CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

be further explored to improve access to care and HIV and HCV prevention for PWUD who may otherwise never receive them. 1024 HIGH PREVALENCE OF PrEP INDICATION IN PEOPLE WHO INJECT DRUGS IN BOSTON, MA, 2018 Joel J. Earlywine 1 , Katie Biello 2 , Angela R. Bazzi 1 1 Boston University, Boston, MA, USA, 2 Brown University, Providence, RI, USA Background: PrEP is recommended for HIV prevention in people who inject drugs (PWID) in the US. In Massachusetts, increasing prevalence of injection drug use has contributed to outbreaks of HIV, potentially identifying missed opportunities for PrEP. Understanding PrEP need, knowledge, and use among PWID will help inform and evaluate PrEP as an HIV prevention tool. Methods: We used the 2018 National HIV Behavioral Surveillance (NHBS) data from PWID in Boston, MA. Eligible participants were ≥18 years old, reported past year injection drug use, lived in the Boston Metropolitan statistical area, could complete the interview in English or Spanish, and consented to be interviewed. Based on US Preventive Services Task Force (USPSTF) guidelines, we estimated the proportions of PWID with PrEP indication by types of HIV acquisition risk: injection risks only (i.e., sharing syringes or injection equipment), sexual risks only (i.e., past-year sexually transmitted infections, being in serodiscordant relationships, or inconsistently using condoms with known MSM or PWID), and overlapping injection and sexual risks. We then evaluated PrEP awareness, conversations with healthcare providers about PrEP, and actual (self-reported) PrEP use among those with and without PrEP indications. Results: Overall, among 433 HIV-uninfected PWID, 399 (92%) had PrEP indication based on USPSTF guidelines as follows: 298 (69%) were indicated for injection risks only, 3 (<1%) were indicated for sexual risks only, and 98 (23%) were indicated for both injection and sexual risks. As shown in Figure 1, among the 399 PWID with PrEP indication, 155 (39%) had PrEP awareness, 42 (11%) had discussed PrEP with a healthcare provider, and 9 (2%) had used PrEP in the last year. Conclusion: The majority of PWID in the Boston 2018 NHBS had PrEP indication based on current guidelines. Although most PWID were indicated for PrEP due to high risk injection-related behaviors, nearly a quarter also reported high risk sexual behaviors. PrEP awareness was suboptimal, conversations about PrEP with providers were uncommon, and PrEP use was extremely low. These findings highlight important areas for clinical and community-based interventions to improve PrEP uptake among PWID.

via internet for its generic drug at their own expense. The definition of HBV infection was positive conversion of HBc antibody or HBs antigen during follow-up period. The participants were followed between January 2018 and September 2019 and incidence rate of HBV infection were evaluated. Participants who acquired HBV infection or HIV infection were censored. Use of vaccination of HBV were defined as self-report of their experience of HBV vaccination or HBs antibody >= 10 mIU/ml (CLIA method). The cox proportional hazards regression analysis was used to evaluate prophylactic effect of PrEP against HBV infection and other factors including HBV vaccination. Factors with statistically significance (p<0.05) and the use of HBV vaccination as a known preventive factor against HBV infection were entered into multivariate analysis. Results: 827 MSM were included in the cohort as of September 2019. Of 827 MSM, 25 and 211 MSM were excluded from the study due to HIV infection and HBc antibody positivity at the enrollment, respectively. 591 (148 were PrEP+ and 443 were PrEP-) were followed every 3 months with 419.8 person-years [mean age (SD), 34.5 years (9.3)]. The incidence rate of HBV infection was 3.57 cases per 100 person-years (15 HBV infections, one in the PrEP+ group and 14 in the PrEP- group, Log Rank test p=0.012,). The table identified the preventive and risk factors estimated by the cox hazard analysis which showed significant prophylactic effect of PrEP against HBV infection. Conclusion: PrEP is a good indication especially for non-responders to HBV vaccination among MSM.

Poster Abstracts

1026 AV AND HBV VACCINATION COVERAGE AND ACCEPTABILITY AMONG MSM ON PrEP Paul Le Turnier 1 , Isabelle Charreau 2 , Audrey Gabassi 3 , Diane Carette 2 , Laurent Cotte 4 , Gilles Pialoux 5 , Cécile Tremblay 6 , Bruno Spire 7 , Marie-Laure Chaix Baudier 3 , Laurence Meyer 8 , Catherine Capitant 2 , Constance Delaugerre 9 , Jean-Michel Molina 9 , François Raffi 1 , for the ANRS IPERGAY study group 1 CHU de Nantes, Nantes, France, 2 INSERM, Villejuif, France, 3 Assistance Publique – Hôpitaux de Paris, Paris, France, 4 CHU de Lyon, Lyon, France, 5 Tenon Hospital, Paris, France, 6 Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada, 7 INSERM, Marseille, France, 8 INSERM, Le Kremlin-Bicetre, France, 9 Hôpital Saint- Louis, Paris, France Background: Sexually transmitted viral hepatitis have a rising incidence in MSM. During the ANRS IPERGAY PrEP trial (NCT 01473472), vaccination against HAV and HBV was offered free of charge to non-immune participants. We assessed baseline immune status, vaccine acceptability and efficacy in IPERGAY participants. Methods: All subjects included in the IPERGAY blind and/or open phases were studied. HAV and HBV immune status were assessed at baseline and after vaccination. Anti-HAV IgGs and anti-HBs antibodies (Abs) were analyzed on available samples taken 1 to 3 months after each vaccine dose and on the latest available sample. The vaccination scheme was analyzed in subjects with a follow-up >6 months after receiving the 1st vaccine dose. Vaccination was considered incomplete when the last dose was not administered (3rd if HBV, 2nd if HAV). Subjects who started vaccination before trial initiation were excluded from acceptability and efficacy analyses. Sociodemographic factors associated with baseline immune status were explored by univariate analysis. Results: A total of 429 subjects were analyzed. Two subjects were excluded because of isolated anti-HBc Abs at baseline. The median follow-up was 2.2 years (IQR 1.6-2.9). Absence of anti-HAV IgG at baseline (50%, 215/427) was associated with younger age (p=0.0001) and tobacco use (p=0.02). HBV

1025 PROPHYLACTIC EFFECT OF PrEP AGAINST HBV INFECTION AMONG MSM Daisuke Mizushima 1 , Misao Takano 1 , Haruka Uemura 1 , Yasuyuki Yanagawa 1 , Takahiro Aoki 1 , Koji Watanabe 1 , Hiroyuki Gatanaga 1 , Shinichi Oka 1 1 National Center for Global Health and Medicine, Tokyo, Japan Background: Universal HBV vaccination had not been available in Japan until 2016 and men who have sex with men (MSM) are still vulnerable to hepatitis B virus (HBV) infection. Thus, we evaluated incidence of HBV infection and prophylactic effect of pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF/FTC) against HBV infection among a non HIV-infected MSM cohort, sexual health clinic (SHC) in Tokyo. Methods: MSM over 16 years old were included in SHC cohort. Participants were examined for HIV infection, syphilis (quantitative RPR/TPHA), pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections, and HBs antigen/antibody and HBc antibody, HCV antibody and HAV IgG antibody every 3 months. Entry criteria of the study were HBc antibody negative (< 1.0 S/CO CLIA method) and HIV negative at the study enrollment. TDF/FTC for PrEP were provided for free via an official program of daily PrEP or purchased

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