CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

infection (rapid HIV test reactive and confirmed) were referred to an HIV care provider. CD4 cell count and viral load laboratory reports received by NYC’s HIV surveillance program were used to determine HIV care continuum outcomes. Individuals with a reported CD4 count or viral load were considered linked to care. Retention in care was defined as two CD4 or VL tests ≥ 90 days apart. Viral suppression was defined as a VL < 200 copies/mL. The proportion of patients linked to care, retained in care and achieving viral suppression were compared using chi square and fisher’s exact tests. Results: From October 2011 to October 2013, 525 STOP participants were newly diagnosed with HIV infection including 60 with AHI. A similar proportion of individuals with acute and established HIV infection were linked to care within 3 months of diagnosis (91.7% vs. 90.5%, p=0.78). Among the 36 participants with AHI who had 12 month follow up information, 86.1% (n=31) were retained in medical care and 65% (n=26) were virally suppressed at their most recent visit. Participants with established HIV infection had comparable outcomes (Figure 1). Patients aged 25 or older at diagnosis (vs. <25 years, p<0.01), testing at a facility co-located with treatment services (vs. not co-located, p=0.04) and patients of white race/ethnicity (vs. non-white, p<0.02) were more likely to achieve viral suppression within 12 months. Median time to viral suppression was 175.5 days (AHI) versus 149.5 days (established infection), (p<0.05).

Conclusions: We found high rates of linkage to care and viral suppression in this sample and this did not differ for people with acute HIV, compared to those with established HIV infection. Better strategies are needed for youth and racial/ethnic minorities to ensure they receive, and benefit from early HIV treatment. 1070 Drivers of HIV Treatment Success Among a Population-Based Sample of Younger Black MSM John A. Schneider 1 ; Britt Skaathun 1 ; Stuart Michaels 2 ; LindsayYoung 1 ; Keith Green 1 ; Ethan Morgan 1 ; RobertW. Coombs 3 ; Sam Friedman 4 ; Edward Laumann 1 On behalf of UConnect StudyTeam 1 University of Chicago, Chicago, IL, US; 2 NORC, Chicago, IL, US; 3 University of Washington, Seattle, WA, US; 4 National Development Research Institute, New York, NY, US Background: Improving treatment outcomes for younger Black MSM (YBMSM) is critical to controlling the HIV epidemic domestically. A seminal meta-analysis conducted by Millet in 2012 reviewed factors associated with increased rates of HIV among Black MSM and highlighted several disparities compared to white MSM. We examine how these disparate factors are related to HIV treatment continuummetrics from the first population-based sample of YBMSM 16-29 years of age. Methods: From 2013-2014 a representative sample of YBMSM was generated using Respondent Driven Sampling (RDS) in Chicago (n=626). HIV antibody/Ag and RNA testing were performed using dry blood spots. Outcomes were computed for steps in the treatment continuum including HIV tested, HIV diagnosed, linkage to care within 6 months, retained in care (2 or more visits 3 months apart in 1 year), 30 day adherence to ARVs, and laboratory confirmed viral suppression. RDS-unweighted models examined the associations between key factors known to disparately impact BMSM and each of the continuummetrics independently with observations inclusive of participants unique to each step. These models included age, education, unemployment, homelessness, health care coverage, drug use, incarceration and depression. Results: YBMSM had a 28% seropositivity rate; 31% of positives were virally suppressed. Treatment continuum outcomes are in Figure 1. Factors associated with HIV diagnosis included older (aOR, 1.12; p=0.001), insured (aOR, 2.31; p=0.001), and drug using (aOR, 1.86; p=0.01) YBMSM. Factors associated with linkage to care included unemployment (aOR, 6.76; p=0.04) and insured status (aOR, 4.24; p=0.04). Those who used drugs were both less likely to be prescribed ARVs (aOR, 0.003; p=0.024) and less likely to adhere to ARVs (aOR, 0.29, p=0.046). There were no factors associated with retention in care or viral suppression.

Poster Abstracts

625

CROI 2015