CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

newborns <10%tile birthweight, and one preterm birth were recorded. No HIV transmissions occurred during follow-up. Conclusion: Under conditions of near perfect adherence, TFV-DP in African AGYWwas 31-37% lower in pregnancy than postpartum. With sequential measurements and a novel measure of cumulative drug exposure, these findings extend prior studies showing lower plasma TFV during pregnancy. There are few data correlating HIV protection and TFV-DP concentrations in women; however, our results suggest that strict adherence is needed during pregnancy. They also provide guidance for assessing PrEP adherence using TFV-DP levels in DBS for pregnant/postpartum African women.

never married vs married (aIRRs=3.04[95%CI=2.74-3.37]), previously married vs married (aIRRs=4.05[95%CI=3.70-4.43]); age 20-24 vs 15-29 (aIRR=1.71 [95%CI=1.55-1.87]), 25-29 (aIRR=1.29 [95%CI=1.13- 1.47]), and 30-34 (aIRR=1.21[95%CI=1.05-1.39]). Persistence of SHR was associated with male sex (aPRRs=1.15[95%CI=1.08-1.23]); never married vs married (aPRRs=3.05[95%CI=2.77-3.36]), previously married vs married (aPRRs=2.62[95%CI=2.36-2.91]). Recurrence of SHR also associated with male sex (aIRRs=1.39[95%CI=1.14-1.71]), never married vs married (aPRRs=2.97[95%CI=2.37-3.73]), and previously married (aPRRs=2.81[95%CI=2.25-3.53]). Conclusion: Persistence of SHR was modest in this population while incidence and recurrence of SHR were high. The overall prevalence of SHR steadily increased. PrEP programs in similar settings should expect short and repeated PrEP eligibility periods with turnover due to incidence and recurrence of SHR.

Poster Abstracts

983 IMPLEMENTATION OF MOBILE PrEP, STI, AND HIV PREVENTION SERVICES IN SOUTH FLORIDA Mary Tanner 1 , Weiming Zhu 1 , Kashif Iqbal 1 , Kenneth L. Dominguez 1 , Kirk D. Henny 1 , Karen W. Hoover 1 1 CDC, Atlanta, GA, USA Background: Men of color who have sex with men (MSM) and transgender women (TGW) of color are disproportionately affected by HIV. National testing guidelines state that sexually active MSM should have HIV testing annually, and persons at higher risk of acquisition may consider testing every 3-6 months. Little is known about HIV testing patterns of MSM and TGW of color. The THRIVE demonstration project promotes HIV care and prevention services through health department-led collaboratives at 7 sites in the United States. We used THRIVE client data to compare HIV testing patterns for MSM and TGW of color based on PrEP screening results. Methods: Preliminary THRIVE data from 2016-2019 were used. Inclusion criteria were: 1. HIV-negative MSM or TGW of color, 2. Received ≥2 HIV tests, 3. At least 180 days follow-up time. We calculated median and interquartile ranges (IQR) for: days from first to last test, number of tests, and days between tests. We determined what proportion of persons had testing intervals of 90, 120, 180, and 365 days among persons screened for PrEP and found to have 1. PrEP indications and 2. No PrEP indications. Chi squared tests were used for statistical comparisons. Results: For the 2490 MSM and TGW of color, 92% had PrEP indications. Overall, the median (IQR) days to last test was 335 (167-503); median number of tests 3 (2-5); and median days between tests 110 (73-183). Overall, cumulative percentages of persons tested were 36%, 55%, 74%, and 93% for intervals of at least 90, 120, 180, and 365 days respectively. For persons with PrEP indications, cumulative percentages were 37%, 58%, 77%, and 95% for the same intervals; cumulative percentages were 36%, 47%, 63%, and 87% for the same intervals for persons without PrEP indications. Proportion tested every 90 days did not differ significantly between groups; for all other testing intervals significantly more persons with PrEP indications were tested (p<0.05). Conclusion: The majority of MSM and TGW of color with evidence of serial HIV testing are tested at least annually, however, persons without indications for PrEP were significantly less likely to receive annual testing. Similar proportions of MSM and TGW of color with and without PrEP indications were tested

981 WITHDRAWN 982 WAXING AND WANING HIV RISK: DYNAMICS OF PrEP ELIGIBILITY IN RAKAI, UGANDA Victor Ssempijja 1 , Robert Ssekubugu 2 , Godfrey Kigozi 2 , Gertrude Nakigozi 2 , Joseph Kagaayi 2 , Tom Lutalo 2 , Anthony Ndyanabo 2 , Anna Mia Ekström 3 , David Serwadda 2 , Thomas C. Quinn 4 , Ronald H. Gray 5 , Maria Wawer 5 , Larry W. Chang 2 , Steven J. Reynolds 4 1Leidos Biomedical Research, Inc, Frederick, MD, USA, 2Rakai Health Sciences Program, Kalisizo, Uganda, 3Karolinska Institute, Stockholm, Sweden, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA, 5Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Background: PrEP is based on the presence of substantial HIV risk (SHR) behaviors making PrEP eligibility and retention dynamic. We used population- based data to describe longitudinal patterns of SHR of PrEP eligibility and identify factors associated with incidence, persistence and recurrence of PrEP eligibility. Methods: Between August 2011 – June 2018, 4 surveys including SHR-focused questions were conducted by the Rakai Community Cohort Study among consenting adults aged 15-49 years. SHR was defined by the Uganda national PrEP eligibility as either reporting sexual intercourse with >1 partner of unknown HIV status, non-marital sex without a condom or having transactional sex. Recurrence of SHR was defined as the resumption of SHR after stopping SHR, while persistence of SHR meant SHR on >1 consecutive visit. Poisson and log-binomial regressions with generalized estimating equations and robust variance estimators were used to estimate adjusted incidence rate ratios (aIRRs)

and prevalence rate ratios (aPRRs) for PreP eligibility with 95%CIs. Results: 25,695 HIV-negative individuals participated in the cohort, including 13,010 participants with SHR assessment data at ≥ 2 visits (24,132 person-intervals). Overtime, prevalence of SHR increased from 20.1% to 25.2% (p<0.001), and incidence of SHR increased from 6.0/100pys to 7.7/100 pys (p<0.001). Recurrence of SHR was 27.4%. Persistence of SHR at 24, 36 and 48 months was 67.5%(95%CI=66-69), 46.9%(95%CI=45-49) and 26.0%(95%CI=24-28), respectively. Incidence of SHR was associated with male sex (aIRRs=1.27[95%CI=1.19-1.36]);

CROI 2020 369