CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

1099 Sexually Transmitted Disease Partner Services Increase HIV Testing Among MenWho Have Sex With Men Matthew R. Golden 1 ; David A. Katz 1 ; David Kern 2 ; David Heal 2 ; Roxanne Kerani 1 ; Julia C. Dombrowski 1 1 University of Washington, Seattle, WA, US; 2 Washington State Department of Health, Tumwater, WA, US Background: MSMwith bacterial sexually transmitted infections (STI) are at elevated risk for HIV infection. Only approximately half of such men are HIV tested at time of their STI diagnosis or treatment. We instituted and evaluated a program promoting HIV testing through public health STI partner services (PS). Methods: Starting in May 2012, health departments in WA State, USA, revised PS programs with the objective of providing PS to all MSM with early syphilis, gonorrhea or chlamydial infection, and ensuring that all MSM without a prior HIV diagnosis tested for HIV. PS staff recorded HIV testing as an explicit PS outcome. We compared the percentage of MSM without a prior HIV diagnosis who tested for HIV within four weeks of STD diagnosis or treatment in the period before (March 2010-April 2012) and during the revised program (May 2012-June 2014). New HIV diagnoses were ascertained through HIV surveillance. Negative HIV testing was ascertained through PS and confirmed with medical providers or test records when possible. We used chi-square tests and logistic regression to compare the precentages of MSM receiving PS, HIV testing and newly diagnosed with HIV. Results: Among MSMwithout a prior HIV diagnosis, 1896 (62%) of 3083 in the pre-intervention period and 3367 (76%) of 4435 in the intervention period received PS (p<.001). The percentage of MSM receiving PS tested for HIV increased from 63 to 91% concurrent with the intervention (p<.001). PS recipients were more likely to be newly HIV diagnosed then men who did not receive PS in both the pre-intervention (0.93 vs. 2.5%, p=.002) and the intervention periods (1.4 vs. 2.4%, p=.050). The percent of all MSM newly diagnosed with HIV in the state who had a concurrent STI diagnosis increased from 7.7 to 15.2% (p<.001). Among all MSM with bacterial STI (including men who did not receive PS), 59 (1.9%) in the pre-intervention period and 96 (2.2%) in the intervention period were newly diagnosed with HIV infection (p=45). On multivariable analysis, being newly diagnosed with HIV was independently associated with having early syphilis or rectal gonorrhea (p<.001 for both), but not with intervention period. Conclusions: Promoting HIV testing through STI PS is feasible and increases HIV testing among men at high risk for HIV infection. It is uncertain whether the increase in HIV case- finding among MSM with bacterial STI observed concurrent with our intervention reflects an intervention effect, or a general increase in simultaneous STI and HIV testing among MSM. 1100 Expanding HIV Testing in Hospital Emergency Departments and Inpatient Admissions Pollyanna R. Chavez 1 ; Elizabeth Greene 2 ; Kate Buchacz 1 ;Theresa Gamble 2 ; Steven F. Ethridge 1 ; Laura McKinstry 3 ; Gheetha Beauchamp 3 ; Matthew Connor 3 ;Wafaa M. El-Sadr 4 ; Bernard M. Branson 1 1 US Centers for Disease Control and Prevention (CDC), Atlanta, GA, US; 2 FHI360, Durham, NC, US; 3 Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, US; 4 Columbia University, New York, NY, US Background: The Expanded HIV Testing (EHT) component of HPTN 065, the Test, Link to Care, Plus Treat (TLC-Plus) study, aimed to evaluate if it is feasible to increase HIV testing though universal offering of HIV testing during inpatient (IP) and emergency department (ED) admissions at participating hospitals in the Bronx, NY (NY), and Washington, DC (DC), and shift to laboratory-based (LB) from point-of-care (POC) rapid HIV testing. Methods: We analyzed testing data from February 1, 2011, to January 31, 2014, for IP admissions and ED visits from 7 participating hospitals in DC and 9 in NY. Indicators for each municipality included testing percentages (the total number of ED visits or IP admissions during which an HIV test was conducted among the total number of ED visits or IP admissions), the percentage of positive tests, and the number of tests conducted by type (POC or LB) for each 12- month period during the study. We assessed trends in testing percentages and positivity percentages across time via Cochran-Armitage chi-square analysis. Results: Throughout the 3-year study period, the percentages of IP admissions with testing provided increased from 22.67% in year 1 to 24.09% in year 3 in DC (p<0.0001) and from 12.96% to 13.60% in NY (p<0.0001). For IP admissions in NY hospitals, the percentage of LB HIV tests increased from 28.84% to 55.79% (p<0.0001) and the percentage of positive tests increased from 1.45% to 2.26% (p<0.0001). For IP in DC hospitals, the percentage of LB HIV tests decreased from 96.72% to 82.91% (p<0.0001) and the percentage of positive tests also decreased from 4.87% to 3.99% (p<0.001). The percentage of ED visits with testing provided increased from 6.59% to 6.91% (p<0.0001) in NY and increased from 11.20% to 15.87% in DC hospitals (p<0.0001). LB testing in EDs increased from 0.27% to 19.95% in NY and from 5.09% to 26.58% in DC (p<0.0001). DC EDs reported an increase in the percentage of positive tests, from 0.60% to 0.84% (p<0.0001) and in NY EDs the percentage of positive tests remained essentially unchanged.

Poster Abstracts

Expanded HIV testing implementation indicators in hospital emergency department visits and inpatient admissions, Washington, DC and Bronx, NY, US, 2011-2013: Data from the TLC-Plus (HPTN 065) Study Conclusions: During the 3 years of EHT, the percentage of IP admissions and ED visits with an HIV test showed little change. However, use of POC rapid tests diminished as the adoption of lower cost LB testing increased, providing opportunities for more efficient future scale-up of HIV testing.

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CROI 2015