CROI 2024 Abstract eBook

Abstract eBook

Oral Abstracts

Methods: This report led NMDOH and CDC to investigate possible transmission of HIV through cosmetic injection services. The period of interest for active case finding was from spring 2018, when the initial case received a vampire facial, to fall 2018 when the spa closed, and on-site inspection of the spa was conducted. Names and phone numbers were compiled and cross-referenced from spa client consent forms, handwritten appointment records, and cell phone contacts to form a list of potentially affected clients who were directly contacted to encourage testing for bloodborne pathogens. From 2018-2023, suspected cases were reported to NMDOH from clinical providers throughout the state, and blood specimens were submitted to CDC for nucleotide sequence analysis (NSA) to determine cluster association. Results: Active case finding identified one client with a previous diagnosis of HIV in 2012, 20 clients who received vampire facials, and 59 clients who received other injection services (e.g., Botox) during spring-fall 2018. Among the 198 former spa clients and their sexual partners tested during 2018-2023, no new HIV, Hepatitis B, or Hepatitis C infections were identified. The on-site inspection revealed several unsafe infection control practices including storage of unlabeled tubes of blood on the kitchen counter. Five suspect cases, four former spa clients plus one sexual partner of a spa client, were reported to NMDOH all of whom had HIV diagnosed during 2018–2023 and no known HIV risk factors. NSA revealed highly similar HIV strains among all cases indicating vampire facials as the likely transmission route of HIV for three cases in this cluster. The other two cases, who had previous HIV infections, were likely attributed to sexual contact. Sequences from the former client living with HIV did not cluster with any sequences from cases. Conclusion: This investigation underscores the importance of assessing novel sources of HIV transmission among persons with no known HIV risk factors, and adequate infection control practices at spa facilities offering cosmetic injection services.

symptoms with the greatest effects among participants in Kenya (0.54; 0.38 0.79) and those re-engaging in care (0.67;0.55-0.82). Predictors (odds ratio; 95% CI) of at least mild depression included feeling sexual pressure (10.6;3.8-29.4), feeling physically threatened (6.5;3.3-12.5), and recent life events (4.2;2.6-6.7), including sickness (4.1;2.4-7.0) or family death (7.5;4.0-14.1). Conclusion: The SEARCH Youth intervention reduced the prevalence of depressive symptoms particularly for those re-engaging in care. Recent major life events and the perception of sexual or physical threat were key drivers of depression in this population. We postulate that life-stage based discussions helped providers and patients identify and navigate challenging issues, building resilience against both depression and lapses in adherence and care. Role of Community-Level Factors in Declines in HIV Incidence and Prevalence Among Rakai Adolescents Stephanie A Grilo 1 , Julia Thompson 1 , Ivy S. Chen 1 , Fred Nalugoda 2 , Tom Lutalo 2 , Ying Wei 1 , Esther Spindler 1 , Susie Hoffman 1 , Philip Kreniske 1 , David Serwadda 2 , Mary Kate Grabowski 3 , Maria J. Wawer 3 , Fred M. Ssewamala 4 , Larry W. Chang 3 , John S. Santelli 1 1 Columbia University Medical Center, New York, NY, USA, 2 Rakai Health Sciences Program, Kalisizo, Uganda, 3 The Johns Hopkins University, Baltimore, MD, USA, 4 Washington University in St Louis, St Louis, MO, USA Background: HIV acquisition among adolescents (15-19 years) and young adults (20-24 years) is influenced by individual factors, community factors, and public policies and programs. We explored the association of HIV incidence and prevalence with these factors over time among adolescents and young adults (AYA) in Rakai, Uganda. Methods: We examined trends among AYA (n= 35,938 person rounds) from nine survey rounds (2005-2020) of the Rakai Community Cohort Study (RCCS), a population-based open cohort of individuals living in 30 continuously followed communities in southcentral Uganda. We evaluated the impact of community viremia (CV, a measure of community-level ART use and HIV prevalence) on HIV incidence and prevalence among AYA. Logistic GEE, Poisson GLM and univariate models were run for HIV prevalence, HIV incidence, and predictors of interest, respectively. Results: HIV incidence and prevalence declined after round 14 (2010-2011) by 66% among AYA men and after round 17 (2015-16) by 60% among AYA women. Between survey round 11 and round 19, the proportions reporting sexually experience declined from 58% to 38% in adolescent men and from 65% to 35% among adolescent women. The prevalence of male medical circumcision (MMC) among AYA men increased from 20% in round 11 to 79% in round 19. At the community-level, we found substantial increases in ART use among PLHIV (15% in round 11 and 86% in round 19) and corresponding declines in CV. In multivariable analyses, a combination of individual and community-level factors were found to predict HIV incidence and prevalence among AYA, notably MMC among young men and CV among young women. Conclusion: Declines in HIV incidence and prevalence occurred first among AYA men and later among AYA women. These coincided with declines in sexual experience and with public policies to increase access to MMC and ART. Combination HIV prevention with AYA needs to address risk factors at multiple levels. Individual risk behaviors continue to play a role in HIV incident and prevalence infection. Thus, it remains important to have conversations with AYA about their individual behaviors. However, community level factors are playing an important role and therefore these conversations should occur within the context of larger social forces of transmission risk. Investigation of HIV Transmission Associated With Receipt of Vampire Facials: New Mexico, 2018-2023 Anna M Behar 1 , Mika N. Gehre 2 , Liana Atallah 3 , Tegan Clarke 3 , Ana-Alicia Leonso 3 , Francella Jojola 4 , Haoqiang Zheng 1 , Hongwei Jia 1 , Sheryl Lyss 1 , William M. Switzer 1 , Scott P. Grytdal 1 , Miranda Durham 5 , N. Mariam Salas 3 , Marla Sievers 2 , Chad Smelser 2 1 Centers for Disease Control and Prevention, Atlanta, GA, USA, 2 New Mexico Department of Health, Santa Fe, NM, USA, 3 University of New Mexico, Albuquerque, NM, USA, 4 Albuquerque Public Schools, Albuquerque, NM, USA, 5 Indian Health Service, Corrales, NM, USA Background: HIV transmitted through cosmetic injection services via contaminated blood has not been previously documented in the United States. In summer 2018, the New Mexico Department of Health (NMDOH) was notified of a diagnosis of HIV infection in a female with no known HIV risk factors who reported exposure to needles from cosmetic platelet-rich plasma micro needling (vampire facial) received at a spa in spring 2018.

190

Oral Abstracts

192

Trends in Black-White Disparities in HIV Diagnosis: 2017-2021, United States André Dailey , Zanetta Gant Sumner, Anna Satcher Johnson, Juliet A. Morales, Sue Reynolds Centers for Disease Control and Prevention, Atlanta, GA, USA Background: The largest disparities in HIV diagnoses in the United States are between Black and White persons. Federal initiatives for HIV prevention have evolved over the years, with the 2025 National HIV/AIDS Strategy including a focus on health equity. We examined trends in Black-White HIV diagnosis disparities to evaluate progress towards achieving equity in HIV diagnosis in the United States. Methods: Data from CDC's National HIV Surveillance System were used to assess temporal trends in absolute and relative disparities in HIV diagnosis between Black and White persons during 2017–2021. Predicted values based on four years (2017–2019 and 2021) of data were used. Data for the year 2020 were excluded due to the impact of COVID-19 on HIV diagnoses. Estimated annual percentage change (EAPC) and 95% confidence intervals (CIs) were calculated to assess trends by selected characteristics. Results: During 2017 to 2021, absolute disparities in Black-White HIV diagnosis decreased among males from 65.7 per 100,000 population to 57.6 per 100,000 population (absolute: EAPC = -3.2 [CI: -3.6, -2.7]) and from 22.5 per 100,000 population to 17.7 per 100,000 population (absolute: EAPC = -5.8 [CI: -6.5, -5.0]) among females. Relative disparities decreased from 15.1 per 100,000 population to 10.8 per 100,000 population among females (EAPC = -7.2 [CI:

191

52

CROI 2024