CROI 2015 Program and Abstracts

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Poster Abstracts

Conclusions: In fishing communities along Lake Victoria, Uganda, alcohol is associated with high risk behaviours and 64% of all new HIV infections are associated with alcohol consumption. It might be important to integrate interventions for reducing alcohol consumption in HIV/AIDS control packages. 1039 Risky Sexual Behavior and HIV Infection Among Fisher Folk: Lake Kyoga Region, Uganda

Rose Apondi 1 ; RhodaWanyenze 2 ; Herbert S. Kiyingi 2 ; Abdu-Maliki Muyinda 2 ; Elizabeth Meassick 1 ; Joy Kusiima 2 ; David Serwadda 2 1 CDC Center for Global Health, Division of Global AIDS/HIV, Kampala, Uganda; 2 Makerere University School of Public Health, Kampala, Uganda

Background: Several studies in Sub-Saharan Africa have documented higher HIV infection rates in fishing communities than the general population. An understanding of the specific sexual behavior associated with increased HIV infection risk in fishing communities is critical to the design of effective prevention interventions. This study assessed risky sexual behavior and its association with HIV infection among fishing communities around the Lake Kyoga region in Uganda. Methods: A two stage sampling design was used in a cross-sectional survey to obtain blood, urine and stool samples to determine HIV-1 status for 1786 individuals. The survey collected quantitative and qualitative data on HIV knowledge, sexual behavior and access to health services. Risky sexual behavior was defined as report of transactional sex and or report of sex with multiple sexual partners coupled with non- consistent condom-use. Using univariate and bivariate analysis, socio-demographic factors associated with risky sexual behavior and HIV infection were identified including alcohol and drug use. Results: This fishing community presents an HIV prevalence rate of 14.3%, which is twice the national general population HIV rate. The HIV prevalence rate for this region is much lower than the rate reported in the Lake Victoria region ranging from 22% to 40%. There was no difference in rates of condom use between the HIV infected or uninfected respondents (Unadjusted OR: 1.3 [0.78 – 2.00]), p-value <0.35). This was also true of HIV infected individuals who engaged in transactional sex. We found no difference in risky behavior between the men and women (Unadjusted OR: 1.0 (0.88 – 1.16). HIV infection rates were highest among those who were divorced or separated. The odds of being HIV positive among individuals who reported ever swallowing, sniffing, smoking, or injecting drugs were higher than for individuals who did not (Unadjusted OR 1.90 [1.09 – 3.33]). Conclusions: This study offers evidence on risky behavior and HIV infection contrary to data from other fishing communities. HIV infected individuals in this population reported protected sex which may explain the lower population HIV prevalence rates. Longitudinal studies on risky behavior for HIV-infection would be important to maximize public health benefits among fishing communities as treatment for prevention rolls out. 2:30 pm– 4:00 pm Incidence and Prevalence of HIV Infection, Including Acute HIV 1040 Increases in HIV Diagnoses Among MSM in Metropolitan Statistical Areas, United States, 2003 – 2012 Lorena Espinoza ; H. Irene Hall;TianTang; Anna Satcher Johnson; Amy Lansky US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US Background: Monitoring trends in HIV diagnosis by metropolitan statistical area (MSA) provides public health programs with data to develop and evaluate more effective prevention strategies and to set priorities for resource allocation. Methods: Using data from the National HIV Surveillance System (NHSS) reported through December 2013, we assessed trends in HIV diagnoses in MSAs in the United States and Puerto Rico. We determined the annual numbers and rates (per 100,000 population) of HIV diagnoses during 2003–2012 among persons aged ≥ 13 years. MSAs were defined as population ≥ 500,000. Poisson regression was used to calculate the estimated annual percent change (EAPC) in annual rates or numbers. MSAs with case counts < 12 were excluded from EAPC calculations. Data were adjusted for missing information on risk factors. Because of a non-monotone trend in HIV diagnoses among men who have sex with men (MSM), we report on diagnoses during 2008-2012 (adjusted for reporting delays). Results: During 2003–2012, the overall annual rate of HIV diagnoses in MSAs decreased 3.9% per year (95% confidence interval [CI] = − 4.0,–3.7). Significant decreases were observed in 64% of the 105 MSAs. Annual rates in MSAs decreased overall ( − 2.9%; 95% CI= − 3.0,–2.8) among males (54% of individual MSAs) and ( − 6.9%; 95% CI= − 7.1,–6.7) among females (68% of individual MSAs). Rates decreased among blacks overall ( − 4.2%; 95% CI= − 4.4, − 4.0) and in 42% of individual MSAs, Hispanics/Latinos ( − 4.9%; 95% CI= − 5.1, − 4.7; 59% of individual MSAs) and whites ( − 3.8%; 95% CI= − 4.0, − 3.6; 47% of individual MSAs). However, rates increased in 5 MSAs among blacks and in 2 MSAs among whites. The number of diagnoses among MSM increased from 2003 to 2007 (relative percent increase, 10.8%) and then decreased (-4.1%). However, in the later period diagnoses among MSM significantly decreased only in 4 MSAs and increased in 9 MSAs. In 59 MSAs with >12 annual diagnoses among MSM 13-24 years, diagnoses increased in 19 MSAs among these young MSM. Conclusions: Increases in HIV diagnoses were observed in particular MSAs among MSM, blacks and whites. The geographic disparity in HIV burden indicates a need to target prevention 1041 Disparities in HIV by Race and Age Among MenWho Have Sex With Men, 20 US Cities CyprianWejnert; Kristen Hess; Chuck E. Rose; Alexandra B. Balaji ; Justin C. Smith; Gabriela Paz-Bailey On behalf of the NHBS Study Group US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US Background: We evaluated disparities by age and race in HIV prevalence, awareness of infection, and risk behaviors among men who have sex with men (MSM) in 2011 and changes in disparities in HIV prevalence between black and white MSM from 2008 to 2011. Black MSM are disproportionately affected by HIV. According to CDC, 45% of the estimated new infections in 2010 among black MSM occurred among those younger than 25 years old. Methods: We examined National HIV Behavioral Surveillance (NHBS) data among MSM from 20 U.S. cities in 2008 and 2011. Time-location sampling was used to recruit men for interview and HIV testing. We analyzed data for men who reported ≥ 1 male sex partner in the past 12 months and had a valid HIV test result. Using 2011 data, we used Poisson models with robust error variances to test racial/ethnic disparities by age in HIV prevalence, HIV awareness, past 12 months condomless anal sex (CAS), and CAS with a partner of discordant or unknown HIV status at last sex. Finally, we use a Poisson model to compare changes in racial/ethnic disparities in HIV prevalence between 2008 and 2011. Results: Among 2216 black MSM tested in 2011, 665 (30%) were HIV infected; among 802 young black MSM aged 18-24 years tested in 2011, 167 (20%) were HIV infected. In all age groups younger than 40 years, black MSM were significantly more likely to be HIV infected than all other racial/ethnic groups analyzed. HIV-infected black MSM were less THURSDAY, FEBRUARY 26, 2015 Session P-W5 Poster Session Poster Hall

Poster Abstracts

609

CROI 2015