CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Methods: Eligibility criteria were assigned male at birth, age 18-50 years, HIV-negative, ≥2 male anal sex partners of HIV+/unknown status and receptive anal sex without condoms ≥3 times in last month, reside in NYC. 30 participants (ppts) were recruited via websites and referrals. They were randomized to daily vs. sex act-based self-administered rectal swab collection for 2 months. Self-administered online surveys on risk behaviors and acceptability (based on Likert scale 1 to 5), HIV testing, and blood sample collections were performed at baseline and month 2 visits. Ppts were asked to complete daily mobile app-based sex diaries. Presence of human and Y chromosome DNA (Quantifiler Duo PCR) was used to distinguish successful collections from empty rectal swabs. Results: Of 29 MSM and 1 TGW enrolled, 32%were 18-29 years, 30% Black and 23% Latino. Ppts reported median 6 sex partners and median 8 receptive anal sex acts in the last 60 days. The proportion of swab returns vs. expected was 59.7% in the daily arm and 49.7% in the sex act- based arm (p=0.27). Acceptability measures based on comfort level (mean Likert score=4.4 [SD 0.8] for both groups) and ease (mean 4.3 [SD 0.8] for both groups) in self-collecting rectal swabs were high. Ppts reported that having information about HIV detection in rectal swabs after condomless anal receptive sex to lower their HIV infection risk was very important (mean Likert score=4.0 [SD 1.5]). In comparing human and Y chromosome DNA results from rectal swabs to matching mobile app self-reported data on anal sex and condom use, adherence in swab collection was higher in the sex act-based arm compared with daily arm (87.2% vs. 71.9%, p=0.0054). Conclusion: Self-administered rectal swab collection for testing of biomarkers for HIV exposure and condomless anal sex was acceptable among MSM/TGW, with higher adherence in the sex act-based arm. Methods to improve adherence to rectal swab collection and return should be explored. 898 FEASIBILITY AND REACH OF A HOME-TEST GIVEAWAY IN NEW YORK CITY, 2015–2016 Zoe R. Edelstein 1 , Paul M. Salcuni 1 , Benjamin Tsoi 1 , Paul Kobrak 1 , Adriana Andaluz 1 , David A Katz 2 , Demetre C. Daskalakis 1 , Julie Myers 1 1 New York City DHMH, Queens, NY, USA, 2 Univ of Washington, Seattle, WA, USA Background: The home HIV test may increase HIV status awareness. Advantages include convenience and privacy; barriers include cost and limited access. New York City (NYC) Health Department distributed HIV self-tests (HIVST) to men and transgender people who have sex with men (MTSM) at no charge by mail. We examined the feasibility and reach of our HIVST Giveaway (HTG) model. Methods: Participants were recruited on dating applications and websites. Eligibility was limited to adult NYC residents who were MTSM and not previously HIV-diagnosed. Eligible participants were emailed a code to redeem on the manufacturer’s website for a HIVST. Data collected via online eligibility survey included age, race/ethnicity, and time since last HIV test. Approximately 2 months after distribution ended, an online follow-up survey was used to collect information on test receipt, use, experience, result and, if appropriate, confirmatory testing. Sociodemographic factors and behaviors related to risk of HIV exposure were also assessed. To examine representativeness of those who followed up, we compared eligibility survey responses of all code redeemers to test receivers (reported on follow-up) (Chi-square test). Results: Recruitment concluded in 23 days with 2500 codes distributed. Among those screened, 74%were deemed eligible (Table). Among eligible participants, 71%were code redeemers. Response to the follow-up survey was 48%. Among respondents, 74% of test receivers had used the test. Most test users (72%) were <35 year-old, 41%were of color, 18% had income <$20,000/year, 86% reported risk of HIV exposure (past 6 months), and 14% and 28% reported never testing and testing >1 year prior, respectively. Most test users (71%) reported testing sooner than usual or for the first time and 98% reported being likely to recommend HTG to a friend. Among 868 test users, 7 reported a reactive result (0.8%), of whom 5 reported no previous diagnosis; among the latter, 80% (4/5) reported receiving a confirmatory test. No differences were detected comparing all code redeemers to test receivers (p<0.05). Conclusion: The HTG rapidly distributed a large volume of tests to a diverse set of NYC MTSM, many of whom had never tested or not tested recently. Despite reaching those at higher risk of HIV exposure, reported seropositivity was relatively low. Findings have motivated future HTG adaptions, including partnership with community-based organizations to recruit those at risk of HIV exposure who may not be reached online.

Poster and Themed Discussion Abstracts

899 STATE-LEVEL ESTIMATES OF HIV INCIDENCE, PREVALENCE, AND UNDIAGNOSED INFECTIONS Anna S. Johnson , Ruiguang Song, Irene Hall

CROI 2017 390