CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

430

Disparities in Mpox Vaccination Among Cis Men and Trans Persons With HIV in Los Angeles County Colleen Leonard 1 , Erin Nguyen 1 , Kathleen Poortinga 1 , Sherry Yin 1 , Andrea A. Kim 1 , Olivia Moir 1 , Natalie Frey 1 , Abraar Karan 2 , Sonali Kulkarni 1 , Rebecca Cohen 1 , Kwa Sey 1 , Shobita Rajagopalan 1 , Mario J. Pérez 1 1 Los Angeles County Department of Public Health, Los Angeles, CA, USA, 2 Stanford University, Stanford, CA, USA Background: The CDC recommends the 2-dose JYNNEOS vaccine for protection against mpox for people with HIV (PWH) due to a high proportion of US mpox cases occurring in PWH and an increased risk of severe mpox disease among those with uncontrolled HIV infection. In Los Angeles County (LAC), 45% of mpox cases have occurred in PWH, primarily among cis-men and transgender persons. We aim to identify demographic and health-related predictors of JYNNEOS vaccination among cis-men and transgender PWH in LAC. Methods: Cis-men and transgender adults aged ≥ 18 years with diagnosed HIV in LAC were included. Unvaccinated PWH with a prior mpox diagnosis were excluded. Potential predictors of JYNNEOS vaccination included: demographics, viral suppression, CD4 count, HIV transmission mode, receipt of HIV care (past 12 months), retention in HIV care*, recent STI (in 2021), and ≥ 1 prior COVID-19 vaccination (proxy for individual vaccine confidence). Fully nonproportional odds models were used to measure the associations between predictor variables and the outcome (2, 1 or 0 doses of JYNNEOS). Results: Among 37,613 cis-men or transgender PWH, 8,757 (23.3%) were fully vaccinated, 3,473 (9.2%) had received 1 dose, and 25,383 (67.5%) were unvaccinated. Disparities by age group, race/ethnicity, and healthy places index (HPI) were observed. Full vaccination was lowest among PWH who were aged 18-29 (14.5% vs 26.2% aged 40-49), Black (17% vs 30.3% Asian and 28.8% White), or living in zip codes in the lowest quartile of HPI (20% vs 31% highest). Prior COVID vaccination (adjusted odds ratio [aOR] 2.9, confidence interval [CI] 2.7-3.2), receipt of HIV care in the past 12 months (aOR 2.3, CI 1.9-2.7), recent STI diagnosis (aOR 1.6, CI 1.5- 1.7), and living in the highest HPI quartile (aOR 1.5, CI 1.4-1.6) were significant predictors of JYNNEOS vaccination (Figure). Black (aOR = 0.67, CI: 0.62-0.73) and Latinx (aOR = 0.73, CI: 0.68-0.78) PWH were less likely to be fully vaccinated against mpox compared to White PWH. Conclusion: Patients engaged in HIV care or who had a recent STI diagnosis were significantly more likely to receive the JYNNEOS vaccine; this may be attributable to vaccine receipt during an HIV/STI visit or underlying individual healthcare seeking behaviors. These findings also highlight the importance of tailoring vaccine outreach efforts to improve vaccine confidence and access, especially for younger individuals, underserved neighborhoods, and Black and Latinx communities.

that require a healthcare provider and a speculum exam, creating a barrier to participation and limiting longitudinal studies. To overcome these challenges, we developed a novel method to collect leukocytes from cervicovaginal fluid (CVF) utilizing Softdiscs. Methods: Non-menstruating persons with vaginas of reproductive age were asked to self-insert disposable Softdiscs and wear for up to 4 hours on three sequential days. After self-retrieval, CVF was removed from the disk via washing, followed by treatment with DTT to thin mucus, passage through a cell strainer, and cryopreservation. Cells were subsequently thawed, enriched for CD45+ cells using magnetic cell separation, and stained with a 28-color antibody panel focused on T cell phenotyping. Results: Across 15 samples (5 participants x 3 days) we recovered high numbers of CD45+ cells (median: 6,233; range: 212-57,703), CD3+ T cells (median: 1,182; range: 12-11,554), and CD19+ B cells (median: 1,072, range: 8-4,690). Of CD3+ T cells, frequencies ranged from 37-87% for CD4+ T cells and 7-55% for CD8+ T cells. Within CD4s there were both regulatory (Tregs) and conventional subsets and within CD8s both tissue resident (TRM) and migratory populations. To demonstrate reproducibility, we compared populations across days and found that within individuals the distribution was strongly conserved. For example, comparing the first and last day of sampling, the frequency of CD4s (R2=0.78, p=0.12) and CD8s (R2=0.90, p=0.04) of CD3s, Tregs of CD4s (R2=0.75, p=0.15), and TRM of CD8s (R2=0.93, p=0.02) were all correlated. Of note, while population distributions were strongly conserved within individuals, they were unique across individuals (Fig 1). Conclusion: Collection of CVF from Softdiscs represents a novel, non-invasive approach to study FGT immune cell populations, including both tissue resident and migratory memory T cell subsets. This approach yielded high quality immune cells which could be cryopreserved and had reproducible population structure and phenotype across multiple days. This self-collected sampling will empower a more diverse population of individuals to participate in future studies of FGT immunity.

Poster Abstracts

432

Identification of Innate Lymphoid Cell Subsets in the Human Female Genital Tract That Respond to HIV Alexandra E Werner , Laura Moreno de Lara, Francisco J. Carrillo-Salinas, Anna Borchers, Siddharth Parthasarathy, Marta Rodriguez-Garcia Tufts University, Boston, MA, USA Background: Women acquire HIV mainly through sexual contact. Identification of innate immune mechanisms that protect against infection in the female genital tract (FGT) will enable strategies to prevent HIV acquisition. Innate lymphoid cells (ILCs) are tissue-resident cells specialized in cytokine secretion that provide mucosal protection against infections in mice. However, human ILCs remain poorly characterized and their potential role in HIV prevention is unknown. Methods: Human hysterectomies (n=35) were enzymatically digested to generate mixed-cell suspensions from endometrium, endocervix, and ectocervix. ILC phenotype and function was assessed with high-dimensional spectral flow cytometry for surface and intracellular molecules (22-parameters). To define ILC-mediated anti- HIV responses, genital mixed-cell suspensions were stimulated with HIV for 30 minutes in vitro, and cytokine content (IL-22 and IFNγ) and degranulation (CD107a) were analyzed by flow cytometry.

431

A Novel Non-Invasive Approach to Sample Female Genital Tract Immune Cell Populations M Quinn Peters 1 , Eva Domenjo-Vila 2 , Melanie Gasper 1 , Smritee Dabee 1 , Blair Armistead 1 , Christopher Whidbey 3 , Heather Jaspan 1 , Martin Prlic 2 , Whitney E. Harrington 1 1 Seattle Children's Research Institute, Seattle, WA, USA, 2 Fred Hutchinson Cancer Center, Seattle, WA, USA, 3 Seattle University, Seattle, WA, USA Background: An increased understanding of immune cell populations in the female genital tract (FGT) is essential for efforts to decrease risk of HIV and other sexually transmitted infections and to develop vaccines that induce mucosal responses. To-date, FGT immune cell collection has utilized techniques

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