CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusion: In a geographically diverse cohort of US women, we found a preference for LAI vs oral ART, while about 20% remained undecided. Findings suggest potential differences in ART preference by adherence, age, site, income and race/ethnicity. To maximize the benefits of LAI ART and ensure equitable access to treatment for all women across the US and globally, it is critical to tailor education and support around LAI ART that is specific to each patient's unique needs and experiences.

discontinuing LAI CAB/RPV after a median time of 4 months (IQR 1-6 months). Missing visits and adverse events explained two- thirds of discontinuations (Figure 1). Conclusion: We found significant referrals for and uptake of LAI CAB/RPV in a clinic serving primarily Black/African American PWH. However, challenges exist in starting PWH on LAI CAB/RPV, especially among those without VS. More work is needed to support providers, patients, and clinic systems to deliver LAI- CAB/ RPV to this group.

1238 Uptake of Long-Acting Injectable Antiretroviral Therapy in Florida: An Assessment of EHR Data Yiyang Liu , Rebecca Fisk-Hoffman, Maitri Patel, Robert Cook, Mattia Prosperi University of Florida, Gainesville, FL, USA Background: In January 2021, the US Food and Drug Administration approved the first long-acting injectable antiretroviral therapy (LAI ART) regimen, cabotegravir/rilpivirine, providing an alternative to daily oral regimens. However, scarce literature exists on the uptake of LAI ART using real-world data. Leveraging electronic health records from a large clinical research network in the Southern US - OneFlorida+ linked with Medicaid (updated to 08/2022) - we identified a cohort of people with HIV (PWH) who received LAI ART and characterized their demographics, clinical characteristics, and HIV care outcomes. Methods: LAI ART recipients were identified by screening both prescribing and dispensing records using a combination of medication name, RxNorm, and National Drug Code. Results: A total of 234 LAI ART recipients were identified: 56.8% female, mean age 44.9, 51.3% non-Hispanic Black, 20.9% non-Hispanic White, 19.7% Hispanic, 78.2% on Medicaid and 4.7% on private insurance. About 20% of LAI ART users did not have two or more visits at least 90 days apart in the year before LAI ART initiation (i.e., were not engaged in care). Lifetime substance use disorder diagnoses included18.8% with cannabis use disorder, 13.7% with cocaine use disorder, and 8.5% with opioid use disorder. After the initiation of LAI ART, 53.8% exclusively used LAI ART, 15% concurrently used other oral ART, and 31.2% potentially switched back to oral ART (i.e., receiving oral ART after last record of LAI ART). Most people (68.4%) had 2+ records of LAI ART injections, among them the average time gap between injections is 50.6 days (SD 45.2) and more than half had at least one time gap greater than 65 days. Of the 54 people with HIV viral load test results after the initiation of LAI ART, only 1 record of virologic failure (viral load>200 copies/ml) was observed. Conclusion: Our study demonstrates that people with suboptimal care engagement and substance use disorder were not excluded from the treatment with LAI ART. While LAI ART is considered a complete regimen for HIV, a small proportion of individuals concurrently received other oral ART, possibly due to personalized treatment plans or bridging treatment. Our study reveals a likely noteworthy discrepancy between the current guidelines, which suggest a two-month interval between LAI ART injections, and the observed common prolonged time gap between injections. Despite limited evidence for optimal LAI ART adherence, virologic failure remains rare among LAI ART users. 1239 Interest in Long-Acting Injectable PrEP Among Transgender Women in the United States Erin E Cooney 1 , Sari Reisner 2 , Tonia C. Poteat 3 , Keri N. Althoff 1 , Asa Radix 4 , Meg Stevenson 1 , Andrew J. Wawrzyniak 5 , Christopher Cannon 6 , Jason S. Schneider 7 , Kenneth H. Mayer 8 , Chris Beyrer 9 , Carolyn Brown 10 , Vani Vannappagari 10 , Annemiek de Ruiter 11 , Andrea Wirtz 1 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 Brigham and Women's Hospital, Boston, MA, USA, 3 Duke University, Durham, NC, USA, 4 Callen-Lorde Community Health Center, New York, NY, USA, 5 University of Miami Miller School of Medicine, Miami, FL, USA, 6 Whitman- Walker Health, Washington, DC, USA, 7 ViiV Healthcare, London, United Kingdom, 8 Harvard Medical School, Boston, MA, USA, 9 Duke Global Health Institute, Durham, NC, USA, 10 ViiV Healthcare, Durham, NC, USA, 11 ViiV Healthcare, London, UK Background: Long-acting injectable (LAI) PrEP is a highly efficacious HIV prevention tool. Among communities with high HIV burden, such as transgender

1237 Associations Between Interest in Oral vs Long-Acting Injectable ART Among US Women With HIV Morgan M Philbin 1 , Tara McCrimmon 2 , Lauren F. Collins 3 , Margaret Pereyra 2 , Corbin Platamone 1 , Anandi N. Sheth 3 , Mardge H. Cohen 4 , Tracey Wilson 5 , Catalina Ramirez 6 , David B. Hanna 7 , Stephen J. Gange 8 , Aadia Rana 9 , Bani Tamraz 1 , Lakshmi Goparaju 10 , Maria L. Alcaide 11 1 University of California San Francisco, San Francisco, CA, USA, 2 Columbia University, New York, NY, USA, 3 Emory University, Atlanta, GA, USA, 4 John H Stroger Jr Hospital of Cook County, Chicago, IL, USA, 5 State University of New York Downstate Medical Center Downstate Medical Center, Brooklyn, NY, USA, 6 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 7 Albert Einstein College of Medicine, Bronx, NY, USA, 8 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 9 University of Alabama at Birmingham, Birmingham, AL, USA, 10 Georgetown University, Washington, DC, USA, 11 University of Miami, Miami, FL, USA Background: Long-acting injectable (LAI) ART has the potential to improve suboptimal medication adherence and health outcomes for people with HIV, yet studies of patient interest and acceptance are mixed and may differ by sex. We surveyed U.S. women to examine factors associated with preferences for LAI vs oral ART. Methods: From Sept. 2020- Nov. 2021, we administered a cross-sectional survey to 1,078 women with HIV across MACS/WIHS Combined Cohort Study sites in Atlanta, GA; Birmingham, AL/Jackson, MI; Bronx, NY; Brooklyn, NY; Chapel Hill, NC; Chicago, IL; Miami, FL; San Francisco, CA; and Washington, DC. The survey assessed demographic characteristics and ART modality preferences. Multinomial logistic regression assessed factors associated with preference for LAI vs oral ART vs undecided, controlling for age, education, race/ethnicity, income, adherence and site. Results: Median age was 54, the majority of women were Black (72%) and Hispanic (13%), and most (58%) had an annual income of ≥$12K. Over one-third (37%) of women finished more than high school while 88% reported ≥95% oral ART adherence. In the sample, 43% preferred LAI ART, 36% oral ART, and 21% were undecided. In adjusted models, women who reported ≥95% oral ART adherence (relative risk (RR): 0.39; CI: 0.24-0.63) and older age (RR: 0.98 per year; CI: 0.97-1.00) were less likely to prefer LAI ART vs oral ART. Compared with women in Miami, those in other sites (RR: 2.12-3.05) preferred LAI to oral ART. Comparing women who preferred LAI ART vs being undecided, women with ≥95% oral ART adherence were less likely to prefer LAI ART (RR: 0.58; CI:0.33 0.99) whereas Hispanic women were more likely (RR: 2.30; CI:1.01-4.87). When comparing oral ART vs undecided, women whose racial category was 'other' were more likely to prefer oral ART (RR: 3.32; CI: 1.17-9.46) whereas women whose income was ≥$12K were less likely to prefer oral ART (RR: 0.58; CI: 0.39 0.86). Women in sites other than Miami (RR: 0.26-0.32) were less likely to prefer oral ART vs undecided.

Poster Abstracts

CROI 2024 406