CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

trends is that transmission of HIV between MSM and women has decreased. We explored temporal changes in HIV transmission between MSM and women. Methods: Using National HIV Surveillance System data reported through December 2016, we calculated the annual number of HIV diagnoses during 2011–2015 for 1) heterosexual women and 2) MSM, overall and in two subgroups: men who have sex with men and women (MSMW) and men who have sex with men only (MSMO), using standard CDC methodology to adjust for missing risk information. Estimated annual percentage changes (EAPCs) and 95% confidence intervals (CIs) were calculated. Using HIV-TRACE, we also analyzed partial HIV-1 polymerase sequences to identify potential transmission partners (persons whose HIV strains are extremely similar) between MSM and heterosexual women at a genetic threshold of ≤ 1.5%. Results: From 2011 to 2015, HIV diagnoses among heterosexual women decreased from 7563 to 6483 (EAPC: -3.6; CI: -4.6, -2.7) (Figure). During the same time period, diagnoses among MSM overall were stable at 26,107 in 2011 and 26,539 in 2015 (EAPC: 0.5; CI: 0.0, 0.9). However, diagnoses among MSMW decreased from 7781 to 6545 (EAPC: -4.3; CI: -5.3, -3.3). Among 38,364 MSM with a potential transmission partner identified, the percentage linked to a heterosexual woman decreased from 4.4% during 2008–2011 to 3.5% during 2012–2015. Conclusion: These data indicate that the number of HIV diagnoses among MSM who also report sex with women has declined in recent years and that the already small percentage of MSM with possible transmission linkages to heterosexual women has decreased further in recent years. These findings suggest that reduced HIV diagnoses among heterosexual women may be attributable, at least in part, to reduced transmission fromMSM to women.

regression was used to compare characteristics of previously diagnosed men who did or did not report a prior HIV diagnosis. Results: We analyzed samples and data from 183 men who were HIV-infected at screening; 67 (36.6%) of the 183 men reported that they were HIV infected. Among the 116 men who did not report a prior HIV diagnosis, 36 (31.0%) had ARV drugs detected (30 reported a negative HIV status, one reported not knowing his status, and five reported no prior HIV test). After accounting for ARV drug use, 103 (56.3%) of the men were classified as previously diagnosed and 80 (43.7%) were classified as newly diagnosed. Among previously diagnosed men, the following groups were more likely to report a positive HIV status: men from Soweto, South Africa (compared to men from Kenya, p=0.006) and men who reported having sex with men only (compared to men who reported having sex with men and women, p=0.002). Conclusion: In this cohort, ~30% of the HIV-infected men screened for the study who did not report that they were HIV-positive were on ART. HIV-infected men who reported having sex with men only were more likely to report knowledge of their HIV status. The accuracy of self-report for identifying individuals who are aware of their HIV-positive status has serious limitations. Understanding factors associated with disclosure of HIV status in different populations and settings may help inform HIV treatment and prevention studies. 913 FACTORS ASSOCIATED WITH VIRAL SUPPRESSION AMONG MSM IN WASHINGTON, DC Auntre D. Hamp, Jenevieve Opoku , Adam Allston District of Columbia Department of Health, Washington, DC, USA Background: Between 2012 and 2016, new diagnoses amongst MSM decreased by 54% in the District of Columbia (DC). Despite the decrease in new infections, Black MSM represented 57.8% of all diagnosed and living cases in DC in 2016. In order to sustain decreases in new infections in MSM of color, the examination of HIV care patterns and viral suppression among this group is critical. The aim of this study is to examine factors associated with viral suppression amongst MSM in DC. Methods: Data were extracted from the DC HIV surveillance system. All newly diagnosed HIV cases, who were diagnosed between 2011 and 2015 and living DC at the end of 2015 were included in this analysis. Continuous retention in care was defined as having at least two CD4 counts or viral load (vl) laboratory tests, at least 90 days apart in 2015. Sporadic retention in care was defined as having at least one CD4 count or vl laboratory test in 2015. Viral suppression was defined as having a last known lab in 2015, of less than or equal to 200 copies/mL. Logistic regression was used to identify factors associated with viral suppression in 2015. Race/ethnicity, age, retention in care in 2015 and year of diagnosis were evaluated in this model. Results: Between 2011 and 2015, there were 1,350 MSM and MSM/IDU newly diagnosed and living in DC at the end of 2015. Logistic regression analysis revealed that those aged 25 to 29 (OR 1.96; CI 1.21, 3.20), aged 30 to 39 (OR 3.00; CI 1.77, 5.10), aged 40 to 49 (OR 3.11; CI 1.68, 5.76) and aged 50 to 59 (OR 6.27; CI 2.59, 15.17) were more likely than those aged 20 to 24 to be virally suppressed. Persons who were Black (OR .35; CI .20, .59) or Hispanics (OR .47; CI .24, .91) were less likely than white, non-Hispanics to be virally suppressed. Persons who were sporadically retained in care (OR .31; CI .22, .43) were less likely than those who were continuously retained in care to be virally suppressed. Additionally chi-squared tests showed that while there was no difference in retention in care by race (p=.49), Black MSM were more likely to not be virally suppression than other racial groups (<.01). Conclusion: Results of this analysis identify factors related to viral suppression amongst MSM in DC. These findings provide increased insight that being continuously retained in care may be a critical factor in treatment and ultimately viral suppression, but the current measurement of retention in care may not take into account various other factors that impact viral suppression for certain populations.

Poster Abstracts

912 RELIABILITY OF SELF-REPORTED HIV STATUS AMONG AFRICAN MSM SCREENED FOR HPTN 075 Jessica M. Fogel 1 , Yinfeng Zhang 1 , Xu Guo 2 , William Clarke 1 , Autumn Breaud 1 , Vanessa Cummings 1 , Erica Hamilton 3 , Arthur Ogendo 4 , Noel Kayange 5 , Ravindre Panchia 6 , Karen Dominguez 7 , Ying Q. Chen 2 , Theodorus Sandfort 8 , Susan H. Eshleman 1 1 The Johns Hopkins University, Baltimore, MD, USA, 2 Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 3 FHI 360, Durham, NC, USA, 4 Kenya Medical Research Institute, Kisumu, Kenya, 5 Malawi Coll of Med–Johns Hopkins Univ Rsr Proj, Blantyre, Malawi, 6 University of the Witwatersrand, Soweto, South Africa, 7 University of Cape Town, Cape Town, South Africa, 8 Columbia University, New York, NY, USA Background: In many research studies, individuals who test positive for HIV infection are asked if they had a prior HIV diagnosis. We evaluated the reliability of self-report of HIV status among men who have sex with men (MSM) who were screened for participation in the HIV Prevention Trials Network (HPTN) 075 study. This study evaluated the feasibility of recruiting and retaining MSM in sub-Saharan Africa for HIV prevention trials. Methods: The HPTN 075 study population included HIV-infected and HIV- uninfected MSM ages 18-44 years at four study sites (Kisumu, Kenya; Blantyre, Malawi; Soweto and Cape Town, South Africa). Men who were on antiretroviral therapy (ART) or in HIV care were not eligible for the study. Knowledge of HIV status at screening was assessed with self-report and retrospective antiretroviral (ARV) drug testing using an assay that detects 20 ARV drugs. Men were classified as previously diagnosed if they reported being HIV-infected or had ARV drugs detected that indicated that they were on ART. Logistic

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