CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

individuals on PrEP and 201 in PLHIV; p=0.755): NG 194 (34.6%), syphilis 130 (23.2%), CT 121 (21.6%), and LGV 79 (14.1%) and 36 (6,4%) were other STIs; 416 (74.2%) were asymptomatic. Table 1 provides details of symptomatic and asymptomatic STIs in both groups. Some subjects had NG and/or CT in multiple sites. Coincident STIs were detected in 20.3% of the cases. There were no seroconversions among individuals on PrEP. Conclusion: Asymptomatic STIs are strikingly prevalent in this high-risk MSM population. No differences in clinical presentation were observed between individuals on PrEP and PLHIV for any of the studied STIs. There is an urgent need to implement new prevention strategies to control STIs in these high-risk populations.

1172 Low Prevalence of Sexually Transmitted Infections Among Adolescents and Young Adults Living With HIV Lynda M Oluoch 1 , Paul Mwangi 1 , Jane Gacheru 1 , Irene Njeru 1 , Kenneth Ngure 2 , Linda Eckert 3 , Denise A. Galloway 4 , Anna Wald 4 , Ruanne V. Barnabas 5 , Nelly R. Mugo 1 1 Kenya Medical Research Institute, Nairobi, Kenya, 2 Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya, 3 University of Washington, Seattle, WA, USA, 4 Fred Hutchinson Cancer Center, Seattle, WA, USA, 5 Massachusetts General Hospital, Boston, MA, USA Background: Approximately 50% of sexually transmitted infections (STIs) are concentrated in people within the age range of 15 to 24 years. This coincides with age estimates at sexual debut. This cohort is of particular public health concern due to the potential consequences of STI transmission to new sexual partners. In a longitudinal cohort study of young females and males living with HIV, we assessed the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections. Methods: We enrolled 158 participants who had previously received the quadrivalent HPV vaccine and collected genital samples for CT and NG infections at enrolment and again at month 12. Nucleic acid amplification testing (NAAT) was performed on genital swabs to detect NG and CT, using the Gen-Probe APTIMA test. Cross-sectional data on demographic, medical and sexual history were gathered at enrolment. Descriptive statistics were employed to establish the baseline demographic characteristics. STI diagnoses were correlated with the age at sexual debut, gender, partner's age at first sexual activity, education level, financial dependency and viral load. Results: At enrolment 158 participants provided samples and 155 at month 12 visit. At enrolment 9/158 (5.7%) were diagnosed with CT or NG and at month 12, 16/155 (10.3%). Two participants had a positive result at both time points. Among those diagnosed with STIs at 12-month visit, 12/16 (75.0%) were females, 13/16 (81.3%) had never married and 9/16 (56.3%) were financially dependent. HIV RNA viral load (VL) ≥ 1000 was noted among 3/16 (26.6%) of those diagnosed with an STI, while more than 50% of participants with VL≤ 1000 had STIs, 12/16(75%). In a multivariable logistic model, STI and older age reduced odds by 0.56 times per year (aOR 0.56, 95% CI 0.34-0.85). Tertiary education lowered odds by 0.03 times versus primary education (aOR 0.03, 95% CI 0.04-3.30). Substance use in the past six months increased the odds by 6.75 times (aOR 6.75, 95% CI 1.29-46.84). Having an older first sexual partner increased odds by 1.25 times (aOR 1.25 (1.06-1.50), while abstaining at younger age reduced odds by 0.65 times (aOR 0.65, 0.46-0.90). Conclusion: Young men and women living with HIV had lower STI prevalence than other comparable population level age cohorts. Higher education and delayed sexual debut were protective while older sexual partner, female gender and financial dependency had increased risk, emphasizing the need for structural social protection interventions. The figure, table, or graphic for this abstract has been removed. 1173 Reaching ECP Users With HIV and PEP Services in Kenyan Pharmacies Nicholas Kipkurui 1 , Dorothy Oketch 1 , Scholastica Wanjiru 1 , Gerald O. Owuor 1 , Alloys Koloo 1 , Elizabeth Bukusi 1 , Alison Roxby 2 , Kawango Agot 1 1 Impact Research and Development Organization, Kisumu, Kenya, 2 University of Washington, Seattle, WA, USA Background: Adolescent girls and young women (AGYW) seeking emergency contraceptive pills (ECP) to prevent conception also face increased risk of HIV acquisition due to implied unprotected sex. AGYW who are eligible for ECP are therefore likely to also be eligible for post-exposure prophylaxis (PEP) to reduce their risk of HIV acquisition. Pharmacies, where most AGYW purchase ECP, can serve as convenient outreach points for HIV prevention services including PEP. We assessed the willingness of AGYW seeking ECP to test for HIV and initiate PEP Methods: We assessed willingness to test for HIV and initiate PEP as the main outcomes in a study among AGYW aged 15-24 seeking ECP in 5 pharmacies in Kisumu and Nairobi, Kenya, between May and August 2023. We trained pharmacy providers on research ethics, documentation, screening and

1171 Lymphogranuloma Venereum Among Men Who Have Sex With Men: 7 Versus 21 Days Doxycycline Effectiveness Angelo Roberto Raccagni 1 , Alessia Siribelli 1 , Sara Diotallevi 2 , Michela Sampaolo 2 , Nicola Clementi 1 , Riccardo Lolatto 2 , Roberto Burioni 1 , Antonella Castagna 1 , Silvia Nozza 1 1 San Raffaele Vita-Salute University, Milan, Italy, 2 San Raffaele Scientific Institute, Milan, Italy Background: Current guidelines on treatment of symptomatic Lymphogranuloma venereum (LGV) caused by Chlamydia trachomatis (Ct) serovars L1-3 recommend 21 days of doxycycline (DOXY). Methods: Retrospective study on men who have sex with men (MSM) diagnosed with rectal or urethral Ct, treated with 7 or 21 days of DOXY between 2015-2022 at San Raffaele Scientific Institute, Milan, Italy. Nucleic acid amplification test with sequencing serovar determination was used; only people with available test of cure (TOC) were included. Microbiologic cure (MC) was defined as negative TOC or positive TOC with different genotype (re-infection). Proportions of MC according to presence of symptoms and treatment durations were compared using exact binomial test; these comparisons were performed either including (counted as failure of cure; worst scenario) or excluding (exclusion scenario) samples with non-amplifiable positive TOC. Results: Overall, 158 MSM included: 59 (37%) had LGV, 72 (46%) non-LGV and 27 (17%) non-amplifiable. LGV serovars were L1 5%, L2 39%, L2b 19%, L2c 37%; rectal LGV was detected in 95%, urethral 2%, both 3%. Symptomatic LGV cases were 45 (76%); 23 (40%) received 7 days of DOXY and 36 (60%) 21 days according to physician preference. Median age was 40 (IQR=34-48) years; 95% Caucasian, 3% Hispanic, 2% Caribbean; 53 (90%) PLWH, with a median CD4+ 759 (622-930) cells/μL at LGV. Median time to TOC was 0.66 (0.3-1.4) years since LGV diagnosis. MC occurred in 58 people (98%; 90% negative and 8% Ct infection, non-LGV); all symptomatic MSM were clinically cured after treatment. Proportions of MC among MSM with LGV receiving 7 vs 21 days of DOXY according to presence of symptoms shown in Figure; 100%MC was found either among MSM with LGV symptomatic or asymptomatic treated with 7 and 21 days of DOXY (exclusion scenario). In the worst scenario, no significant effect of treatment duration on %MC in symptomatic MSM with LGV (100% vs 97%, p=0.99); 100%MC were also observed in MSM asymptomatic in both treatment groups. No significant differences of %MC between LGV and non-LGV either symptomatic (worst 100% vs 88%, p=0.62; exclusion 100% vs 100%) or asymptomatic (worst 100% vs 81%, p=0.32; exclusion 100% vs 94%, p=0.99) treated with 7 days of DOXY in both scenarios. Conclusion: Among MSM with LGV or non-LGV serovars, comparable clinical and virologic cure proportions were found after 7 or 21 days of DOXY, regardless of presence of symptoms. These data support the use of DOXY short course for Ct treatment.

Poster Abstracts

CROI 2024 382