CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

Methods: We used data from seven US urban areas, which simultaneously used virtual and in-person recruitment to reach and interview MSM for CDC’s 2023 National HIV Behavioral Surveillance. We reported weighted percentages and 95% confidence intervals (CI) of MSM’s demographics and HIV sexual behaviors and compared them per recruitment type using Rao-Scott Chi-square tests. We calculated adjusted prevalence ratios (aPR) and 95% CI using multivariable logistic regression models with predicted margins to characterize the associations of recruitment type with MSM demographics and sexual behaviors. Statistical significance was determined by p<0.05 . Results: Among 2822 MSM, 386 (13.7%) were recruited virtually and 1203 (42.6%) had a college degree or higher education. A plurality, 1005 (35.8%) were Hispanic/Latino. Compared to MSM recruited in-person (IPR), those recruited virtually (VR) had the higher prevalence of: a college degree or higher education (62.1% VR, 95%CI [51.2-73.0] vs 40.8% IPR, 95%CI [36.2-45.5]), condomless anal or vaginal sex with a casual partner in the past 12 months (62.5% VR, 95%CI [55.5-69.4] vs 51.2% IPR, 95%CI [46.1-56.3]), and multiple (≥2) partners (90.9% VR, 95%CI [86.3-95.5] vs 74.2% IPR, 95%CI [69.8-78.6]) in the past 12 months (for all behaviors p<0.05 ). After controlling for region, having condomless sex (aPR=1.19, 95%CI [1.02-1.39]) and multiple partners in the past 12 months (aPR=1.23, 95%CI [1.14-1.32]) were higher among MSM recruited virtually ( p<0.05 ). However, having a college degree or higher education was not significantly different between MSM recruited virtually and in-person (aPR=1.29, 95%CI [1.00-1.67], p>0.05 ). Conclusions: MSM who were more likely to engage in behaviors associated with HIV were recruited virtually. Recruiting MSM in virtual and in-person spaces may both be needed to identify diverse HIV-related behaviors. 1080 Identifying Effective Recruitment Strategies to Engage Black Sexual Minority Men Living With HIV Derek Dangerfield II 1 , Rodman Turpin 2 , DeMarc Hickson 3 1 The George Washington University, Washington, DC, USA, 2 George Mason University, Fairfax, VA, USA, 3 Us Helping Us, People Into Living, Inc, Washington, DC, USA Background: Identifying effective strategies to engage Black sexual minority men living with HIV (SMM LWH), including those with diversity in HIV care outcomes, socio-economic status, and geography, is crucial to obtaining a robust understanding of the HIV epidemiology in this population and developing effective public health programming to end the U.S. HIV epidemic. However, strategies to effectively recruit this group demonstrate inconsistent efficacy and those with suboptimal care outcomes remain elusive. Therefore, we implemented and assessed targeted recruitment strategies for a digital, limited interaction cohort study to identify the most effective ways to engage this population. Methods: A total of 1,006 Mid-Atlantic Black SMM LWH were recruited between 2023-2024 using targeted active and passive strategies including geosocial networking apps (i.e., Jack’d), community/clinical e-newsletters, private social media groups on Facebook, friends/word of mouth, and participants from previous studies. Bivariate analyses tested for associations between recruitment method and sociodemographic characteristics along with HIV care outcomes. Kruskal-Wallis and Chi-Square tests were conducted for associations with ordinal and binary measures respectively. Results: Most participants were ages 25-44 (94.6%). Both advertisements were associated with recruitment spikes significantly greater than expected proportions. Jack’d ads yielded the most participants (36.3%) followed by friends/word of mouth (23.5%). Jack’d ads were associated with recruiting Black SMM LWH who were 18-34 years old, had lower education, and annual income of $80,000 or less. Participants recruited through Jack’d ads were more likely to have detectable HIV loads and have missed ART doses in the past month. Conclusions: Geosocial networking platforms show significant promise to engage Black SMM LWH with sub-optimal HIV care outcomes, particularly younger individuals with lower socioeconomic status. Friends and social networks also show promise to engage this oftentimes referred to subpopulation as “hard-to-reach.” Future research should optimize and expand online advertising strategies and social networks to address care disparities, improve health outcomes, and reduce community viral load to mitigate further HIV transmission.

Disease Control and Prevention and the Ryan White HIV/AIDS Program (RWHAP) define VS for a year as the last viral load (VL) in the year is suppressed and require a person with HIV (PWH) to have at least 1 VL test to be included in the metric. We quantified the annual prevalence of this VS definition and 3 DVS outcomes at one RWHAP clinic to identify how different definitions impact results. Methods: For 2018-2021, the cohort included PWH who were >18 years and had established care at the University of Virginia RWHAP clinic by 1/1/2018. We excluded PWH who died, relocated, or were incarcerated on or before 12/31/2021. We collected sociodemographic, clinical, and lab data. For each VS/DVS definition (Table 1), we quantified the annual VS/DVS prevalence for those with the required number of VLs and performed a sensitivity analysis that imputed not having VS/DVS if the required number of VLs was not met. Results: Of the cohort (n=618), median age was 51 (interquartile range 40-57). 71% were male, 6% were uninsured, 28% had Medicaid, and 38% had an income below the Federal Poverty Line. Of the definitions, VS had the highest prevalence (range 94-95%, Table 1). DVS#1 prevalence was lower than VS prevalence for each year (range 87-92%). All DVS metrics that required 2 VLs decreased in prevalence from 2019 to 2020. For each year, DVS#3 had the lowest prevalence (range 83-91%). The prevalence of having no VL result was <5% in each year. The prevalence of having only 1 VL result in a year was lower pre-COVID-19 (2018: 17%, 2019: 12%) than in years impacted by COVID-19 (2020: 32%, 2021: 24%). Analyses assuming PWH without the required number of VLs did not have DVS demonstrate that DVS prevalence may have been as low as 53-73% (DVS#3). Conclusions: For a study that included the COVID-19 pandemic, VS was high. However, DVS results shed light on gaps in VS, and the sensitivity analyses show worst case scenario results. The more restrictive VS definitions exclude more people, and those excluded may not be a random subset of PWH, which could lead to selection bias. This work has implications for HIV care evaluation. National/state outcomes that rely on 1 VL are likely overestimating the true DVS of PWH in the United States. Federal and state agencies should consider reporting (1) additional annual VS/DVS metrics that require at least 2 VLs and (2) sensitivity analyses.

Poster Abstracts

1079 Characteristics of Men Who Have Sex With Men Recruited via Virtual- v In-Person Venue-Based Sampling Danielle Lonbong Njiometio 1 , Julie Berg 2 , Catlainn Sionean 3 , Amy Baugher 3 , for the NHBS Study Group 1 Oak Ridge Institute for Science and Education, Atlanta, GA, USA, 2 DLH Corporation, Atlanta, GA, USA, 3 Centers for Disease Control and Prevention, Atlanta, GA, USA Background: Men who have sex with men (MSM), a group with high HIV incidence, may seek sexual partners through virtual (geosocial or dating apps) or in-person (bars or clubs) venues. Both types of venues facilitate partnerships among MSM and increase transmission of sexually transmitted infections and HIV. This analysis assessed if virtual and in-person sampling methods recruit MSM with different demographics and sexual behaviors.

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