CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

collected for HIV testing. Symptomatic participants (i.e. men with urethral or anal discharge, dysuria or rectal pain) were tested for NG infection by NAAT and Gram stain from rectal or urethral specimens. Syphilis testing was performed annually. We calculated NG incidence per 100 Person-Years (PY) by survival analysis, and determined factors associated with NG infection using Cox regression. Results: Among 1,595 participants who had a specimen at enrollment, the prevalence of rectal and urethral NG was 6.1% and 1.8%, respectively. Of the 1,450 participants for whom data were available for at least one follow-up visit, 119 had NG infection, including 97 (81.5%) with urethral infection and 22 (18.5%) with rectal infection. Forty-one (34.4%) participants had repeat infections at either site, with a median time to repeat infection of 294 days (Interquartile range: 175-461 days). The incidence rate of NG infection was 2.0 per 100 PY. Significant factors associated with incident NG infection were completion of 60 months of follow-up (Adjusted Hazard Ratio, AHR, 1.7), being circumcised at baseline (AHR 0.4), report of condomless insertive-only anal intercourse at baseline (AHR 2.5), report of a casual sex encounter at home at baseline (AHR 1.7), prevalent or incident HIV infection (AHR 1.6), prevalent or incident syphilis infection (AHR 1.8), and CT infection at baseline (AHR 1.9). Conclusions: Incident NG infection among BMCS participants was associated with high risk sexual behaviors, co-infection with HIV or other STIs, and being uncircumcised. Repeat NG infections were common and imply ongoing high risk behavior and STI/HIV transmission risk within this population.

WEDNESDAY, FEBRUARY 25, 2015 Session P-W4 Poster Session

Poster Hall

2:30 pm– 4:00 pm Transmission Through Needles and Heterosexual Contact 1027 Occupationally Acquired HIV Infection by Healthcare Personnel–United States, 1985-2013 M Patricia Joyce ; David Kuhar; JohnT. Brooks US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US

Background: Since 1991, CDC has investigated all cases of HIV infection reported as acquired occupationally by healthcare personnel (HCP). We reviewed CDC data to update the last report on this subject from 2003, noting that since 1987 CDC has recommended use of standard precautions to prevent HIV exposures and since 1990 occupational post- exposure prophylaxis with antiretrovirals to prevent infections. Methods: Investigations were led by state HIV surveillance staff with CDC assistance. HCP were defined as anyone working in healthcare settings, including but not limited to physicians, nurses, laboratory personnel, students, trainees, and support staff whether paid or not paid. A confirmed case of infection was defined as occupationally acquired if seroconversion in the HCP was temporally related to a specific exposure to a HIV-positive source and no other temporally related HIV exposures had occurred. A possible case was defined as an infection in a HCP found to be HIV seropositive and whose job duties may have exposed them to HIV but who lacked both a known and documented workplace exposure and any nonoccupational risk. Results: During 1985-2013, 58 confirmed (figure) and 150 possible cases of occupationally acquired HIV by HCP were reported to the CDC. Among the 58 confirmed cases, the routes of exposure were percutaneous puncture or cut (n=49), mucocutaneous exposure (n=5), both percutaneous and mucocutaneous exposure (n=2), and unknown (n=2). The exposures were to HIV-infected blood (n=49), concentrated virus in laboratories (n=4), visibly bloody body fluid (n=1), and unspecified body fluids (n=4). Since 1999, only one confirmed case has been reported.

Poster Abstracts

Conclusions: Confirmed cases of occupationally acquired HIV require documented seroconversion temporally related to a specific exposure. Occupational acquisition of HIV infection by HCP is now exceedingly rare . 1028 Analyzing Trends in HIV Risks for Injection Drug Users by Respondent-Driven Sampling Kathleen A. Brady ;Tanner B. Nassau; Jennifer Shinefeld; Catherine Mezzacappa Philadelphia Department of Public Health, Philadelphia, PA, US Background: Philadelphia new HIV cases among IDU declined 80% from 2006-2013 with only 5% of new HIV cases in 2013 classified as IDU. We analyzed National HIV Behavioral Surveillance (NHBS) data among IDU to determine predictors of sharing injection equipment among IDUs and to evaluate trends to illuminate both past successes and future potential means to reduce HIV incidence among IDUs.

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CROI 2015