CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusion: A training intervention regarding HIV screening delivered to a majority of primary care providers in a health area significantly reduced the proportion of late and advanced HIV diagnoses compared to a nationwide control group.

tests decreased slightly going from the pandemic to endemic phase (IRR = 0.80, 95%CI: 0.7, 0.92) and HIV testing did not return to pre-pandemic levels (IRR = 0.77, 95%CI: 0.64, 0.93). Similar trends were observed when stratified by race/ ethnicity, however greater decreases in number of tests during the pandemic phase were greater for White and Hispanic/Latinx participants compared to Black/African American and Asian/Pacific Islander participants (Figure). Conclusion: The overall reduction of HIV testing levels compared to pre pandemic suggests a new strategy needs to be developed to understand which participants are not returning for testing and why as well as what additional efforts are needed to increase the reach of these necessary preventive services.

1082 WITHDRAWNCommunity-Based Sample Collection to Improve HIV Viral Load Coverage in Multiple States in Nigeria Ughweroghene K Omo-Emmanuel 1 , Feyisayo E. Jegede 2 , Pamela N. Gado 1 , Blessing O. Airiagbonbu 3 , Eloghosa Omorogbe 4 , Usman B. Haliru 5 , Laide K. Badmus 6 1 United States Agency for International Development Nigeria, Abuja, Nigeria, 2 Bayero University, Kano, Nigeria, 3 Heartland Alliance, Lagos, Nigeria, 4 FHI 360 , Uyo, Nigeria, 5 Society for Family Health, Yola, Nigeria, 6 National AIDS and STDs Control Programme, Abuja, Nigeria Background: Measuring HIV viral load(HVL) is crucial for assessing the success of antiretroviral therapy treatment.In Nigeria, USAID, through its partners, introduced a community-driven strategy to expand HVL access in hard-to-reach areas. The effectiveness of HVL sample collection in community had not been extensively documented. This paper presents the experience of Community Based Sample Collection Approach (CBSCA) across 17 USAID-supported Nigerian states from October 2020 to December 2022. Methods: USAID, in collaboration with implementing partners, initiated the CBSCA June 2020. The approach involved several strategies:home visits for client convenience, community hubs, clinical platforms, and support groups. Trained Case Managers collected VL samples. The process began with a daily audit of folders to identify clients due for VL testing. Clients were grouped around hubs based on their addresses. Community gatekeepers were informed of the scheduled CBSCA dates. Clients and hubs were mobilized with flexibility, including weekends and various time slots, for blood collection. Collected samples were transported within 6 hours to nearest laboratory, where they were processed and stored. Client information was updated in registers and electronic medical records, and samples were remotely logged into the PCR Laboratory Information Management Systems. National Integrated Sample Referral Network Riders shipped samples to PCR laboratories, and results were electronically retrieved across 17 states in Nigeria from October 2020 to December 2022. Prospective data was periodically collected and entered into Microsoft Excel for cleaning and analysis. Results: CBSCA significantly improved HVL sample collection, with 76%(854,219) of 1,128,868 samples collected in community, compared to 24%(274,649) in health facilities and one-stop shops. This led to a substantial increase in routine HVL access and a rise in USAID Nigeria's VL coverage from 89% in 2020 to 97% in 2022.Likewise, 77% of 1,087,954 results were obtained from samples collected in the community, while only 23% were from health facilities and OSS.However, CBSCA was associated with a higher sample rejection rate of 62%, compared to 38% in health facilities and OSS, with 1,894 samples rejected due to poor quality. Conclusion: Client-centric approaches, such as CBSCA, resulted in improved HVL coverage across the 17 states of Nigeria. To mitigate sample rejections, there should ensure regular retraining of Community Case Managers on sample management. 1083 Test-All Model for SARS-CoV-2 Testing Is More Cost-Effective Than Screen & Test in Kenya & Cameroon Mario J Songane 1 , Boris Tchounga 2 , Rose Masaba 3 , Tatiana Djikeussi 2 , James Ndimbii 3 , Carolyn Mwancha-Kwasa 4 , Emilienne Epée 5 , Anne Bissek 5 , Aida Yemaneberhan 6 , Laura Guay 6 , Rhoderick Machekano 6 , Nilesh Bhatt 6 , Appolinaire Tiam 6 , Sushant Mukherjee 6 1 Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique, 2 Elizabeth Glaser Pediatric AIDS Foundation, Discotheque, Cameroon, 3 Elizabeth Glaser Pediatric AIDS Foundation, Meru, Kenya, 4 Kiambu County Health Research and Development Unit, Kiambu, Kenya, 5 Ministry of Public Health, Yaoundé, Cameroon, 6 Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA Background: Cameroon and Kenya currently use a SARS-CoV-2 "screen and test" (ST) model, offering testing if clients have COVID-19-like symptoms or

1081 Late HIV Diagnosis in CoRIS, 2012-2022, and Impact of a Formative Session in 20 Primary Care Centers Alejandro G García-Ruiz De Morales 1 , Javier Martínez-Sanz 1 , Maria Jesus Vivancos 1 , Santos Del Campo Terrón 1 , Beatriz Romero Hernández 1 , Marta Montero Alonso 2 , María Remedios Alemán Valls 3 , Enrique Bernal 4 , Félix Gutiérrez 5 , Antonio Rivero Román 6 , Miguel Cervero Jiménez 7 , Gemma Navarro 8 , David Dalmau Juanola 9 , María Jesús Pérez Elías 1 , for CoRIS 1 Hospital Ramón y Cajal, Madrid, Spain, 2 Hospital Universitario La Fe, Valencia, Spain, 3 Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain, 4 Hospital General Universitario Reina Sofía, Murcia, Spain, 5 Hospital General Universitario de Elche, Elche, Spain, 6 Hospital Universitario Reina Sofia, Cordoba, Spain, 7 Hospital Universitario Severo Ochoa, Madrid, Spain, 8 Parc Taulí Hospital Universitari, Sabadell, Spain, 9 Hospital Universitari Mútua de Terrassa, Terrassa, Spain Background: Late HIV diagnosis is one of the main drivers of ongoing HIV transmission. We aimed to evaluate the evolution of late HIV diagnosis in CoRIS, a Spanish multicenter prospective HIV cohort, between 2012 and 2022, and assess the impact of a wide formative intervention at primary care centers assigned to Ramón y Cajal Hospital (RyC) in Madrid, Spain. Methods: In 2017, we conducted two training sessions to encourage HIV screening among primary care providers in 20 primary care centers assigned to RyC. 454 out of a total of 630 (72%) primary care providers attended the sessions. We compared the rates of late HIV diagnosis (CD4 <350 cells/µL and/ or AIDS-defining illness, excluding documented recent infection) and advanced HIV disease (CD4<200/µL or AIDS-defining illness) between the centers with intervention (intervention group) and the remaining centers included in CoRIS (control group) before (2012-2017) and after (2017-2022) the intervention. Association measures (adjusted odds ratio [AOR]) were obtained using a logistic regression. Covariates included age, sex, geographical origin, mode of transmission, and educational level. Results: A total of 10,184 patients newly diagnosed with HIV were included, 341 of whom belonged to centers with intervention. 88.4% were male, the mean age at diagnosis was 36.45 years, 70.4% were men who had sex with men (MSM) and 51.8% were Spanish (Table 1). In the control group, late diagnosis significantly increased between both periods (39.0% before, 45.4% after; AOR 1.22 [95%CI 1.13–1.33], p<0.001). In contrast, the intervention group showed a non-significant decrease in late HIV diagnosis rates between both periods (58.9% before, 48.7% after; AOR 0.70 [95%CI 0.45–1.09], p=0.121). Notably, the intervention had a significant effect on reducing late diagnoses when comparing both groups (p = 0.017). When examining the proportion of advanced HIV disease, we noted an increase in the control group from 20.8% before the intervention to 22.7% after (AOR 1.10, [95%CI 1.00-1.22], p=0.061), compared to a non-significant reduction in the intervention group (35.6% vs. 24.1%; AOR 0.66 [95%CI 0.40-1.08], p=0.095). Importantly, the intervention had a significant effect on reducing advanced HIV disease when comparing both groups (p=0.044).

Poster Abstracts

CROI 2024 350