CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

(83.3%) reported an HIV test in the past year, and 15.3% reported HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. Among YMSM, low-income was associated with higher odds of HIV self-reported prevalence in Brazil (aOR=1.31, 95%CI:1.00-1.74) and Peru (aOR=1.59, 95%CI:1.04-2.48) but not in Mexico (aOR=0.81, 95%CI:0.56-1.18). Lower education was also associated with higher odds of HIV self-reported prevalence in Brazil (aOR=1.34, 95%CI:1.03- 1.76) but not in Mexico nor in Peru. YMSM from the three countries sexually attracted to men had at least twice higher odds of HIV self-reported prevalence than those preferring women or both (Table 1). Conclusion: In this large, cross-country study, HIV prevalence among YMSM was high. Social-economic disparities were associated with higher odds of HIV self-reported prevalence. Interventions to increase awareness to prevention technologies including PrEP targeting socio-economic disadvantaged YMSM are urgent in Latin America.

1 CAPRISA, Durban, South Africa, 2 Epicentre, Cape Town, South Africa, 3 University of Cape Town, Cape Town, South Africa Background: High HIV incidence in young women in Sub-Saharan Africa remains a key challenge to HIV epidemic control. HIV incidence rates in young women exceed those of men and older women, and the proportion of young HIV-positive women who know their status and are virally suppressed falls well short of the UNAIDS ‘90-90-90’ targets. This study examined the factors associated with seroconversion in young women in a hyperendemic area of South Africa. Methods: We analysed prospective cohort data of HIV-negative women (15-24 years) from the HIV Incidence Provincial Surveillance System conducted in KwaZulu-Natal, South Africa. Participants (n=2,710) completed a questionnaire and provided blood samples for laboratory testing (pregnancy, HIV and other STIs) at enrolment and follow-up approximately 18 months later. The association between risk factors and HIV-seroconversion was assessed using Cox proportional hazards models. Results: The incidence rate of young women was 3.92 (95% confidence interval (CI): 3.27-4.69) per 100 women-years; 3.74 (95% CI: 2.87-4.86) and 4.13 (95% CI: 3.20-5.33) per 100 women-years for women aged 15-19 and 20-24 years respectively. At follow-up, median (interquartile range) viral load of seroconverters was 4,400 (280-50,000) copies/ml and 17% reported knowing their HIV-positive status. Risk of seroconversion in young women increased significantly with the number of lifetime partners reported at baseline. Among teenage girls (15-19), risk of seroconversion was positively associated with being an orphan (adjusted hazard ratio (aHR)=4.38, p=0.005) and having a baseline STI (aHR=2.37; p=0.016), and negatively associated with having family support (aHR=0.46, p=0.022) and having a circumcised partner (aHR=0.58, p=0.047). For women aged 20-24 years, failure to complete high-school (aHR=1.78; p=0.042) and inconsistent condom use (aHR=2.72; p=0.024) were associated with HIV acquisition. Conclusion: This study suggests that structural factors contribute to the high HIV incidence rates observed in young women in this population. However, programs supporting sexual health, male circumcision and condom use remain effective ways to reduce risk. In addition to supporting such programs, it is imperative that HIV testing frequency of young women be increased so that infections can be diagnosed timeously, treatment can be provided and transmission risk reduced. 857 SOCIOECONOMIC DISPARITIES ARE ASSOCIATEDWITH HIV IN YOUNG MSM WITHIN LATIN AMERICA Thiago S. Torres 1 , Lara Coelho 1 , Kelika A.Konda 2 , E. Hamid Vega-Ramirez 3 , Oliver A.Elorreaga 2 , Dulce Diaz-Sosa 4 , Brenda Hoagland 1 , Cristina Pimenta 5 , Marcos Benedetti 1 , Beatriz Grinsztejn 1 , Carlos Carceres 2 , Valdilea Veloso 1 , for the ImPrEP Study Team 1 Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro. Brazil, 2 Universidad Peruana Cayetano Heredia, Lima, Peru, 3 National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico, 4 Condesa-Iztapalapa Specialized Clinics, Mexico City, Mexico, 5 Ministry of Health, Brasilia (DF), Brazil Background: Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess social-economic and behavioral factors associated with HIV self-reported prevalence among YMSM participating in a survey conducted in Brazil, Mexico and Peru. Methods: Through March to May, 2018, MSM were recruited to complete a web-based survey through advertisements on geosocial network (GSN) dating apps (Grindr and Hornet) and Facebook. Inclusion criteria were cisgender men, ≥18 years, living in Brazil, Mexico or Peru. For this analysis, we included YMSM aged 18-24 years who self-reported their HIV status (negative/positive). Multivariable logistic regression models assessed factors associated with HIV self-reported prevalence among YMSM for each country. The models were adjusted for geographical region within each country, race (only Brazil and Peru: white vs. non-white), monthly income (low vs. middle/high, according to countries definition), schooling (>secondary school vs. ≤), steady partner (yes/ no), sexual attraction (men, women or both) and time since last HIV testing (≤1 year vs. >1 year). Results: Among 43,687 MSM that started the questionnaire, 27,475 (62.9%) reported their HIV status; 7,055 (25.7%) were YMSM and were included in the analysis. The majority of YMSM (83.1%) were recruited on GSN apps. Most

858 FORCED SEX IN HAITI: IMPLICATIONS FOR THE HIV EPIDEMIC AMONG MSM AND TRANS WOMEN Nicole Y. Frascino 1 , Lauren Y. Zalla 1 1 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background: Sexual violence is an often perpetrated, but rarely studied risk factor for HIV, particularly among men who have sex with men (MSM) and transgender women (TW) living in the Caribbean. This study aimed to describe the prevalence of forced sex and HIV among MSM and TW and the association between forced sex and HIV prevalence in Haiti. Methods: Five-hundred and twenty MSM and 109 TWwere recruited from 2,339 venues where men and women meet new sexual partners, such as bars, nightclubs, and hotels, in nine of the ten departments in Haiti. Venues were selected using the Priorities for Local AIDS Control Efforts (PLACE) methodology. All MSM and TW completed an interview and HIV test. History of forced sex was defined as ever having experienced forced sexual intercourse or forced sex without a condom. Results: HIV prevalence among MSM and TW in the study population was 2.15% and 27.64%, respectively, while 40.77% and 64.22% reported a history of forced sex. In general, MSM and TWwere young, educated, in a primary relationship, and received money or gifts in exchange for sex in the past 12 months (MSM: 54.62%; TG: 59.63%). In an unadjusted log binomial regression, MSMwith a history of forced sex were 8.19 (95% CI, 3.09-21.67) and TWwere 7.02 (95% CI 1.90-26.00) times more likely to be HIV positive than those without a history of forced sex. When adjusting for age, education, in a primary relationship, receiving money or gifts for sex in the past 12 months, the number of sexual partners in the past four weeks, if a condomwas used at last anal sex and self-identification as LGBTQ in a log binomial regression, MSMwith a history of forced sex were 5.67 (95% CI, 2.63-12.24) times as likely to be HIV positive than those without a history of forced sex. When adjusting for age, education, in a primary relationship, the total number of sexual partners in the past four weeks, if a condomwas used at last anal sex and perceived risk of acquiring HIV in a log Poisson regression, TW with a history of forced sex were 4.83 (95% CI, 1.59-14.61) times as likely to be HIV positive than those with a history of forced sex. Conclusion: Understanding the pathways through which history of forced sex influences mental health and sexual risk behaviors can provide evidence for integration of mental health services in HIV-prevention efforts among MSM and TW in Haiti. 859 SEXUAL HEALTH OF RURAL AND URBAN YOUNG MALE COUPLES IN THE UNITED STATES Elissa L. Sarno 1 , Kyle Jozsa 1 , Emily Bettin 1 , Michael E. Newcomb 1 1 Northwestern University, Chicago, IL, USA Background: Young men who have sex with men (YMSM) are disproportionally affected by HIV, and main partnerships account for a large proportion of new HIV infections among YMSM (35-68%). The number of YMSM living with HIV

Poster Abstracts

CROI 2020 320