CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

in PWID and FSW, all young subgroups, and drug injecting MSM and FSW. In between-round comparison, there was a significant almost two-fold increase between 2013 and 2015 in MSM (from 4.3% to 7.8% overall, p<0.001 1.9% to 4.3% in young subgroup, p<0.001) while there was an insignificant decrease in drug-injecting MSM (from 16.1% to 11.4, p=0.227). Prevalence increased in 2015 in all PWID (from 18.1% in 2013 to 22.0%, p<0.001), but not in younger subgroup (from 4.29% in 2013 to 4.27% in 2015, p=0.974). There were no significant changes between 2013 and 2015 in FSW. Conclusion: The pooled analysis of four nationally-representative IBBS surveys in Ukraine has confirmed the decreasing trend in HIV prevalence in PWID and FSW. Prevalence in younger subgroups, commonly used as a proxy indicator for incidence, has decreased markedly in all three populations. The change in PWID may be explained by the effect of the massive harm reduction program supported by the Global Fund, covering more than 60% of estimated PWID nationally. The decreases in MSM and FSW, covered by prevention to a lesser extent, may be driven by the decline in PWID. The recent increase in MSM, especially the younger subgroup, may indicate a new wave of non-injection related transmission, which is correlated with other studies.

for men who have sex with men, those aged 13-34 years, and those residing in urban areas and the West. The increasing trend in the South represents an emerging threat. 931 COMPLEX HIV EPIDEMIC DYNAMICS IN MIGRANTS IN EUROPEAN UNION/ ECONOMIC AREA (EU/EEA) Julia Del Amo 1 , Inma Jarrin 1 , Victoria Hernando 1 , Cristina Moreno 1 , Belen Alejos 1 , Anastasia Pharris 2 , Teymur Noori 2 1 Institute of Health Carlos III, Madrid, Spain, 2 European Centre for Disease Prevention and Control, Stockholm, Sweden Background: We aim to understand the impact of migrants from sub-regions within Sub-Saharan Africa (SSA), Europe, and Latin America/the Caribbean (LAC) to HIV epidemic dynamics in the EU/EEA. Methods: HIV Surveillance data from 30 EU/EEA countries from 2004 till 2015 were analysed. Cases in migrants (defined as cases with different country of origin to that of report) from SSA were divided into Western, Central, Eastern and Southern Africa UN sub-regions; those from Europe into Eastern (EE), Central (CE) and Western Europe (WE); and those from LAC into Central (CA), Andean (AA), South-America (SA) and Caribbean (Cb). Differences in CD4 counts at HIV diagnosis were analyzed using multivariate median regression. Results: Of 375,743 reports, 18%were from SSA [35%Western SSA, 31% Eastern, 22% Central, 5% Southern SSA, 7% unknown], 7%were European migrants [48%WE, 31% CE and 21% EE] and 5% from LAC [31% unknown LAC sub-region], 27% Cb, 24% SA, 9% AA and 9% CA]. In migrants from SSA, 86% acquired HIV heterosexually and 3.5% through sex between men (MSM). Absolute and relative HIV declines (2014 vs 2004 to lessen reporting delay) were -98 (-5%), -1750 (-61%), -705 (-40%), -274 (-63%) for Western, Eastern, Central and Southern SSA, respectively. Increases were seen in MSM from SSA. In migrants from Europe, 74% and 57% of reports fromWE and CE, respectively, were in MSM and 34% of reports from EE in persons who inject drugs (PWID). Absolute (+833) and relative (+139%) increases in HIV diagnoses in migrant MSM from Europe were observed. For heterosexually transmitted cases, absolute (+429) and relative (+257%) increases from CE and EE were reported. For PWID, absolute (-63) and relative (-52%) declines in WE and absolute (+54, + 47) and relative (+357%, +62%) increases in HIV diagnoses from CE and EE were observed. In migrants from LAC, 53%were MSM. Absolute and relative +679 (+167%) increases in HIV diagnoses in MSM and corresponding -215 (-27%) declines in heterosexually transmitted cases were reported. CD4 count at diagnosis increased over time for SSA and WE migrants and were higher in women and MSM. Conclusion: Declines in heterosexually transmitted HIV are observed in migrants from Central and Eastern SSA, the Caribbean and WE, together with striking increases in migrant MSM from all regions. Rising CD4 counts reflect more HIV testing in most migrant groups. Migration flows changes from UN-sub regions into EU/EEA are likely to shape these trends.

Poster Abstracts

930 TRENDS IN HIV INFECTION AMONG AMERICAN INDIANS/ALASKA NATIVES, US 2010–2014 Andrew J. Mitsch 1 , Xiao Wang 2 , Dean Seneca 1 , Sonia Singh 1 , Donald Warne 3 1 CDC, Atlanta, GA, USA, 2 ICF International, Atlanta, GA, USA, 3 North Dakota State University, Fargo, ND, USA Background: During 2010-2014, American Indians/Alaska Natives (AIs/ANs) were among the two racial/ethnic groups that experienced increasing annual rates of diagnoses of HIV infection. At year-end 2014, one in five AIs/ANs living with HIV were unaware of their infection. The objective of this analysis was to describe trends among AIs/ANs in annual diagnoses and prevalence by subgroup and variations by place for the purpose of guiding HIV prevention efforts among this population. Methods: Using National HIV Surveillance System (NHSS) data, we determined the number of HIV diagnoses reported to CDC from 2010 through 2014, and through year-end 2014 for prevalence, among US residents with diagnosed HIV infection classified as AI/AN, aged ≥ 13 years. We measured trends in annual diagnoses during 2010-2014 using arithmetic change and for 2014, we calculated diagnosis rate ratios for sex, age group, transmission category, and place of residence at diagnosis. We also measured trends in prevalence during 2010–2014 using estimated annual percent change (EAPC) with 95% confidence intervals (CI), overall and for transmission category and jurisdiction. Results: During 2010–2014, the overall rate of annual diagnoses of HIV infection among AIs/ANs increased by 17.3%. Annual diagnosis rates increased among male AIs/ANs by 25.5%, those aged 13-34 years by 28.0%, in the South by 37.7% and in large metropolitan areas by 16.3%. For 2014, the male to female diagnosis rate ratio was 4.1 and 9.3 for those aged 13-34 years as compared to those aged ≥ 55. In addition, AIs/ANs were 1.6 times as likely to have their HIV infection diagnosed in the West as compared to the Northeast and 3.4 times as likely to have their HIV infection diagnosed in a large metropolitan area as compared to a nonmetropolitan area. Overall prevalence increased, (EAPC 3.2, 2.1-4.3) as did the prevalence among men who have sex with men (EAPC 3.9, 1.6-6.3). Prevalence rates increased in 2 jurisdictions, were stable in 27, decreased in none and could not be calculated in 22 due to small cell sizes. Conclusion: Increasing trends among AIs/ANs suggest growing vulnerability to HIV. Prevention efforts should be strengthened for all AIs/ANs-particularly

932 HIV TESTING AND US ACQUISITION AMONG AFRICAN IMMIGRANTS LIVING WITH HIV IN THE US Roxanne P. Kerani 1 , Amanda Lugg 2 , Baiba Berzins 3 , Oumar Gaye 4 , Lauren Lipira 1 , Camille Bundy 3 , Helena Kwakwa 4 , King Holmes 1 , Matthew R. Golden 1 1 University of Washington, Seattle, WA, USA, 2 African Services Committee, New York, NY, USA, 3 Northwestern University, Chicago, IL, USA, 4 Philadelphia Department of Public Health, Philadelphia, PA, USA Background: African immigrants in the U.S. are more likely to have a late HIV diagnosis than U.S.-born people, potentially leading to onward transmission of HIV. We sought to determine the proportion of African-born people living with HIV (APLWH) who 1) had HIV tested prior to diagnosis, and 2) likely acquired HIV in the U.S. Methods: We interviewed APLWH in King County, WA, New York City, Philadelphia, and Chicago from February, 2014- August, 2017. Participants

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