CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

885 HPTN 067-ADAPT: Factors AssociatedWith PrEP Coverage Among New York City MSM and TGW Sharon Mannheimer 1 ;Yael Hirsch-Moverman 2 ; Julie Franks 2 ; Avelino Loquere 2 ; James P. Hughes 3 ; Maoji Li 4 ;Vanessa Elharrar 5 ; Michael J. Stirratt 6 ; Robert Grant 7 ; for the HPTN 067/ ADAPT Harlem StudyTeam 1 Harlem Hosp, New York, NY, USA; 2 Columbia Univ Mailman Sch of PH, New York, NY, USA; 3 Univ of Washington, Seattle, WA, USA; 4 Fred Hutchinson Cancer Rsr Cntr, Seattle, WA, USA; 5 DAIDS, NIAID, NIH, Bethesda, MD, USA; 6 NIMH, NIH, Bethesda, MD, USA; 7 Univ of California San Francisco, San Francisco, CA, USA Background: New York City participants in the completed HPTN 067 study were more likely to have coverage of sex events (adherence to pre- and post-sex PrEP) when assigned to daily PrEP compared to non-daily regimens. Understanding factors associated with coverage can inform future PrEP support interventions. Methods: Participants in this phase 2, open-label, randomized clinical trial were assigned 1:1:1 to 24 weeks of FTC/TDF PrEP dosed: daily (D), twice weekly plus a post-sex dose (time-driven [T]), or pre- and post-sex doses (event-driven [E]). Coverage of sex events (yes/no) was defined based on pre-clinical research as PrEP taken within 4 days pre- and 24 hours post-sex. Coverage was assessed via electronic monitoring adjusted by self-reported sexual and pill taking behavior collected in weekly interviews. Demographics were collected by staff, other data (including AUDIT to assess alcohol use and CES-D to assess depression) were collected via computer assisted self-interview (Table). Logistic regression for clustered data (clustering on participant) was used to estimate odds ratios and adjusted odds ratios. Characteristics significant at p<0.05 were retained in the final model. Results: Participants (N=179) were: 98%men who have sex with men (MSM), 2% transgender women (TGW); median age 30 years; 60% black, 11%white, 24% Hispanic, 6% other. Arm D participants had significantly higher coverage of sex acts (66% D, 47% T, 52% E; p=0.03). In univariate analyses (Table), other factors associated with better coverage included older age, employment, higher education, and higher PrEP information, motivation, and behavioral skills. Factors significantly associated with lower coverage included heavy alcohol use, black race, depression, and opiate use. In multivariate analyses (Table), significant associations with better coverage included: arm D (aOR=0.49 95%CI 0.29- 0.83 for arm T vs. D; aOR=0.62, 95%CI 0.38-1.01 for arm E vs. D), older age (aOR=1.03, 95%CI 1.01-1.05), employment (aOR=1.67, 95%CI 1.07-2.59), and higher PrEP motivation (aOR=1.03, 95%CI 1.00-1.05). Black race vs. white (aOR=0.49, 95%CI 0.25-0.97) or Hispanic (aOR=0.64, 95%CI 0.31-1.30), and heroin use (aOR=0.34, 95%CI 0.17-0.69) remained significantly associated with lower coverage. Conclusions: This analysis identified factors that may require interventions to optimize adherence to PrEP, including younger age, unemployment, lack of motivation for PrEP, and heroin use. Further study is needed to assess determinants of racial differences.

Poster Abstracts

886 On Demand PrEPWith Oral TDF-FTC in the Open-Label Phase of the ANRS IPERGAY Trial Jean-Michel Molina 1 ; Isabelle Charreau 2 ; Bruno Spire 3 ; Laurent Cotte 4 ; Gilles Pialoux 5 ; Catherine Capitant 2 ; CécileTremblay 6 ; Daniela Rojas Castro 7 ; Laurence Meyer 8 ; for the ANRS IPERGAY Study Group 1 Hopital Saint-Louis, Paris, France; 2 INSERM SC10-US19, Villejuif, France; 3 INSERM UMR 912, Marseille, France; 4 Hospices Civils de Lyon, Lyon, France; 5 Tenon Hosp, Paris, France; 6 CRCHUM, Montreal, QC, Canada; 7 AIDES, Mission Recherche Innovation Évaluation, Pantin, France; 8 INSERM, CESP U1018, Le Kremlin-Bicêtre, France Background: On demand PrEP with oral TDF-FTC has been shown to reduce the incidence of HIV-1 infection in high risk MSM in the ANRS IPERGAY trial from 6.60 per 100 participants-years (py) in the placebo arm to 0.91 per 100 py in the TDF-FTC arm. However, because the placebo armwas discontinued early, the cumulative follow-up time with TDF/FTC was only 219 py and the long term efficacy and safety of this strategy remains to be demonstrated.

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CROI 2016