CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

at diagnosis (rural: 30%, metropolitan: 28%, MSAs: 25%), and a slightly smaller percentage were virally suppressed (rural: 50%, metropolitan: 54%, MSAs: 56%). Conclusion: During our study period, most women with an HIV diagnosis resided in urban areas. Women in rural areas had slightly higher levels of late diagnosis and lower levels of viral suppression, which may result from differences in access to testing and treatment services. Efforts to improve access to testing and care, particularly in the South, may benefit from considering access issues for persons in both urban and rural settings. 918 FACTORS ASSOCIATED WITH HIV INFECTION AMONG FEMALES AGED 15-24 IN ZAMBIA Haotian Cai 1 , Danielle T. Barradas 2 , Sundeep Gupta 2 , Kathy Hageman 2 , Andrea Low 3 , Nzali Kancheya 2 , Katrina Sleeman 4 , Dan B. Williams 4 , Karampreet Sachathep 3 , Hetal Patel 4 , Omega Chituwo 2 , Lloyd Mulenga 5 1 Association of Schools and Programs of Public Health, Washington, DC, USA, 2 CDC Zambia, Lusaka, Zambia, 3 ICAP at Columbia University, New York, NY, USA, 4 CDC, Atlanta, GA, USA, 5 Government of Zambia Ministry of Health, Lusaka, Zambia Background: The Zambia Population-based HIV Impact Assessment (ZAMPHIA), a nationally-representative cross-sectional household survey conducted in 2016, found that adolescent girls and young women (AGYW) aged 15-24 are disproportionately infected with HIV compared to male peers. HIV prevalence was found to be 5.7% (95% CI: 4.9-6.5%) among AGYW, more than three times the prevalence found among males of the same age (1.8%, 95% CI: 1.3-2.3%). Only 40.1% of AGYWwho tested positive reported awareness of their status. This analysis explores the demographic, behavioral, and biological factors associated with HIV infection among AGYW using preliminary ZAMPHIA data. Methods: Among 5,205 eligible AGYW household members, 4,587 AGYW provided questionnaire responses (88.1% unweighted), of which 4,165 AGYW provided blood samples (90.8% unweighted), representative of more than 1.66 million AGYW in Zambia. Multivariate logistic regression models were used to assess the association between HIV infections and demographic, behavioral, and biological variables among AGYWwho reported having at least one sexual partner in the past 12 months (n=2,188, unweighted). Figures presented are weighted unless otherwise specified and account for the complex survey design. Results: Two-thirds of AGYW reported having ever had sexual intercourse. Of these, 81.0% reported having had one or more sexual partner in the past 12 months. Variables significantly associated with higher odds of HIV infection included urban residence (referent: rural; AOR[95% CI]=2.3[1.6, 3.4], p=<.0001), having a reactive syphilis test showing past or active infection (referent: nonreactive syphilis test; past syphilis AOR[95% CI]=2.4[1.1, 5.2], p=.022; active syphilis AOR[95% CI]=3.4[1.8, 6.3], p<.0001), and being in the 20-24 year old age group (referent: 15-19 years old; AOR[95% CI]=2.2[1.4, 3.5], p<.001). Conclusion: These findings provide additional evidence for the factors that may require special consideration in Zambia regarding the provision of HIV services for AGYW, like syphilis infection and urban residence. HIV testing in this age group is of particular concern since ZAMPHIA 2016 found that awareness of HIV status among those who tested positive for HIV was less than half of the UNAIDS target for achieving epidemic control. Additional analyses are needed to clarify these associations, explore interaction terms, and examine other factors, like past pregnancy, upon availability of the final ZAMPHIA 2016 dataset.

Poster Abstracts

917 HIV DIAGNOSES AMONG WOMEN IN RURAL VS NON-RURAL AREAS, UNITED STATES, 2010-2016 Ndidi Nwangwu-Ike 1 , Neeraja Saduvala 2 , Meg Watson 1 , Alexandra M. Oster 1 1 CDC, Atlanta, GA, USA, 2 ICF International, Atlanta, GA, USA Background: Although most people who receive HIV diagnoses are MSM, women are also at risk of acquiring HIV. Women in rural areas face unique challenges to HIV diagnosis and care, including limited access and transportation to testing and treatment facilities. Although recent U.S. HIV surveillance reports point to substantial declines in HIV diagnosis rates among women (from 7.3/100,000 in 2010 to 5.4/100,000 in 2015), little is known about how demographic and clinical characteristics differ for women with diagnosed HIV by population size of area of residence. Methods: We examined demographic and clinical characteristics from National HIV Surveillance System data for women aged ≥13 years with HIV diagnosed during 2010–2016. Assessment of trends included 2010–2015. We also used data from 38 jurisdictions with complete laboratory reporting to determine viral suppression during 2014 among women with HIV infection diagnosed by year-end 2013 and alive at year-end 2014. Analyses were stratified by three categories of population size of area of residence: rural (nonmetropolitan area. population <50,000), metropolitan (population 50,000–499,000) and metropolitan statistical areas (MSAs; population ≥500,000), based on residence at diagnosis (for analyses of diagnoses) and current residence (for analyses of viral suppression). Results: Of 56,941 women with HIV diagnosed during 2010–2016, 2,387 (4.2%) resided in a rural area, this percentage remained stable (4.0% -4.3%) during 2010–2015. The majority of diagnoses were among black/African American women (rural: 57%, metropolitan: 56%, MSAs: 63%). However, rural women were more likely to be white than women in other areas (rural: 30%, metropolitan: 27%, MSAs: 15%). A high percentage of rural women with HIV diagnoses were located in the South (rural: 79%, metropolitan: 70%, MSA: 52%). A slightly higher percentage of rural women had Stage 3 infection (AIDS)

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