CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

1078 MOBILITY, NEW HIV INFECTIONS, AND PROGRESS TOWARD THE 90-90-90 TARGETS IN NAMIBIA Andrea Low 1 , Karampreet K. Sachathep 1 , George Rutherford 2 , Anne-Marie Nitschke 3 , AdamWolkon 4 , Karen M. Banda 2 , Keisha Jackson 5 , Chelsea Solmo 1 , Hetal Patel 5 , Stephen McCracken 5 , Sally Findley 6 , Nicholus Mutenda 3 1 ICAP at Columbia University, New York, NY, USA, 2 University of California San Francisco, San Francisco, CA, USA, 3 Ministry of Health and Social Services, Windhoek, Namibia, 4 US CDC Windhoek, Windhoek, Namibia, 5 CDC, Atlanta, GA, USA, 6 Columbia University, New York, NY, USA Background: Namibia has high HIV prevalence and migration rates, yet little is known about howmigration affects HIV transmission. We assessed the impact of mobility on HIV transmission and treatment outcomes using data from the 2017 Namibia Population-based HIV Impact Assessment (NAMPHIA). Methods: NAMPHIA included a nationally representative sample of adults aged 15–64 years. Recent infection (<130 days) was measured using HIV-1 LAg avidity combined with viral load (>1000 copies/mL) and antiretroviral (ARV) testing data. Awareness of HIV status and ARV use were based on self-report and/or detectable ARVs in blood. Viremia was defined as no viral load suppression (VLS, <1000 copies/ml) regardless of serostatus; community viremia was a weighted average across the sampled enumeration area. Ever migrants (EM) included those who had lived outside their home region, or away from home >1 month in the past 3 years. Recent in-migrants (RM) were those who moved to the community <2 years prior, even if this was an intra-regional move, compared to long-term in-migrants. Hazardous alcohol use was defined reported living outside Namibia, 52.5% had lived in another region, and 28.8% had lived away from home for >1 month, for a total of 62.5% of adults classified as EM; 15.3% of adults were RM. HIV prevalence was 12.6%, and did not differ by migration status; population VLS was 77.4%. RM was associated with recent HIV infection (adjusted odds ratio [aOR], 4.16; 95% confidence interval [CI]: 1.05–16.51) but only in communities with viremia >1%. Both EM and RM had lower proportions of VLS primarily due to less awareness of being HIV positive (Figure). If aware, there were no significant differences in proportion on ART for EM or RM. There was weak evidence that RM on ARVs had less VLS than long- term in-migrants (93% vs. 88%, p=0.059). On multivariable analysis, adjusted odds of VLS were low for RM (aOR, 0.57; 95% CI: 0.35–0.92) and for those with hazardous alcohol use (aOR, 0.29; 95% CI: 0.45–0.92). Conclusion: Namibia has achieved a high level of population VLS. Understanding how to reach at-risk migrants with prevention and treatment can help further optimize the national HIV response. using the AUDIT-C scale. Analyses were run on weighted data. Results: Of eligible adults, 84% (9,671/11,510) of women and 73% (7,268/9,954) of men were interviewed and tested for HIV. Overall, 6.1%

Background: Despite the availability of highly effective antiretroviral treatment (ART), delayed diagnosis and ART initiation, and poor retention in care remain barriers to reducing HIV incidence. We aimed to estimate progress towards the UNAIDS 90-90-90 targets by constructing the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. Methods: Using surveillance and cohort data from Austria, Croatia, Denmark, Germany, Greece, France, Italy, the Netherlands, Spain, Sweden and the United Kingdom, a CoC was constructed with four stages: i) number of people living with HIV (PLHIV); ii) proportion of PLHIV ever diagnosed; iii) proportion of diagnosed who initiated ART; iv) proportion of treated who achieved viral suppression (≤200 copies/mL) at their last visit (July 2015- December 2016). The 11 countries represent 73% of EU population and 85% of PLHIV in the region. Results: The estimated number of PLHIV in the participating countries at the end of 2016 was 702,848, corresponding to 0.19% adult prevalence. Overall, we estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had initiated ART; and 91% of those on ART were virally suppressed. Therefore, among all PLHIV 73%were virally suppressed. The corresponding figures for men having sex with men (MSM) were: 86%, 93%, 93% (and among all PLHIV 74%); for people who inject drugs (PWID): 91%, 88%, 84% (67%); for heterosexuals: 86%, 92%, 91% (72%); for men: 87%, 92%, 91% (73%) and for women: 89%, 92%, 89% (73%). Substantial variation across countries was observed. Conclusion: The EU is near to reaching the 90-90-90 UNAIDS targets, and achieved the UNAIDS final target of 73% of all PLHIV with viral suppression. This finding represents a significant progress compared to 2013, where 60% of all PLHIV were virally suppressed. However, differences between countries and key populations persisted in 2016. To improve outcomes along the CoCs, annual numbers of newly-acquired HIV infections and time intervals spent between stages need to be reduced. Furthermore, strengthening of testing programs and stronger treatment and adherence support, along with HIV prevention measures, are needed to achieve HIV epidemic control and, ultimately, AIDS elimination by 2030.

Poster Abstracts

1080 IMPROVING HIV CARE IN WEST AFRICA: EFFECTS OF A COMMUNITY TREATMENT OBSERVATORY Gemma M. Oberth 1 , Solange Baptiste 2 , Wame Mosime 2 , Alain Manouan 2 , Pedro Garcia 2 , Anta M. Traore 2 , Joelle Murara 2 , Raoul M. Boka 2 1 University of Cape Town, Cape Town, South Africa, 2 International Treatment Preparedness Coalition, Gaborone, Botswana Background: In West and Central Africa, 64% of people living with HIV (PLHIV) are aware of their status, 51% are accessing antiretroviral therapy (ART), and 39% are virally suppressed. Progress is stymied by low demand for services, drug stock-outs, weak health systems and poor quality of care. In 2017, the International Treatment Preparedness Coalition (ITPC) established a Regional Community Treatment Observatory in West Africa to increase accountability for the 90-90-90 targets. Methods: ITPC trained and supported national networks of PLHIV to collect and analyze facility-level HIV treatment data from 125 health centers in 11 West African countries. From January 2018-June 2019, the treatment observatory conducted 1781 monthly monitoring visits to the health centers, complemented by 1501 interviews, and 143 focus group discussions. Feedback was provided to communities, government and health center staff on a quarterly basis to help improve performance.

1079 PROGRESS TOWARDS THE 90-90-90 HIV TARGETS IN 11 EU COUNTRIES Georgia Vourli 1 , Teymur Noori 2 , Kholoud Porter 3 , Josip Begovac 4 , Valerie Delpech 5 , Enrico Girardi 6 , Barbara Gunsenheimer-Bartmeyer 7 , Victoria Hernando 8 , Niels Obel 9 , Ard Van Sighem 10 , Anders Sönnerborg 11 , Virginie Supervie 12 , Robert Zangerle 13 , Giota Touloumi 1 , for the European HIV Continuum of Care Working Group 1 University of Athens, Athens, Greece, 2 European Centre for Disease Prevention and Control, Stockholm, Sweden, 3 University College London, London, UK, 4 University of Zagreb, Zagreb, Croatia, 5 Public Health England, London, UK, 6 Lazzaro Spallanzani National Institute for Infectious Diseases, Rome, Italy, 7 Robert Koch Institute, Berlin, Germany, 8 Institute of Health Carlos III, Madrid, Spain, 9 Copenhagen University Hospital, Copenhagen, Denmark, 10 Stichting HIV Monitoring, Amsterdam, Netherlands, 11 Karolinska Institute, Stockholm, Sweden, 12 INSERM, Paris, France, 13 Innsbruck Medical University, Innsbrusk, Austria

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