CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

1032 HIV and STIs Among Transgendered Populations: Four Country Survey From Central America David Ham 1 ; SannyY. Northbrook 2 ; Sonia Morales-Miranda 3 ; Maria Elena Guardado 4 ; Mary Kamb 1 1 US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US; 2 CDC Central America Region, Guatemala City, Guatemala; 3 HIV Unit of Center for Health Studies, Del Valle University of Guatemala, Guatemala City, Guatemala; 4 TEPHINET/ The Taskforce for Global Health Inc., Guatemala City, Guatemala Background: In Central America, men who have sex with men (MSM) are estimated to have the highest HIV prevalence of any group; however little is known about HIV and STIs among male-to-female transgendered (MTFTG) individuals. We sought to characterize HIV and STI prevalence among MTFTG in 4 Central American countries participating in special surveillance studies. Methods: We used data from a standardized behavioral and biological surveillance survey administered in 4 countries: El Salvador (2007-2008), Guatemala (2012), Honduras (2012), and Nicaragua (2009-2010). Investigators used respondent-driven sampling (RDS) to recruit MSM, defined as a man reporting anal or oral sex with a man in the previous 12 months; a separate question asked about MTFTG identification. Audio computer-assisted self-interviews were used to measure behavioral risks, and biologic specimens were used to measure HIV (EIA and confirmatory testing), syphilis (RPR/TPPA), HSV-2 (EIA), gonorrhea, chlamydia, Mycoplasma genitalium and trichomonas (nucleic acid amplification tests based on urine and/or anal and pharyngeal swabs). We used raw unadjusted RDS data on STIs (3 countries, excluding Guatemala) and HIV (all 4 countries). Results: Of 2,746 MSM surveyed in the 4 countries, 405 (15%) self-identified as MTFTG. Median age was 24 years for MTFTG and 23 years for non-transgendered MSM. Prevalence of specific STIs among MTFTG ranged from 14–23% for TPPA confirmed syphilis, 54–81% for HSV-2, 4–7% for gonorrhea (GC), 5–19% for chlamydia (CT), 2–3% for mycoplasma (M Gen), and 0–1% for trichomonas (Trich) (Table 1). Prevalence of at least one “curable STI” (syphilis, gonorrhea, chlamydia, mycoplasma, or trichomonas) ranged from 22–36% among MTFTG compared to 15–25% among MSM. HIV prevalence among MTFTG ranged from 10% (6/62 tested in Nicaragua) to 28% (23/83 tested in El Salvador). Overall HIV prevalence in MTFTG (4 countries) was 22% (86/391) compared to 11% (232/2199) among MSM survey participants. After adjusting for age and country of origin, MTFTG were almost twice as likely to have HIV as MSM (Adjusted Prevalence Ratio = 1.9; 95% Confidence Interval =1.5, 2.4]).

Poster Abstracts

Conclusions: HIV and other STIs were common among MTFTG participating in the Central American surveys, and HIV prevalence was almost twice that of MSM. Targeted HIV/STI efforts among MTFTG are important to prevent HIV acquisition and transmission in this high risk, highly vulnerable subgroup. 1033 Incidence of Curable Sexually Transmitted Infections Among South AfricanWomen Recently InfectedWith HIV Jennifer E. Balkus 1 ; Marla E. Husnik 1 ;Thesla Palanee-Phillips 2 ; Ravindre Panchia 3 ; Ishana Harkoo 4 ; Arendevi Pather 5 ;Vaneshree Govender 5 ; MarthinetteTaljaard 6 ; Pamina Gorbach 7 ; Sharon Riddler 8 1 Fred Hutchinson Cancer Research Center, Seattle, WA, US; 2 University of the Witwatersrand, Johannesburg, South Africa; 3 Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; 4 CAPRISA/ University of KwaZulu-Natal, Durban, South Africa; 5 Medical Research Council, Durban, South Africa; 6 The Aurum Institute, Klerksdorp, South Africa; 7 University of California Los Angeles, Los Angeles, CA, US; 8 University of Pittsburgh, Pittsburgh, PA, US Background: Curable sexually transmitted infections (STIs), including chlamydia (CT), gonorrhea (GC), and trichomoniasis (TV) are common among HIV-infected women; however, data are limited for women recently infected with HIV. We assessed the incidence of and risk factors for CT, GC and TV among South African women who acquired HIV while participating in VOICE, a phase IIB randomized trial of daily oral and vaginal chemoprophylaxis for HIV prevention in Ugandan, South African, and Zimbabwean women. Methods: Women who acquired HIV during VOICE were invited to enroll in MTN-015, a multi-site, prospective cohort study of women who became HIV-infected in Microbicide Trials Network studies. Demographic and sexual behavior data were collected via face-to-face interviews. Participants were tested for STIs (CT/GC using nucleic acid amplification tests and TV using rapid tests) at enrollment, annual visits and when clinically indicated. Treatment was provided according to WHO guidelines. Cox proportional hazards models stratified by site were used to assess baseline correlates of CT, GC or TV infection during follow-up, each as separate outcomes. Multivariable models were adjusted for age and other factors that were associated with STI acquisition in univariate models (p ≤ 0.1). Results: Of 339 eligible South African women from VOICE, 237 enrolled in MTN-015 and 207 had CT, GC, or TV results at enrollment and during follow-up. Median time from testing HIV+ in VOICE to MTN-015 enrollment was 2.3 months (interquartile range 1.3–3.8). Detection of CT while participating in VOICE was associated with incident CT in MTN-015

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CROI 2015