CROI 2025 Abstract eBook

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Poster Abstracts

background. Each child had 1 blood measurement. We measured 26 inflammatory proteins in blood serum using ELISA and Luminex™ multiplex immunoassays, comprising monocyte-derived biomarkers (IL-18, IL-6, TNF-α, MCP1, IL-1a, S100A9, IL1-ra, S100A8), lymphocyte-derived markers (IL-17, IFNγ, IL-12p70, IP-10, IL-10), response markers (CRP, sCD14, E-selectin), metabolic markers (leptin, adiponectin, resistin, LBP, IL-18, FABP4), and cardiovascular markers (VEGF, E-selectin, IP-10, MCP1, P-selectin, sCD163, VCAM1, ICAM1). We used linear regression to compare the effect of HIV group on each biomarker, adjusting for age, sex and ethnicity. Results are Holm adjusted. Results: Mean age of children with HIV was 8.5 years (unexposed: 9.2 years). After adjusting for age, sex and ethnicity, MCP1, S100A9, IL-6, sCD14, Adiponectin, VEGF and P-selectin levels were significantly higher in early treated children compared to unexposed, whilst IP10 was significantly lower in children with HIV (p<0.05). All other biomarkers showed no significant difference between groups. Conclusions: Despite early ART and sustained viral suppression, early treated children on ART displayed extensive immune marker elevations, clustered around monocyte activation and markers associated with cardio-metabolic disease. These children remain at risk of premature vascular disease events (heart attacks/ strokes).

CI=1.4-3.0) or West (aOR 1.7; 95% CI=1.1-2.7) were associated with PrEP versus residence in the South. Residence in a state with stronger legal protections for LGBTQ+ individuals was also associated with PrEP (aOR 1.4; 95% CI=1.3-1.5), but not residence in a state with adolescent consent laws for HIV care. Conclusions: PrEP prescription rates among at-risk youth remain low in the US, especially among those under 18 years old, with greater odds of receiving PrEP among youth who are older, male, have psychiatric diagnoses, or reside in states with legal protections for LGBTQ+ individuals. Efforts to increase PrEP use among youth are needed, including greater adoption of supportive policies. 1077 Oral and Injectable PrEP Use Among US Adolescents and Young Adults, 2019-2023 Laura M. Mann, Weiming Zhu, Ya-Lin A. Huang, Karen W. Hoover Centers for Disease Control and Prevention, Atlanta, GA, USA Background: Several oral and injectable PrEP medications are available in the United States, all of which are about 99% effective in preventing sexually acquired HIV when taken as prescribed. Adolescents and young adults are a key population that may benefit from PrEP as they account for approximately 20% of new HIV diagnoses. Each PrEP medication offers different benefits, for example tenofovir alafenamide and emtricitabine (TAF/FTC), approved in October 2019, has shown less impact on bone density compared to tenofovir disoproxil fumarate/FTC (TDF/FTC), available since July 2012. Limited information has been available on the use of different PrEP medications by adolescents and young adults. This information is important to monitor PrEP use in this population. Our objective was to analyze a national pharmacy database to estimate trends in US prescriptions for oral and injectable PrEP medications among adolescents and young adults from 2019 to 2023. Methods: We analyzed IQVIA Real-World Data — Longitudinal Prescription Database using a validated algorithm to identify persons aged 13–24 years prescribed PrEP. We estimated the number of adolescents (aged 13–19 years) and young adults (aged 20–24 years) prescribed branded or generic FTC/ TDF, branded FTC/TAF, or long-acting injectable cabotegravir (CAB-LA) during 2019–2023. Results: The annual number of adolescents and young adults prescribed PrEP increased from 14,209 in 2019 to 66,612 in 2023. Branded FTC/TDF was the predominant PrEP medication prescribed for both adolescents and young adults until 2021, when generic FTC/TDF became the predominant medication prescribed (Figure). In 2023, 68,840 (97.7%) adolescents and young adults were prescribed oral PrEP compared to 1,591 (2.3%) prescribed injectable PrEP. The number of persons prescribed injectable PrEP more than doubled between 2022 and 2023 (680 to 1,591). In 2023, generic FTC/TDF was the most prescribed PrEP medication for both adolescents and young adults, representing 6,083 (62.6%) and 35,457 (57.9%) of prescriptions, respectively, followed by branded FTC/TAF (2,910, 29.9%;21,501, 35.1%; respectively). Conclusions: PrEP use has increased among adolescents and young adults from 2019 to 2023. Injectable PrEP use among adolescents and young adults was low compared with oral medication, though its use has increased slightly since it has become available. Increasing PrEP use among young people who would benefit from it remains important to address the HIV epidemic.

Poster Abstracts

1076 Low Rates of HIV Preexposure Prophylaxis Prescriptions Among US Youth in a Claims Database Nicholas Venturelli 1 , Douglas Krakower 2 , Laura Garabedian 3 1 Boston Children's Hospital, Boston, MA, USA, 2 Harvard Pilgrim Health Care Institute, Boston, MA, USA, 3 Harvard Medical School, Boston, MA, USA Background: Adolescents and young adults (AYA) ages 13-24 in the U.S. have disproportionately high rates of new HIV infections but major underuse of HIV preexposure prophylaxis (PrEP). We measured PrEP prescriptions among commercially-insured AYA in the US at increased risk for HIV during January 2018 to June 2023 and identified demographic, clinical, and geographic factors associated with receipt of PrEP. Methods: Within the IBM Marketscan® insurance claims database, we identified a cohort of AYA aged 13-21 who had ICD-10 codes for bacterial sexually transmitted infections or high-risk sexual behaviors suggestive of clinical indications for PrEP. Exclusion criteria included HIV diagnosis, prior PrEP use, or use of antiretrovirals not indicated for PrEP. We identified PrEP using claims data for filled PrEP prescriptions. Using logistic regression, we examined associations between clinical and demographic/geographic characteristics PrEP fill. These included age, sex, psychiatric diagnoses, substance use, and year of cohort entry, US region, state confidentiality laws on HIV care, and state laws protecting LGBTQ+ individuals. Results: Of 101,148 youth in the cohort, 2.2% (n=2209) filled a PrEP prescription, including only 0.8% (197/23,670) of youth under 18. Factors associated with increased odds of PrEP included male sex (adjusted odds ratio [aOR] 16.3; 95% CI=14.3-18.5), older age (adjusted odds ratio [aOR] for 18-19-year-olds = 2.6; 95% CI =2.2-3.1; aOR for 20-21-year-olds = 3.5; 95% CI = 3.0-4.1), male gender (aOR = 18.5; 95% CI=16.2-21.1), mental health diagnosis (aOR 1.7; 95% CI=1.6-1.8). Those with gonorrhea or syphilis were more likely to be prescribed PrEP than those with chlamydia. Substance use and year of cohort entry were not associated with PrEP. Residence in the Northeast (aOR 2.0; 95%

1078 Durable Viral Suppression Using Different Definitions in a Ryan White HIV Program Clinic, 2018-2021 Kathleen A. McManus 1 , Karen Diepstra 2 , Theresa Chen 1 , Andrew Strumpf 1 , Sarah Ratcliffe 1 , Daniel Westreich 2 , Elizabeth T. Rogawski Mcquade 3 1 University of Virginia, Charlottesville, VA, USA, 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 3 Rollins School of Public Health, Atlanta, GA, USA Background: Durable viral suppression (DVS), a metric that evaluates viral suppression (VS) over time, has many different definitions. The Centers of

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