CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1087 WITHDRAWN

1086 High Burden of Untreated HIV in Malawian Fishermen: Prospective Data From a Cluster Randomized Trial Augustine T. Choko 1 , Kathryn L. Dovel 2 , Sekeleghe Kayuni 3 , Donaldson Conserve 4 , Anthony Butterworth 1 , Amaya Bustinduy 5 , J. Russell Stothard 3 , Wala Kamchedzera 1 , Madalo Mukoka-Thindwa 1 , James Jafali 6 , Peter MacPherson 7 , Katherine Fielding 5 , Nicola Desmond 5 , Liz L. Corbett 5 1 Malawi Liverpool Wellcome Trust, Blantyre, Malawi, 2 University of California Los Angeles, Los Angeles, CA, USA, 3 Liverpool School of Tropical Medicine, Liverpool, UK, 4 George Washington University, Washington, DC, USA, 5 London School of Hygiene & Tropical Medicine, London, UK, 6 University of Liverpool, Liverpool, UK, 7 University of Glasgow, Glasgow, UK Background: Despite ubiquitous progress in ART global scale up and significant reductions in mortality and morbidity some populations, such as fishing communities in Africa, continue to lag behind. We investigated the prevalence of, and factors associated with untreated HIV among fishermen using prospective data from a cluster randomized trial from Mangochi, Malawi. Methods: This is analysis of cross-sectional data collected using in-person administered questionnaires between March 2022-January 2023 during the “creating demand for Fishermen’s Schistosomiasis and HIV services (FISH)” cluster randomised trial. The data came from 45 lakeside “boat-team” (clusters) in southern Lake Malawi from three trial arms. We defined the main outcome of having untreated HIV as a person living with HIV but currently not on ART using self-reported variables. Our main exposure was self-reported HIV testing history i.e. whether a person reported having ever tested for HIV before in their life. The analysis estimated the prevalence of untreated HIV and Binomial Exact 95% confidence intervals (CI) in the whole sample (N=5206) and among fishermen who tested HIV positive in the study (n=387). Unadjusted odds ratios (OR) and adjusted (aOR) were computed using random effects logistic regression while accounting for clustering. Results: A total of 5206 fishermen were enrolled from 45 clusters: mean age 33.2 years (sd: 12.3), 3401/5206 (65.3%) were married, only 3032/5206 (58.2%) could read or write, and 4213/5206 (80.9%) had ever tested for HIV before. Prevalence of untreated HIV was 113/5206 (2.2%, 95%CI: 1.8; 2.6%) in the whole sample and 113/387 (29.2%, 95% CI: 24.9; 33.9%) among those who tested HIV positive in the study. Having a previous HIV test was significantly associated with reduced odds of having untreated HIV both in unadjusted OR 0.05 (95%CI: 0.01; 0.16) and aOR 0.07 (95%CI: 0.02; 0.25) when adjusted for age, marital status and HIV knowledge variables (Table 1). There was evidence of clustering with intracluster correlation coefficient value of 0.12. Conclusions: Not testing for HIV and increasing age were strongly associated with having untreated HIV. The findings encourage sustained investments in interventions to expand coverage of HIV testing in underserved populations.

Poster Abstracts

1088 Unique Predictors of Retention and Viral Suppression Among People With HIV in Dominican Republic Wilfredo R. Matias 1 , Karol Reyes 2 , Maria I. Curiel 2 , Rairis A. Morrison 2 , Maria L. Garcia 2 , Carlos Adon 2 , Louise C. Ivers 3 1 Brigham and Women's Hospital, Boston, MA, USA, 2 Instituto Dominicano de Estudios Virológicos, Santo Domingo, Dominican Republic, 3 Massachusetts General Hospital, Boston, MA, USA Background: In recent years, the HIV epidemic in the Dominican Republic and surrounding regions in Latin America has disproportionately affected migrants, particularly those from Haiti and Venezuela. Migrants often face unique challenges along the HIV continuum of care that require tailored interventions. We conducted a study to understand the drivers of retention, attrition, and viral suppression in this population to identify intervenable factors, improve outcomes and control HIV in the region. Methods: We conducted a retrospective analysis of 1,326 patients enrolled in HIV care from 2019 to 2021 at a major HIV clinic in the Dominican Republic. We used multivariable Cox proportional hazards and logistic regression models to assess sociodemographic and clinical factors associated with retention in care (as of May 1st, 2024) and viral suppression (VL < 200 copies/mL). Key variables included age, nationality, legal documentation status, key population status (e.g., MSM), CD4 count, and site of ART delivery (community- vs. health center based). Results: Of 1,326 participants, 773 (58.3%) remained in care. Retention was associated with older age (40-49 years: HR 0.67, p=0.002; ≥50 years: HR 0.74, p=0.05), identifying as MSM (HR 0.70, 95%CI 0.54-0.90, p<0.001) and receiving ART in community settings (HR 0.14, 95%CI 0.07–0.30, p<0.001). Attrition was more common among undocumented individuals (HR 2.61, 95%CI 2.09-3.25, p<0.001), people from Haiti (HR 1.95, 95%CI 1.55-2.46, p<0.001), and non-Dominican nationals (HR 2.02, 95%CI 1.31-3.13, p=0.002). Among the 759 patients retained in care who had available viral load data, 674 (88.8%) achieved viral suppression. Factors positively associated with viral suppression

CROI 2025 351