CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

1214 Undetectable = Untransmissible: Key Populations With HIV Lag in Sustaining Undetectable Viral Load Abimbola S Phillips 1 , Dorcas Magbadelo 1 , Francis Ogirima 1 , Pius Christopher Izere 1 , Collins Imarhiagbe 1 , Sabra Custer 2 , Sharon Weissman 2 , Bankole Olatosi 2 , Xiaoming Li 2 , Oluwafemi Adeagbo 3 , Akanmu Sulaimon 4 , Akinbami Akinsegun 4 , Adetokunbo B. Oyeledun 1 , Jude Orjih 5 , Dennis Onotu 5 , for the CDC Research Group 1 Centre for Integrated Health Programs, Abuja, Nigeria, 2 University of South Carolina at Columbia, Columbia, SC, USA, 3 University of Iowa, Iowa City, IA, USA, 4 Lagos State University Teaching Hospital, Lagos, Nigeria, 5 Centers for Disease Control and Prevention, Abuja, Nigeria Background: Undetectable viral load (UVL) is the optimal suppression level in people with HIV (PWH) required to maintain health, prevent transmission, and assure safer sex with partners. In Nigeria, about 80% of PWH achieve UVL on treatment. However, this must be sustained over the course of life-long anti-retroviral treatment (ART) for continued benefits. We compared durable UVL levels among key population (KP) groups − female sex workers (FSW), men having sex with men (MSM), and people who inject drugs (PWID) − and the general population (GP). Methods: A cross-sectional retrospective study of PWH diagnosed from 2020 to 2021 using data retrieved from electronic medical records in 57 health facilities across four states (Gombe, Kaduna, Kogi, and Lagos) in Nigeria. We defined durable UVL as viral load of <50 copies per ml from two tests conducted at least 6 months apart. We compared distributions between KP groups and GP using chi-squared tests. Multivariate logistic regression with robust variance estimation was used to obtain adjusted odds ratio (AOR) with 95% confidence interval for durable UVL and other variables in these categories. Results: Within this period, 6,680 client records were reviewed and 5,286 (79%) had achieved UVL within 6 months of ART. This was significantly higher amongst KP (92% [329/358] than GP (78% [4,957/6322]), [χ2 = 38.9, p<0.001]. Among those with UVL, the median age was 33 years (IQR 28 − 40), 65% were females, 59% attained at least secondary education, 77% were unemployed, 62% were married, and 87% received care in their state of residence. Four thousand, three hundred and forty-five clients (82%) had durable UVL, and this was higher among GP (84%) than amongst KP (FSW − 38%; MSM − 50%; and PWID − 61%.) [χ2 = 268.7, p<0.001]. Multivariate analysis showed lower odds of durable UVL among KP groups compared to GP (FSW: AOR = 0.16 [0.12 − 0.20]; MSM: AOR = 0.25 [0.20 − 0.32]; PWID: AOR = 0.41 [0.31 − 0.53]). The odds of durable UVL were lower among the employed than unemployed (AOR = 0.63, [0.45 − 0.89]), and higher among clients aged 40 − 44 years than those 15 − 19 years old (AOR = 1.70 [1.03 − 2.80]). Conclusion: These findings from these four states suggest that although KP groups appear to be more likely than GP to achieve early UVL, they are less likely to sustain it. Providing insights for these differences will help develop appropriate interventions to achieve and sustain viral suppression amongst clients with HIV on ART irrespective of subpopulation. 1215 PrEP Persistence Among Adolescents Men Who Have Sex With Men and Transgender Women in Brazil Fabiane Soares 1 , Laio Magno 2 , Jony Arrais Pinto Junior 3 , Diana Reyna Zeballos Rivas 1 , Dirceu Greco 4 , Alexandre Grangeiro 5 , Ines Dourado 1 1 Federal University of Bahia, Salvador, Brazil, 2 Bahia State University, Salvador, Brazil, 3 Universidade Federal Fluminense, Rio de Janeiro, Brazil, 4 Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, 5 University of Sao Paulo, Sao Paulo, Brazil Background: Adolescent men who have sex with men (AMSM) and transgender women (ATGW) are at a heightened vulnerability for HIV in Brazil. Promoting the use and persistence of HIV prevention strategies, including Pre Exposure Prophylaxis (PrEP), is a relevant challenge for controlling the epidemic in these populations. We aim to analyze the persistence of daily oral PrEP among AMSM and ATGW and their associated factors. Methods: The PrEP1519 study is a daily oral PrEP demonstration cohort study with AMSM and ATGW aged 15 to 19 years, implemented in three large capital cities in Brazil: Salvador, Belo Horizonte and São Paulo. We included in this analysis participants who initiated PrEP between Feb 2019 and Feb 2021 and were followed up until Feb 2022. Study visits occurred at baseline, 30 days, 60 days and quarterly thereafter. PrEP persistence was defined as being in PrEP possession in Feb/2022 or having less than 90 days without PrEP possession. Logistic regressions were used to estimate the odds ratios (OR) of sociodemographic and behavioral factors with persistence in PrEP use.

injection) were collected in a safety subset (SS). Data on serious AEs (SAEs) were collected throughout the study for all participants. Pregnancy outcomes were captured even after participant exit. We report on the first 6 months of follow-up. Results: 14,237 participants were enrolled December 2021 to September 2022, of whom 14,001 participants (median age 39 years, 72% female sex at birth) were included in the Full Analysis Subset (FAS). 83% (11,681) were PWH, with median CD4 count 635 cells/mm 3 and 6.6% with <200 cells/mm^3. 18.5% had a detectable HIV viral load, and 14.5% were not on ART. The SS participants had similar baseline characteristics. The most common solicited AEs among 1,491 SS participants after month 0 and month 1 vaccinations were pain/tenderness at injection site (26.7%), headache (20.4%), and malaise (20.3%). Severe reactions were rare (0.9%); none were fatal/life-threatening. 120 (8%) in the SS experienced an unsolicited AE: 9 (0.6%) potentially vaccine-related, including one severe unsolicited AE. There was one related SAE (grade 3 angioedema). The most common causes of death were tuberculosis, carcinoma, and homicide. Among 236 pregnancy outcomes reported, there were 23 premature live births, 12 spontaneous abortions, 9 still births, and 4 congenital anomalies. There were no Covid-19 deaths or admissions to the intensive care unit. Conclusion: Severe Covid-19 was rare in this large, diverse population of PWH during the Omicron wave. In SSA, the mRNA vaccine demonstrated an acceptable reactogenicity and safety profile, including in PWH, people with prior SARS-CoV-2 infection, and pregnant participants. The figure, table, or graphic for this abstract has been removed. 1213 Data Science Linkage of Public Jail Registries and Surveillance Data for Public Health Action Steven Erly, Leighton Hill, Rachel Amiya Washington State Department of Health, Olympia, WA, USA Background: Jail bookings represent an important opportunity for diagnosis and care linkage for people living with HIV (PLWH). However, jurisdictional data protections and decentralization of facilities can make connecting public health resources to correctional programs challenging. The purpose of this study was to evaluate the use of a novel approach using data scraping of publicly available jail inmate data to develop a real- time dataset of public jail rosters and to estimate the number of PLWH who have regular interactions with jails in Washington State (WA). Methods: We developed scripts to collect public-facing online jail rosters from local and tribal facilities in WA using R software. Between 11/14/2022 and 8/13/2023, we ran these scripts daily and developed a longitudinal database of the incarcerated population. We used a deterministic matching algorithm to link this database to the state HIV registry (as of 7/1/2023) using name, date of birth, and county of residence. We described the population that was jailed by demographic characteristics and CDC-defined viral suppression status on 12/31/2022. We used a zero-truncated Poisson model to estimate the total population of PLWH who are jailed on a regular basis and the subset of this population who was not virally suppressed. Results: We successfully captured data from 57 of the 59 jails identified by the authors in WA. The remaining two jails were small county facilities which were not in compliance with state reporting requirements. In the 9- month study period, we collected 2,270,716 person-days of incarceration data representing 79,088 individuals. We identified 411 PLWH in this population who were jailed 573 times. We estimate that this is a subset of a population of 827 PLWH (95% CI 741-913) who are regularly jailed, which represents 6% of the 14,872 PLWH living in WA (Table 1). Of the 411 identified PLWH, 135 were not virally suppressed (33%, estimated population size: 253, 95% CI 212-294). Conclusion: Public facing jail registries can be used to describe the intersection of PLWH and the criminal legal system and to identify the location of PLWH who are not virally suppressed. Public health programs looking to increase their ability to reach justice-involved populations may consider whether public-facing jail rosters could be a useful data source.

Poster Abstracts

CROI 2024 397