were MSM aged ≥ 16 years recruited using RDS from Feb 2012 – Feb 2014 to complete a self-administered computer-based survey. Seeds were selected online (e.g., Grindr, social media) or offline (e.g., community agency, social group) and recruitment coupons were electronic or paper. All analyses used RDS weights. Manual backward-stepwise multivariate logistic regression was used to examine factors associated with 1) being in a recruitment chain started from an online seed VS not and 2) redeeming an e-coupon VS paper. Results: A sample of 719 MSMwas recruited from 119 seeds (85 online, 34 offline). Of the 600 non-seeds, 283 MSM (47.2%) were in recruitment chains of online seeds, which had smaller network sizes than offline seeds (OR=0.99, p<0.01). MSM from an online seed’s recruitment chain were more likely to be HIV-negative (adjusted odds ratio, AOR=4.18 with [95% Confidence Intervals 2.60-6.71]), be Latin American VS White (AOR=3.69[1.20-11.33]), be an immigrant (refugee or work/student visa) VS born in Canada (AOR=3.88[1.23- 12.27]), have been out for 11-21 VS 1-4 years (AOR=2.45[1.37-4.37]), have a regular partner (AOR=1.75[1.11-2.75]), prefer to bottom VS be versatile (AOR=1.87[1.16-2.99]), and report 201-500 Facebook friends VS >500 (AOR=1.82[1.08-3.07]). Of all participants given coupons (n=644), 75.3% chose only paper, 17.8% chose only e-coupons, and 6.9% chose a mix. MSMwho redeemed an e-coupon to participate (n=93, 11.9%) were more likely to be employed (AOR=2.66[1.26-5.64]), be homeless (AOR=12.25[2.78-53.96]), be out at work (AOR=4.93[1.94-12.53]), be out for 1-4 VS 11-21 years (AOR=2.84[1.22-6.62]), be in a common law relationship / married (AOR=2.76[1.02-7.46]), have no recent anal sex (AOR=6.07[1.80-20.51]), have recent female sexual partners (AOR= 3.03[1.18-7.78]), and be circumcised (AOR=2.60[1.36-4.98]). Conclusions: Innovative use of online seed selection and recruitment e-coupons may assist in reaching MSM who are often omitted in such studies. 1026 Incident Symptomatic Gonorrhea Infection Among MenWho Have Sex With Men, Thailand Marcel E. Curlin 1 ; Sarika Pattanasin 1 ; Pikunchai Luechai 1 ; Anuwat Sriporn 1 ; JarayTongtoyai 1 ; Eileen F. Dunne 1 ;Wichuda Sukwicha 1 ; Oranuch Kongpechsatit 1 ; Pachara Sirivongrangson 2 ;Timothy Holtz 1 1 US Centers for Disease Control and Prevention (CDC), Apo, US; 2 Thai Ministry of Public Health, Nonthaburi, Thailand Background: Neisseria gonorrhoeae (NG) infection may increase the risk of HIV acquisition and transmission among men who have sex with men (MSM). We analyzed NG infection at baseline and factors associated with incident symptomatic NG infection among MSM enrolled in the Bangkok MSM Cohort Study (BMCS). Methods: Sexually-active Thai MSM aged ≥ 18 years from the Bangkok metropolitan area were enrolled in the BMCS during 2006-2010 and followed every 4 months for 3-5 years. At baseline, participants were screened for rectal and urethral NG and Chlamydia trachomatis (CT) infections using nucleic acid amplification testing (NAAT). At every visit, participants answered questions about sexual behaviors in the past four months using computer-assisted self-interview, underwent physical examination, and had specimens

Poster Abstracts

602

CROI 2015