CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

910 USING SURVEILLANCE DATA TO MEASURE PROGRESS ALONG THE HIV CARE CONTINUUM Nancy A. Hessol 1 , Ling Hsu 2 , Sharon Pipkin 2 , Susan Scheer 2 1 Univ of California San Francisco, San Francisco, CA, USA, 2 San Francisco Dept of Pub Hlth, San Francisco, CA, USA Background: HIV viral suppression is necessary to prevent HIV disease progression and reduce forward transmission of HIV. Routinely collected HIV surveillance data can measure progress along the HIV care continuum and evaluate changes overtime. Methods: Newly diagnosed (2009-2014) HIV cases reported to San Francisco California Surveillance were analyzed to measure temporal trends in the HIV care continuum. Care was defined as the presence of a CD4 or HIV viral load test, viral suppression as an HIV viral load <=200 copies and retention in care as a subsequent CD4 or HIV viral load test within 6-12 months of the first laboratory test. The one-sided Cochran-Armitage test was used to test for trends. Kaplan-Meier time to event analyses assessed time to linkage to care, ART initiation, HIV viral suppression, AIDS diagnosis and death by year of HIV diagnosis. Results: In San Francisco from 2009 through 2014 there were 2,544 newly diagnosed HIV cases and a decline in the annual number of diagnoses from 474 in 2009 to 335 in 2014. The proportion of cases who were male (P=<0.001), Asian/Pacific Islander or Latino (P= 0.01), or men who have sex with men (P= 0.002) increased. Linkage to care within three months of diagnosis increased from 86% in 2009 to 92% in 2014 (P=0.04). Among the 2390 cases who did not move out of San Francisco within the first 12 months of their diagnosis, ART initiation and viral suppression within 12 months of diagnosis increased; 63% in 2009 to 96% in 2014 (P <0.001) and 49% in 2009 to 88% in 2014 (P <0.001), respectively. The proportion who died within 12 months of diagnosis declined from 27% in 2009 to 16% in 2014 (P <0.001). Time to care, time to ART initiation and time to viral suppression were significantly shorter in more recent years of diagnosis (logrank P<0.001). Time from HIV to AIDS diagnosis was significantly longer in more recent years (logrank P<0.001). There was no significant difference for time to death by year of diagnosis. Conclusion: Routinely collected surveillance data provides a population-based data source to measure progress along the HIV care continuum and success of HIV prevention and care programs. We observed declining numbers of HIV diagnoses and improvements in each of the HIV care continuum indicators over time. 911 IMPROVED HIV CARE OUTCOMES FOR INMATES REFERRED TO COMMUNITY PROGRAMS IN PHILADELPHIA Makeda Carroll 1 , Tanner Nassau 1 , Melissa Miller 1 , Cody Poerio 2 , Hannah Zellman 3 , Bruce Herdman 4 , Coleman Terrell 1 , Kathleen Brady 1 1 Philadelphia Dept of Pub Hlth, Philadelphia, PA, USA, 2 Action Wellness, Philadelphia, PA, USA, 3 Philadelphia FIGHT, Philadelphia, PA, USA, 4 Philadelphia Prison System, Philadelphia, PA, USA Background: HIV-infected prison inmates constitute a vulnerable population for which information regarding long-term health outcomes post-release is lacking. We aimed to characterize predictors of care after release for inmates diagnosed in the Philadelphia Prison System (PPS). Methods: We used data from HIV surveillance, PPS and two community referral programs (CRP) who work within PPS to identify all persons diagnosed with HIV within PPS from 2009-2013. CRPs provide advocacy, support, education, and linkages to medical care and supportive services to HIV-infected inmates upon release. Outcomes of interest included: (1) Linkage to care 90 days post-release from PPS, (2) Retention in care 1 year post-release (> 2 CD4 or viral loads (VL) at least 90 days apart), and (3) Viral suppression 1 year post- release (VL <200 copies/ml at the last measure). Multivariable logistic models evaluated factors associated with each outcome. All models were adjusted for AIDS status, length of diagnosis, prior to release length of incarceration, gender, age at release, race/ethnicity, mode of transmission, and CRP status. Results: Of 410 inmates diagnosed within PPS, 41%were linked to care within 90 days after release, 35% and 10%were retained in care and virally suppressed at 1 year after release. Forty percent of those diagnosed in PPS were linked to a CRP. Those diagnosed for greater than 5 years were 3.2 times as likely (95% C.I. 1.9-5.4) as those diagnosed ≤ 6 months to be linked to and retained in care. Race significantly predicted retention, as black inmates were 49% less likely than whites (AOR, (95% CI 0.3-0.9) to be retained 1 year after release. Individuals that were connected to a CRP for post-release follow up were 2.4 times as likely (AOR, 95% C.I. 1.5-3.6) to be linked to care, and were 2.5 times as likely (95% C.I. 1.9-5.4) to be retained in care, as those not referred to a program. No significant predictors of viral suppression were identified. Conclusion: HIV-infected inmates have low rates of post-release linkage to care, retention in care and viral suppression. Inmates connected to CRPs that work with newly diagnosed HIV were more likely to link to care within 90 days of release, and to be retained in the 1 year after release compared to inmates that did not access such programs. This evidence supports the need to increase referral of soon-to-be discharged inmates to CRPs as these programs can be a valuable resource in improving long-term health outcomes for this high-risk population. 912 HEALTH LITERACY AND DEMOGRAPHIC DISPARITIES IN HIV-1 VIRAL SUPPRESSION Peter F. Rebeiro 1 , Tristan McPherson 2 , Kathryn Goggins 1 , Megan M. Turner 1 , Sally S. Bebawy 1 , Lauren Brinkley-Rubinstein 3 , Anna K. Person 1 , Timothy R. Sterling 1 , Sunil Kripalani 1 , April C. Pettit 1

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