CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

likely to be aware of their infection than their white counterparts (p<0.001). Black MSM did not report higher percentages of CAS in the past 12 months or CAS with a partner of discordant or unknown HIV status at last sex. The disparity in HIV prevalence between black and white MSM increased between 2008 and 2011 (p=0.014). Conclusions: Our findings show racial disparities in HIV infection among MSM are especially large among young MSM. These findings show that black MSM are being infected with HIV at younger ages compared to MSM of other racial/ethnic groups. In our data, 1 in 5 black MSM aged 18-24 were infected with HIV. Black MSMwere most likely to be infected with HIV and least likely to be aware of their infection, but did not report higher levels of sexual risk behavior than other MSM. Further, racial disparities in HIV prevalence between black and white MSM increased from 2008 to 2011. Prevention efforts focused on black MSMmay maximize their impact by addressing the prevention needs of black MSM younger than 25 years old. 1042 HIV Incidence Estimates, Introducing the Limiting Antigen Avidity EIA to Existing HIV Surveillance in Kiev City, Ukraine: 2013–2014 Ruth Simmons 1 ; Ruslan Malyuta 2 ; Nelli Chentsova 3 ; Iryna Karnets 3 ; Gary Murphy 4 ; Antonia Medoeva 3 ;Yuri Kruglov 5 ; AlexanderYurchenko 3 ; Kholoud Porter 1 ; Andrew Copas 1 1 Medical Research Council at University College London, London, United Kingdom; 2 Perinatal Prevention of AIDS Initiative, Odessa, Ukraine; 3 Kyiv City AIDS Centre, Kyiv City, Ukraine; 4 Public Health England, London, United Kingdom; 5 Institute of Epidemiology, Kyiv, Ukraine Background: Little is known about HIV incidence in Ukraine which is important for an accurate picture of those at greatest risk of HIV. Serological methods to differentiate recent from non-recent HIV infections were introduced to routine surveillance in Kiev City, to estimate incidence and to characterise those newly-diagnosed and infected. Methods: Using existing testing services within Kiev City, residual samples from persons newly diagnosed with HIV were tested to differentiate a recent from non-recent infection using an avidity assay. All persons ( ≥ 16yrs) presenting for an HIV test April 2013 - March 2014 were included and demographic data on possible risk factors for HIV acquisition, and testing history were added to the existing data collection. Incidence rates were estimated using an extrapolation method published by Prejean et al. Results: During the study period 6370 individuals tested for HIV. Of these, 467 (7.8%) were HIV positive, equivalent to a diagnosis rate of 21.5 per 100,000 population. The highest prevalence was among 31-35 year olds (11.2%), males (9.4%), people who inject drugs (PWID) (17.9%) and men who have sex with men (MSM) (24.1%). Incidence estimates for Kiev City were 21.5 per 100,000 (18.2-26.1), with 6.5% classified as recent. The disproportionate distribution of HIV among MSM and PWID was evident. Adjusting for all variables in a multivariate model the only independent predictor for being recently infected was HIV risk group, with MSMmore likely to test recent compared with heterosexual contact. We estimate incidence to be between 2289.6 and 6868.7 per 100,000 for MSM and 350.4 for PWID in Kiev City. Conclusions: This is the first estimate of HIV incidence in Ukraine and should enable targeted public health action and health promotion work to be made, laying the foundation for local and national guidelines. 1043 Detection of Acute HIV Infection, US National HIV Surveillance System, 2008 – 2012 Laurie Linley ; Qian An; Kristen Mahle Gray; Alexandra Oster; Angela L. Hernandez US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US Background: Detection of acute HIV infection (AHI) is critical to delay disease progression and reduce the spread of HIV. In June 2011, an updated laboratory HIV diagnostic testing algorithm that facilitates detecting acute HIV was included in the revised laboratory-based HIV testing guidelines issued by the Clinical and Laboratory Standards Institute (CLSI). We used laboratory and testing history data collected as part of the U.S. National HIV Surveillance System (NHSS) to identify persons with AHI, assess potential shifts from recent changes in HIV testing technology, and describe populations newly acquiring and transmitting HIV. Methods: We analyzed NHSS data for persons aged ≥ 13 years with HIV diagnosed during 2008-2012 who had a date of most recent HIV antibody-negative test either through a laboratory test result or patient/provider report. Those with a negative test ≤ 60 days before HIV diagnosis were considered AHI. We compared persons with AHI to all persons diagnosed with HIV by demographic, risk, and geographic characteristics, and CD4 and viral load (VL) data measured within 3 months after diagnosis. Results: Of 219,773 HIV-diagnosed persons, 56,944 (25.9%) had a previous negative test date, of whom 1,791 (3.1%) met criteria for AHI. Although the percentage of diagnoses categorized as AHI was relatively stable during 2008-2011, there was a significant increase from 3.2% in 2011 to 3.6% in 2012 (p<0.05). Compared with all HIV-diagnosed persons, significantly higher percentages (p<0.0001) of persons with AHI were white or Hispanic/Latino, aged 13-29 years, men who have sex with men, and from the Western or Northeastern regions of the United States [Table]. Compared with all HIV-diagnosed persons with CD4 or VL results within 3 months of diagnosis, a significantly higher percentage of those with AHI had a CD4 result >350 (72.7% vs. 44.8%, p<0.0001) or VL >1,000,000 copies/ m l (14.3% vs. 8.9%, p<0.0001).

Poster Abstracts

Conclusions: NHSS data indicate demographic and geographic disparities in the detection of AHI among HIV-diagnosed persons. The increase in AHI in 2012 may suggest a potential shift in testing technology and reporting to public health following the revised CLSI guidelines. Widespread implementation of CDC’s updated recommendations for laboratory HIV testing released in June 2014 will enhance the detection of acute HIV infection and optimize opportunities for treatment and prevention.

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CROI 2015