CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

966 FOUR-YEAR TRENDS IN AWARENESS AND USE OF HIV PREP AMONG GBMSM IN VANCOUVER, CANADA Moliehi Khaketla 1 , Nathan J. Lachowsky 2 , Heather L. Armstrong 3 , Zishan Cui 3 , Mark Hull 3 , Paul Sereda 3 , Robert S. Hogg 3 , Julio S. Montaner 3 , Eric Roth 2 , David Moore 1 1 Univ of British Columbia, Vancouver, Canada, 2 Univ of Victoria, Victoria, Canada, 3 BC Cntr for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada Background: Gay, bisexual and other men who have sex with men (gbMSM) are at highest risk for incident HIV infection in British Columbia (BC), Canada. Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine was licensed in Canada in February 2016 but is currently not publicly funded in British Columbia (BC). We explored 4-year trends in, and factors related to awareness and use of PrEP among an gbMSM cohort in Vancouver, BC. Methods: We analyzed data from the Momentum Health Study, a longitudinal cohort study of gbMSM in Vancouver, BC. MSM aged ≥16 years were recruited through respondent- driven sampling and completed a computer-assisted self-interview at enrolment with follow-up every 6 months. Stratified by HIV status, we examined awareness and use of PrEP among participants using data from February 2012 to February 2016. We conducted univariable and multivariable generalized linear mixed effect model analyses to examine trends in the proportion of participants aware of and using PrEP, and then to identify factors associated with PrEP awareness over time among HIV-negative gbMSM. Results: 2991 study visits were completed by 732 participants (median follow-up 2.5 years), of whom 27.9%were HIV-positive, 75.7% Caucasian and median age was 34 years. The proportion of HIV-negative men who were aware of PrEP increased from 18% in 2012 to 80% in 2016 (p<0.001 for trend); among HIV-positive men, awareness increased from 35% to 77% (p<0.001). While 73% of HIV negative men reported to have insurance that covered prescription medication, only 8 (2%) reported using PrEP in any 6-month period. In the final model, HIV-negative men were more likely to be aware of PrEP if they had annual incomes ≥$60,000 (aOR=2.24), had more than a high school education (aOR=2.10), were aged 28 – 40 (aOR=1.66) reported viral load sorting as an HIV prevention practice (aOR=2.56), had used ecstasy in the past 6 months (aOR=1.46), scored higher on the Sensation Seeking Scale (aOR=1.04) and had reported ≥2 previously diagnosed STIs (aOR=1.97); gbMSM who were Aboriginal (aOR= 0.36) or Latino (aOR=0.40), who were single (aOR=0.70) and who had received drugs for sex (aOR=0.22) were less likely to be aware of PrEP. Conclusion: PrEP awareness increased dramatically over time, and was associated with several HIV risk behaviours among HIV-negative gbMSM. However, only a small proportion of HIV-negative gbMSM reported PrEP use, highlighting that PrEP access should be expanded for at-risk gbMSM in BC. 967 Background: Men who have sex with men (MSM) who use crystal methamphetamine (meth) are at particularly high risk of HIV acquisition. However, meth-using MSM are under- represented in PrEP programs in Seattle, WA. It is critical to understand the knowledge of and concerns about PrEP in this population to better target effective HIV prevention services. Methods: In August 2016 we administered an anonymous, online, 17-item survey to meth users. Respondents were recruited by peer educators from Project NEON, a harm reduction program for gay, bi, and trans* male meth users. Eligibility criteria included reporting cisgender male or trans* identity, sex with male or trans* partners in the past year, meth use in the past 3 months, and negative or unknown HIV status. The survey collected demographic characteristics, frequency of meth use, and knowledge of PrEP and barriers to use. Participants were sent a $10 gift card for survey completion. Results: The majority of the 221 participants identified as male (97.7%) with a median age of 31 years (IQR 25-35, range 19-53). 84.2% reported having sex only with men, 9.1%with men and women, 5.4%with men and trans* partners, and 1.4%with women and trans* partners. 159 participants were white (71.9%), 46 were black (20.8%), and 16 reported other racial identities (7.2%). Approximately one-third were currently homeless (35.8%). 214 participants had insurance (96.8%) and, of those insured, 79.0% had Medicaid and 20.1% private insurance. 6.8% participants reported using meth daily, 77.8%weekly, 13.1%monthly, and 2.3% less frequently. The majority of respondents had “heard of PrEP before” (96.4%); however, only 7 had ever used it (3.3%). Out of the 206 who had heard of PrEP but not used it 93.2% knew where to access PrEP. Despite the rare use of PrEP in this high-risk population, most participants reported no concerns about it (58.7%). Of the 88 reporting concerns, the most common were that it would not prevent HIV (47.7%), meth may impact PrEP’s efficacy (31.8%), and that it would not be safe to use while using meth (30.7%). Conclusion: A high number of participants had heard of PrEP, knew where to access it, and did not have insurance-related barriers to PrEP. Despite this, a very small minority had ever used it. Additional research is needed to assess what education about PrEP may be needed for meth users and understand barriers to uptake in order to increase access to effective HIV prevention services among the highest-risk individuals. 968 A CLINICAL HIV PREEXPOSURE PROPHYLAXIS EDUCATION INTERVENTION AMONG MSM Julia Raifman 1 , Catherine E. Oldenburg 2 , Amy Nunn 3 , Madeline C. Montgomery 3 , Alexi Almonte 4 , Allison Agwu 1 , Renata Arrington-Sanders 1 , Philip A. Chan 4 1 The Johns Hopkins Univ, Baltimore, MD, 2 Univ of California San Francisco, San Francisco, CA, USA, 3 Brown Univ, Providence, RI, USA, 4 Miriam Hosp, Providence, RI, USA Background: Pre-exposure prophylaxis (PrEP) effectively prevents HIV among high-risk groups, including men who have sex with men (MSM), but implementation has been slow. While sexually transmitted diseases (STD) clinics are increasingly implementing PrEP education programs, the impact of PrEP education programs on awareness and use has not been established. We evaluated the impact of a brief education intervention on PrEP awareness and use among MSM attending a STD clinic in Rhode Island. Methods: We reviewed data on HIV-negative MSM presenting to the Rhode Island STD Clinic between 2012-2015. We estimated the impact of a brief (≤5 minutes) clinic-wide PrEP education intervention for all MSM at their first visit on PrEP awareness and use at a second clinic visit. We considered all MSM whose first clinic visit occurred before intervention KNOWLEDGE ABOUT PREP AMONG MSM AND TRANS* METHAMPHETAMINE USERS IN SEATTLE Vanessa McMahan 1 , Aleks Martin 2 , Lindsay Garske 2 , Jared Baeten 1 , Caleb Banta-Green 1 , Joanne Stekler 1 1 Univ of Washington, Seattle, WA, USA, 2 Proj NEON, Seattle, WA, USA

CROI 2017 419