CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

1 University of North Carolina Chapel Hill, Chapel Hill, NC, USA, 2 The Ohio State University, Columbus, OH, USA, 3 Johns Hopkins University, Baltimore, MD, USA, 4 University of Wollongong, Wollongong, Australia, 5 Wits Reproductive Health and HIV Institute, Johannesburg, South Africa Background: Sexual partners play a critical role in HIV transmission, but efforts to study and target sexual partner types for HIV prevention have been stymied by current measurement approaches, which have not shown clear associations with HIV acquisition, and do not provide clear guidance on the design of specific, targeted interventions to prevent HIV acquisition across different sexual partner types and contexts. Methods: This secondary analysis examined the sexual partners of 1034 sexually active, adolescent girls and young women (AGYW), ages 13-20, enrolled in a 3-year randomized controlled trial of cash transfers for HIV prevention (HPTN 068) in Mpumalanga Provence, South Africa. AGYWwere tested for HIV infection annually and reported the following 10 indicators for each sexual partner (up to three partners per visit): partner age, school enrollment, children with AGYW, children with other women, cohabit with AGYW, sex only one time, always use condoms, partner HIV-status, partner concurrency status, and transactional sex with partner. We used these indicators to identify sexual partner types using Latent Class Analysis (LCA), and estimated risk ratios (RR) and 95% confidence intervals (CI) for the association between LCA-identified sexual partner type and incident HIV-infection using generalized estimating equations with a robust variance estimator and exchangeable correlation matrix, controlling for confounders. Results: Over the course of 2140 AGYW-visits, 1034 AGYW reported 2968 sexual partners, and 63 AGYW become HIV infected. We identified six, distinct sexual partner types: only one partner type was older, two were not enrolled in school, condom use was low across all but one type, while transactional sex was present in all but one type (Table 1). Compared to AGYWwith “monogamous” partners, AGYWwith “older” partners had more than 3 times the risk of HIV infection (RR: 3.35, 95% CI: 1.43, 7.85), while AGYWwith “unprotected” partners had more than 2 times the risk of HIV infection (RR: 2.45, 95% CI: 1.11, 5.44). AGYWwith “casual protected” or “anonymous” partners were at increased risk of infection, while AGYWwith “cohabiting” partners were at decreased risk compared to AGYWwith “monogamous” partners (results not statistically significant). Conclusion: Partner types based on explicit, reported partner characteristics predict incident HIV-infection among AGYW, and offer an alternative approach for measuring and targeting specific partner types for HIV research and intervention.

922 VIOLENCE AND HIV RISK FACTORS AMONG WOMEN WHO EXCHANGE SEX FOR MONEY OR DRUGS Christine Agnew-Brune 1 , Lina Nerlander 2 , Dita Broz 1 , Zaida Lopez 3 , Stephanie Schuette 4 , Vivian Griffin 5 , Alexis Rivera 6 , Sara N. Glick 7 , Gabriela Paz-Bailey 1 1 CDC, Atlanta, GA, USA, 2 European Centre for Disease Prevention and Control, Stockholm, Sweden, 3 Houston Health Department, Houston, TX, USA, 4 Chicago Department of Public Health, Chicago, IL, USA, 5 Southeastern Michigan Health Association, Detroit, MI, USA, 6 New York City Department of Health and Mental Hygiene, Long Island City, NY, USA, 7 University of Washington, Seattle, WA, USA Background: Violence among women who exchange sex is pervasive and has been associated with risk for HIV infection. Client-perpetrated violence (CPV) and intimate-partner violence (IPV) introduce vulnerability that place women at higher risk of sexual and drug-use behaviors associated with HIV and may affect their ability to seek healthcare services. Despite the importance of violence and HIV risk among women who exchange sex, data for prevention efforts in the US is lacking. We used data from CDC’s National HIV Behavioral Surveillance to examine violence experienced by women who exchange sex and estimate associations between violence and behaviors known to increase risk for HIV. Methods: In 2016, women who exchanged sex for money or drugs in the prior 12 months were recruited via respondent-driven sampling and interviewed in five cities (Chicago, Detroit, Houston, New York City, and Seattle). Using log-linked Poisson regression, we calculated separate adjusted prevalence ratios (aPR) for associations between 4 violence measures and 2 past-year behavioral outcomes: condomless sex (vaginal or anal) and injection drug use. The violence measures included physical (e.g., slapped, punched, kicked) or sexual (forced or pressured vaginal, oral or anal sex) perpetrated by clients or intimate partners (boyfriend, spouse, or other sex partner). Models were adjusted for city and age. Results: Of 1,790 women sampled, most were black (65%) or Latina (13%) and the median age was 46. Injection drug use was reported by 26% of women and 43% reported condomless sex. Over 85% visited a healthcare provider in the past year and 83% had health insurance. Physical CPV was reported by 10% of women, sexual CPV by 13%, physical IPV by 32%, and sexual IPV by 29%. Sexual CPV and sexual IPV were associated with injection drug use (aPR=1.47, confidence interval [CI]: 1.16–1.86; aPR=1.26, CI: 1.04–1.53, respectively) while physical violence were not. Physical and sexual CPV were associated with condomless sex (aPR=1.28, CI: 1.08–1.51; aPR=1.19, CI: 1.01–1.39, respectively) as were physical and sexual IPV (aPR=1.25, CI: 1.10–1.41; aPR=1.25, CI: 1.11–1.41, respectively). Conclusion: Among sampled women who exchange sex, CPV and IPV were prevalent and associated with sexual and drug use HIV risk factors. Most women sampled were engaged in healthcare, suggesting an opportunity for provider- initiated routine screening for violence and integration of services to address HIV risk in this population. 923 SEXUAL PARTNER TYPE AND INCIDENT HIV-INFECTION AMONG ADOLESCENT GIRLS IN HPTN 068 Nadia Nguyen 1 , Kimberly A. Powers 1 , Annie Green Howard 1 , William C. Miller 2 , Carolyn T. Halpern 1 , Yaw Agyei 3 , Catherine MacPhail 4 , Kathleen Kahn 5 , Audrey Pettifor 1

Poster Abstracts

CROI 2018 352