CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

accompanying 95% confidence intervals (CIs) to quantify differences between groups. Results: Overall, 86.4% of WWH reported receiving a cervical Pap smear in the past 3 years. Of sexually active WWH, 38.5% had documented sexually transmitted infection (STI) testing for syphilis, gonorrhea, and chlamydia in the past 12 months, per CDC guidelines. Of WWH who engaged in vaginal sex, 88.9% used ≥1 form of contraception in the past 12 months, including 16.3% who used long-acting reversible contraceptive methods (Figure). Over half (53.4%) had ≥1 pregnancy since their HIV diagnosis, of whom 81.5% had ≥1 unplanned pregnancy, 24.6% had ≥1 miscarriage or stillbirth, and 9.8% had ≥1 abortion. WWH living in households <100% of the federal poverty level (FPL) were less likely to receive Pap smears (PD: -9.13; 95% CI: -14.77– -3.50) and more likely to have unplanned pregnancies (PD: 16.57; 95% CI: 2.63–30.50) than those living in households ≥139% of the FPL. However, WWH attending Ryan White HIV/AIDS Program (RWHAP)-funded clinics were more likely to receive STI testing at their HIV care facility than those who did not attend RWHAP-funded facilities (PD: 20.08; 95% CI: 10.55–29.61). In MMP states that did not expand Medicaid, WWH with Medicaid coverage were less likely to have Pap smears (PD: -12.39; 95% CI: -20.49– -4.29) and more likely to have unplanned pregnancies (PD: 27.17; 95% CI: 11.15–43.19)* than those with private coverage. *Should be interpreted with caution due to small sample sizes. Conclusion: Many WWH have suboptimal SRH screening and pregnancy outcomes, particularly those living in poverty. Expansion of safety net programs that provide substantial coverage of SRH services, including Medicaid, RWHAP, and Title X, could help improve care access and outcomes among WWH.

1162 Altered Cellular Immune Response in the Context of Syphilis and Acute HIV Coinfection Jasper Mundt, Lennart Nicksch, Carola Horn, Ute Sandaradura de Silva, Isabelle

Suarez, Max Augustin , Clara Lehmann Cologne University Hospital, Cologne, Germany

Background: The co-infection of syphilis and acute HIV infection is gaining clinical significance due to rising co-infection rates and the unique interaction between these two sexually transmitted infections. Syphilis enhances HIV transmission and acquisition, while HIV accelerates the progression of syphilis. This study aimed to investigate the cellular immune responses in the context of acute HIV/syphilis co-infection. Methods: A cross-sectional analysis was conducted, comparing four cohorts of 15 patients each (total N=60): acute HIV infection with syphilis (aHIV/S), acute HIV infection without syphilis (aHIV), chronically coinfected syphilis/ HIV+ patients on antiretroviral treatment (cHIV/S), and healthy controls (CTRL). Flow cytometry assessed PD-1, HLA-DR, and CD38 expression on various T-cell subsets (CD3+CD4+ (TCD4), CD3+CD8+ T cells (TCD8)), memory T cells (CD4+CD45RO+ memory T-cells (TM), CCR7±CD27± memory subsets (TCM: T central memory, TEM: T effector memory, TTM: T transitional memory), antigen naive cells (CD4+CD45RO- TN)), regulatory T-cells (CD49b+LAG-3+(TR1)), and plasmacytoid dendritic cells (BDCA2+CD123+ (pDC)). IFN gamma (IFNγ) levels were measured in plasma using Simoa technology (Quanterix). Results: In patients with acute HIV/syphilis co-infection, the frequency of TCD4 (p<0.0001) and TCD8 (p<0.0001) cells was significantly lower compared to other groups, while CD38 expression was highest (p <0.0001). The frequency of pDC (p <0.0001) and TR1 (p=0.0365) decreased significantly in aHIV/S, aHIV, and cHIV/S groups compared to CTRL. Interestingly, T central memory cells were significantly increased in aHIV/S (p=0.0005). Notably, the highest PD-1 expression on type 1 regulatory T cells was observed in acutely HIV-coinfected patients (p=0.0003), and it correlated positively with viral plasma load (r=0.6 p=0.0314). Furthermore, the highest levels of IFNγ were found in acutely HIV coinfected patients. Conclusion: The impaired T-cell function, activation, and exhaustion observed in acute HIV/syphilis coinfection result in reduced control of HIV replication. Longitudinal studies of patients coinfected with HIV and syphilis, especially after initiating antiretroviral treatment, are warranted to investigate their effects on the HIV reservoir. The figure, table, or graphic for this abstract has been removed. 1163 Gaps in Sexual and Reproductive Health Care Among Cisgender Women With Diagnosed HIV Sharoda Dasgupta , Stacy Crim, John Weiser, Angela Blackwell, Jen-Feng Lu, Background: Cisgender women with HIV (WWH) are defined by more than their HIV viral loads. Comprehensive women's health, including sexual and reproductive health (SRH), is an important component of overall health and well-being. We used data from the CDC's Medical Monitoring Project (MMP) to describe nationally representative estimates of SRH outcomes among WWH of reproductive age. Methods: During 6/2018–5/2021, MMP interviews were conducted and medical records were abstracted to ascertain data on SRH among WWH. Among WWH aged 18–44 years (N=855), we report weighted percentages and calculated prevalence differences (PDs) with predicted marginal means and Margaret Lampe, Ada Dieke, Robyn N. Fanfair Centers for Disease Control and Prevention, Atlanta, GA, USA

Poster Abstracts

1164 Genital and Extragenital Sexually Transmitted Infections Among Reproductive Age Women in Southern US

Nicholas F Nogueira 1 , Paola Beato Fernandez 1 , Yue Pan 1 , Ana Salazar 1 , Maria G. Rodriguez 1 , Gray Kelsey 1 , Patricia Del Carmen Raccamarich 1 , Daniel Westreich 2 , Seble Kassaye 3 , Elizabeth F. Topper 4 , Aadia Rana 5 , Deborah Konkle-Parker 6 , Deborah Jones Weiss 1 , Anandi N. Sheth 7 , Maria L. Alcaide 1 1 University of Miami, Miami, FL, USA, 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 3 Georgetown University, Washington, DC, USA, 4 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 5 University of Alabama at Birmingham, Birmingham, AL, USA, 6 University of Mississippi Medical Center, Jackson, MS, USA, 7 Emory University, Atlanta, GA, USA Background: Sexually transmitted infections (STI) are highly prevalent among women of reproductive age (WRA) and increase the risk of HIV acquisition and transmission. However, the burden of genital and extragenital STIs is understudied among WRA in the U.S. Estimates of disease are urgently needed, including among women with and without HIV, to inform sex-specific screening guidelines. Methods: Cross-sectional data from 519 cisgender women, 18-45 years-old enrolled in the STAR cohort from March 2021 to January 2023 at 6 Southern US sites were analyzed. Women with and without HIV (at least one HIV risk behavior in the previous 5 years). Socio-demographic and behavioral assessments were performed using structured interviewer-administered questionnaires. Nucleic Acid Amplification Test (NAAT) was performed regardless of symptoms on self collected urine, rectal, and pharyngeal swabs to detect chlamydia, gonorrhea, and trichomoniasis. Sociodemographic characteristics, risk factors, and rates of STIs were tabulated and group comparisons by HIV status were examined. Results: Mean age was 34.6 ± 6.95 years; 79.6% were Black, 15.5% White, and 11.4% Hispanic. Overall, 52.8% had never married, 45.7 % had a monthly income

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