CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Results: Overall, 521 BMSM and 668 WMSMwere analyzed. The age distribution and HIV prevalence was constant for WMSM across time, but BMSM were older in 2011 and had a higher HIV prevalence in 2014 versus other years. In 2008, 2011, and 2014, the prevalence of crystal meth use among BMSM was 4.4%, 6.0% and 9.9% (p=0.04) and 9.5%, 5.1%, and 4.7% respectively among WMSM (p=0.04). Among BMSM, independent correlates of crystal meth use were having ≥4 sex partners vs 1-3 (AOR: 2.7; 95% CI: 1.3, 5.8) and being HIV positive (AOR: 4.2; 95% CI:1.8, 9.7); there was an elevated odds of crystal meth use in 2014 versus 2008 (AOR: 2.5; 95% CI: 1.0, 6.5). Among WMSM, being older (AOR:2.5; 95%CI: 1.0,5.9), earning <$20K per year vs >$50K (AOR: 8.5; 95% CI: 3.1, 23.0), having ≥4 sex partners (AOR: 3.2; 95% CI: 1.3, 7.9), and being HIV positive (AOR: 10.6; 95% CI: 4.4, 25.3) were associated; there was reduced odds of crystal meth use over time for WMSM (2011: AOR: 0.4; 95% CI: 0.2, 0.9 and 2014: AOR: 0.3; 95% CI: 0.1, 0.7 vs 2008). Condomless anal sex was not associated with crystal meth use for either racial group. Conclusion: We observed an increase in crystal meth use among venue-attending BMSM and a decrease among WMSM between 2008-2014. There is a need to better understand the changing pattern of use that might impact HIV risk, particularly for BMSM. Across both races, recent crystal meth use was associated with more sex partners and HIV-positivity, highlighting the continued need for interventions among crystal meth users to reduce HIV transmission risks.

Poster and Themed Discussion Abstracts

873 INCREASING METHAMPHETAMINE USE AMONG NON-MSMWHO INJECT DRUGS IN KING COUNTY, WA Sara N. Glick 1 , Richard Burt 2 , Kim Kummer 1 , Joe Tinsley 2 , Caleb Banta-Green 1 , Matthew R. Golden 1 1 Univ of Washington, Seattle, WA, USA, 2 Pub Hlth - Seattle & King County, Seattle, WA, USA

Background: In King County, WA, men who have sex with men (MSM) who inject methamphetamines (meth) are among the populations at highest risk for HIV infection, while HIV prevalence among other people who inject drugs (PWID) is low. Local drug problem indicators suggest recent increased meth use. It is not known if this increase is among MSM or non-MSMmen and women, and if these networks are connected through injection equipment sharing. We investigated temporal trends in meth use among PWID in King County and estimated frequency and characteristics of injection equipment sharing. Methods: We used data from two serial cross-sectional surveys of PWID in King County. From 2005-2015, four National HIV Behavioral Surveillance (NHBS) IDU surveys used respondent-driven sampling to survey PWID about their drug use behaviors (N=2,103). From 2004-2015, the Public Health–Seattle and King County Needle Exchange (NX) conducted 5 behavioral surveys of all NX clients over a two week period (N=1,964). These analyses were restricted to PWID who reported any sex in the past year and stratified by MSM, men who have sex with women (MSW), and women. We calculated frequencies and evaluated temporal trends using multivariable Poisson regression with a log link adjusting for age, gender, race, and NHBS field site locations. Results: Any meth injection in the past year increased significantly among PWID – including MSM, MSW, and women – in King County between 2005-2015 (see Figure). NX survey data were nearly identical. In NHBS-IDU, the magnitude of change was greatest among women with reported meth use increasing from 27% in 2005 to 61% in 2015. Among MSW, meth use increased from 40% to 63%, and among MSM from 55% to 88%. These trends remained statistically significant after adjusting for potential confounders. Among NHBS-IDU meth injectors, sharing any drug injection equipment in the last year was reported by 54% of MSM, 73% of MSW, and 78% of women. Among meth injectors who were not MSM, 6% of men and 12% of women reported sharing injection equipment with someone who was likely to be a MSM in the previous 12 months. Likewise, 25% of MSMmeth injectors reported sharing injection equipment with a MSW or woman. Conclusion: Meth use has increased dramatically among PWID in King County over the past decade. Given non-trivial rates of sharing injection equipment with meth-using MSM – a population with an HIV prevalence of 35-40% – non-MSMmen and women who inject meth could be an emerging population at risk for HIV.

CROI 2017 377