CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

1000 Association Between Substance Use Disorder and Sustained Viral Suppression Among People With HIV Buwei He , Shujie Chen, Jiajia Zhang, Xueying Yang, Bankole Olatosi, Sharon Weissman, Xiaoming Li University of South Carolina at Columbia, Columbia, SC, USA Background: Substance use disorder is an increasing problem among the population in many states of the US and is a potential risk factor for suboptimal viral suppression among people with HIV (PWH). This study aims to examine the association between substance use disorder and sustained viral suppression among PWH. Methods: Electronic health record (EHR) data from the South Carolina Department of Health and Environmental Control (DHEC) was used to identify eligible adult (≥18 years old) PWH who were diagnosed with HIV between 01/01/2007 and 12/31/2019. Sustained viral suppression was defined as consecutive suppressed viral load tests (≤ 200 copies/mL) within one calendar year. Impact of substance use disorder on sustained viral suppression was evaluated by generalized linear mixed model. Potential confounders included age, sex, and chronic diseases history such as cancer, dementia, diabetes, etc. Results: Among 9169 eligible participants, 6376 (69.54%) of them had reached sustained viral suppression status during their follow up periods. Substance use disorders, such as alcohol use (AOR=1.16, 95%CI: 1.03-1.29), illicit drug use (AOR=1.19, 95%CI: 1.07-1.33), and tobacco use (AOR=1.18, 95%CI: 1.11-1.26) were negatively associated with sustained viral suppression. Other significant covariates related to sustained viral suppression were also identified. Participants live without Dementia (AOR=2.65, 95%CI: 1.06-6.59) and Diabetes (AOR=1.21, 95%CI: 1.06-1.37) tend to have higher probability to maintain viral suppression. Conclusion: Using a large cohort of PWH with a long follow up time, this study provided a comprehensive evaluation of the association between substance use disorder and sustained viral suppression. Our findings emphasize the negative impact of using alcohol, illicit drug, and tobacco on maintaining sustained viral suppression. Developing long-term problem substance reduction strategies could help HIV patients achieve long-term viral suppression.

between hazardous alcohol use and detectable viremia among women recently diagnosed with HIV (WLWH) in Uganda. Methods: We analyzed data from women in the standard-of-care control arm of The PATH (Providing Access To HIV Care)/Ekkubo Study, a cluster-randomized controlled trial of an enhanced linkage to HIV care intervention in rural Uganda. To analyze temporal associations between hazardous alcohol use (Alcohol Use Disorder Test- Concise, AUDIT-C, score ≥ 3) and subsequent detectable viral load (VL) (>20 copies per mL), we built prospective logistic regression models using 6- and 12-month follow-up data. Models were adjusted for age, baseline VL, wealth index and if participants were diagnosed pre/post universal test and treat (UTT). We also ran the model adjusting for self-reported adherence using a question form the Adult AIDS Clinical Trials Group (AACTG) adherence instrument. Results: Our analytic sample included 128 women who were diagnosed with HIV at study enrollment and had VL data available at follow-up. Median age of participants was 25 years [IQR 21-32]; 31% were enrolled before UTT. Prevalence of hazardous alcohol use was 18% at 6-months follow up. The majority (85%) self-reported they were ART adherent at 12- months. In adjusted models, women who report hazardous alcohol use at 6-months had 2.84 greater odds of a detectable VL at 12-months (aOR 2.83, 95% CI 1.05, 7.62, p=0.039). When also controlling for self-reported adherence to ART at follow-up, the magnitude of this relationship is stronger, with women who reported hazardous alcohol use having four times greater odds of a detectable VL at 12-months (aOR 4.07, 95% CI 1.09, 13.8, p=0.025). Conclusion: Our study provides insight regarding the relationship between hazardous alcohol use and detectable viremia among WLWH. While our adherence measure has limitations (e.g., short time frame), our findings suggest alcohol use may be impacting viremia, underscoring the need to screen for and intervene on hazardous alcohol use among WLWH. 1002 Biomarker Measure Strengthens Alcohol Use Association With HIV Viral Non-Suppression in PWH on ART Cristina Espinosa Da Silva 1 , Robin Fatch 1 , Winnie Muyindike 2 , Evgeny Krupitsky 3 , Nneka Emenyonu 1 , Sarah Puryear 1 , Aaron Scheffler 1 , Kaku So Armah 4 , Gabriel Chamie 1 , Brian Beesiga 5 , Kara Marson 1 , Frank Palella 6 , Phyllis Tien 1 , Judith Hahn 1 , for the MACS WIHS Combined Cohort Study / Intl URBAN Alcohol Research Collaboration on HIV/AIDS Center 1 University of California San Francisco, San Francisco, CA, USA, 2 Mbarara University of Science and Technology, Mbarara, Uganda, 3 Bekhterev National Medical Research Center for Psychiatry and Neurology, St Petersburg, Russian Federation, 4 Boston University, Boston, MA, USA, 5 Infectious Diseases Research Collaboration, Mbarara, Uganda, 6 Northwestern University, Chicago, IL, USA Background: Alcohol use among persons with HIV (PWH) predicts poor antiretroviral (ART) adherence and other co-morbidities, but its association with HIV viral non-suppression is inconsistent. This may be due to the limitations of alcohol self-report. The biomarker phosphatidylethanol, PEth, is an objective blood-based alcohol measure correlated with past month alcohol use. We assessed the association between alcohol use (using a composite of PEth and self-report) and HIV viral non-suppression. Methods: We pooled data from PWH on ART for ≥6 months from three RCTs and three observational studies conducted from 2012-2022 in the US, Russia, and Uganda, and measured alcohol use via PEth and the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) self-reported screener. We categorized PEth/AUDIT-C alcohol use as: (1) no/low risk (PEth<50 ng/mL and AUDIT-C 0-2/women or 0-3/men); (2) moderate risk (50≤PEth<200 ng/ mL and AUDIT-C 3-5/women or 4-5/men); (3) high risk (PEth≥200 ng/mL and AUDIT-C≥6); if PEth and AUDIT-C were discordant, the higher-risk group was selected. We used mixed effects logistic regression to model the associations between alcohol use and HIV viral non-suppression (≥250 copies/mL) adjusting for sex, age, ART regimen, other substance use, study design and location. We accounted for within-individual and between-study clustering, examined associations using PEth and AUDIT-C alone, and explored interaction by the above variables. Results: Among 2343 participants (4137 obs), 51% were male, 8% were HIV virally non-suppressed, median PEth was 53 ng/mL (IQR=<8-281), and median AUDIT-C was 4 (IQR=1-7). We found a significant association between PEth/ AUDIT-C and HIV viral non-suppression (adjusted OR [95% CI]: high vs. no/low risk= 1.88 [1.07-3.31]). The associations were stronger for PEth/AUDIT-C and PEth alone versus AUDIT-C alone (see Table). We found significant interaction by sex (p<0.10) with a stronger association between high-risk alcohol

Poster Abstracts

1001 Hazardous Alcohol Use Predicts Detectable Viremia Among Ugandan Women: A Prospective Analysis Amanda P Miller 1 , Rhoda K. Wanyenze 2 , Rose Naigino 1 , Michael Ediau 2 , Seth C. Kalichman 3 , Nicolas A. Menzies 4 , Mose H. Bateganya 5 , Susan M. Kiene 1 1 San Diego State University, San Diego, CA, USA, 2 Mekerere University, Kampala, Uganda, 3 University of Connecticut, Storrs, CT, USA, 4 Harvard TH Chan School of Public Health, Boston, MA, USA, 5 US Agency for International Development Tanzania, Dar es Salaam, United Republic of Tanzania Background: Hazardous alcohol use is associated with poor HIV care outcomes, including poor adherence to antiretroviral therapy (ART) and viral non suppression. In Uganda, a setting with a generalized HIV epidemic, research has largely focused on understanding this relationship in men because they are more likely to engage in hazardous alcohol use. However, hazardous alcohol use is also prevalent among women. We explore prospective associations

CROI 2024 320