CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

D. Charlebois 2 , Tamara D. Clark 2 , Moses R. Kamya 3 , Diane V. Havlir 2 , Maya L. Petersen 5 1 University of Washington, Seattle, WA, USA, 2 University of California San Francisco, San Francisco, CA, USA, 3 Infectious Diseases Research Collaboration, Kampala, Uganda, 4 University of Massachusetts Amherst, Amherst, MA, USA, 5 University of California Berkeley, Berkeley, CA, USA Background: The social networks of HIV+ persons may facilitate access to HIV testing and care. We constructed community-wide social networks and assessed association between social connectedness and knowledge of HIV status, ART use, and HIV viral suppression among baseline HIV+ residents of rural Ugandan communities in the SEARCH Study (NCT01864603). Methods: From 2013-2014, adults (≥15 yrs) in 10 communities in Uganda West and 10 in Uganda East were enumerated using a census and named social contacts in five domains: health, money, emotional support, food, and free time. Social networks were constructed by matching named contacts to other enumerated residents; 90% of residents were tested for HIV. We evaluated whether HIV+ persons in the lowest tercile of connectedness, based on in-degree (number of persons who named an individual as a contact) and out- degree (number of contacts an individual named), would be less likely to know their HIV status, have initiated ART, and be virally suppressed (HIV RNA<500 cps/ml) than their more connected counterparts. We used generalized estimating equations to adjust for sociodemographic risk factors including mobility and for clustering by community. Results: A total of 57% of named within-community contacts in Uganda West and 63% in Uganda East were matched to enumerated residents, resulting in 20 networks with 108,521 nodes (enumerated persons) and 216,213 edges (social connections). Among 4,587 HIV+ persons who named ≥1 contact, 39%were not aware of their HIV status, 50% had not initiated ART, and 55% had viral non- suppression. HIV+ persons in the lowest tercile of in-degree (<1-2 contacts, depending on community) were less likely to know their status (Uganda West aRR:0.89 (95%CI:0.83, 0.96); Uganda East aRR:0.85 (0.76, 0.96)); to have initiated ART (Uganda West aRR:0.88 (0.80, 0.98); Uganda East aRR:0.81 (0.72, 0.92)), and to have viral suppression (Uganda West aRR:0.84 (0.73, 0.96); Uganda East aRR:0.74 (0.58, 0.94)) than those in the highest tercile (>3-7 contacts) (Figure). Out-degree was not associated with known HIV status or suppression in either region; persons in Uganda East with intermediate out-degree were less likely to have initiated ART. Conclusion: HIV+ persons with fewer people naming them as contacts were less likely to know their HIV status, have initiated ART, or have a suppressed viral load. Interventions targeting HIV+ persons with fewer social connections may contribute to improved clinical outcomes.

866 DISPARITIES IN VIRAL SUPPRESSION AMONG US ADULTS WITH RECENTLY DIAGNOSED HIV Hanna B. Demeke 1 , Stacy M. Crim 1 , Sharoda Dasgupta 1 , John Weiser 1 , R. L. Shouse 1 1 CDC, Atlanta, GA, USA Background: The Ending the HIV Epidemic (EHE) initiative focuses on rapid & effective treatment of people with HIV to achieve viral suppression, which is associated with improved health outcomes & reduced HIV transmission risk. Assessing disparities in viral suppression among persons with recent HIV diagnoses has the potential to guide practice and research. Using nationally representative data from the Medical Monitoring Project (MMP), we explored characteristics associated with viral suppression among adults with recent HIV diagnoses. Methods: During 2015-2018, MMP conducted interviews among adults with diagnosed HIV. Viral load test results were abstracted frommedical records. Viral suppression was defined as <200 copies/mL or undetectable based on the most recent viral load. Generalized anxiety disorder (GAD) in the past 2 weeks was assessed using a validated scale and categorized based on clinically meaningful cutpoints. Persons who reported needing but not receiving services had unmet needs for these services. All characteristics were based on the past 1 year unless otherwise indicated. Among persons with HIV diagnosed in the 5 years prior to interview (N=1,869), we assessed differences in viral suppression by selected characteristics using Rao-Scott χ2 tests (p<0.05). Results: Of persons with recent HIV diagnoses, 31%were not virally suppressed, and 5% reported not currently taking ART. The proportion not virally suppressed varied by race/ethnicity (blacks: 37%, whites: 27%, Hispanics/Latinos: 26%) and age (18-24 years: 50%, 25-34 years: 35%, 35-44 years: 26%, 45-54 years: 23%, and ≥55 years: 22%). Persons who had a history of homelessness (40% vs. 30%), used non-injectable drugs (37% vs. 27%), had GAD (38% vs. 29%), and had unmet needs for HIV medicine (63% vs 29%), HIV case management (55% vs. 28%), and patient navigation services (67% vs. 28%) were less likely to be virally suppressed. Conclusion: More than a quarter of persons with newly diagnosed HIV were not virally suppressed. Providers should ensure all persons with HIV are virally suppressed, including those newly diagnosed. Focusing efforts on programs, including comprehensive engagement, adherence support, & peer navigation, may result in improved health outcomes and reduced number of new HIV infections and supports the EHE initiative. 867 HIV+ PERSONS IN RURAL UGANDA WITH FEWER SOCIAL CONNECTIONS HAVE LOWER HIV SUPPRESSION Yiqun Chen 1 , Gabriel Chamie 2 , Dalsone Kwarisiima 3 , Laura B. Balzer 4 , Jane Kabami 3 , Atukunda Mucunguzi 3 , Asiphas Owaraganise 3 , Lillian Brown 2 , Edwin

Poster Abstracts

868 LIFE EXPECTANCY GAINS WITH ART IN LATIN AMERICA, 2003-2017 Casey Smiley 1 , Peter Rebeiro 1 , Carina Cesar 2 , Francisco Belanzauran 3 , Brenda Crabtree-Ramírez 3 , Denis Padgett 4 , Eduardo Gotuzzo 5 , Claudia P. Cortes 6 , Jean W. Pape 7 , Valdilea Veloso 8 , Catherine McGowan 1 , Jessica L. Castilho 1 1 Vanderbilt University, Nashville, TN, USA, 2 Fundación Huésped, Buenos Aires, Argentina, 3 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, 4 Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras, 5 Universidad Peruana Cayetano Heredia, Lima, Peru, 6 University of Chile,

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