CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

included being part of a key population (predominantly MSM: OR 0.38, 95%CI 0.14-0.91, p=0.04) and an initial CD4 count ≥200 cells/mm³ (OR 0.59, 95%CI 0.35-1.03, p=0.06). Detectable viral loads were associated with undocumented status (OR 2.15, 95%CI 1.08 – 4.23, p=0.03) and non-Dominican nationality (OR 2.73, 95%CI 1.43-5.26, p=0.002). Conclusions: In the Dominican Republic, older age, identifying as MSM, and receiving ART in the community were associated with better retention and outcomes. However, challenges remain for undocumented individuals and migrants, highlighting the need for inclusive strategies that address access to care for this population. By considering these diverse factors, targeted interventions can be developed to improve HIV outcomes and advance epidemic control in the region.

vs. contact of a newly diagnosed index case (AOR 1.69; 95% CI: 1.52-1.88) were associated with ART initiation. Conclusions: The slight increase in ART uptake over time may indicate the effectiveness of the IPT services program. Programs may consider integrating HIV self-test or other services to improve case finding among contacts of index cases. 1090 Understanding Mpox and HIV Coinfection: Insights From a Major Cohort Study in Brazil Mayara Secco Torres da Silva, Thiago Torres, Carolina Coutinho, Eduardo Mesquita Peixoto, Matheus Oliveira Bastos, Pedro Silva Martins, João Paulo Bortot, Amanda Echeverría-Guevara, Maira Braga Mesquita, Ana Paula Lovetro, Edson Elias Silva, Estevão Portela Nunes, Sandra Wagner Cardoso, Valdilea Gonçalves Veloso, Beatriz Grinsztejn Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil Background: In 2024, mpox was declared a public health emergency of international concern for the second time in two years. Brazil was significantly impacted by the 2022 multinational mpox outbreak and has observed a recrudescence in diagnoses since late 2023, primarily driven by sexual transmission. The implications of mpox and HIV coinfection are still not fully understood. This study aims to characterize individuals diagnosed with mpox in Rio de Janeiro, Brazil, with a focus on their HIV status. Methods: Prospective cohort of people with laboratory confirmed mpox assessed at INI-Fiocruz, a state-level referral center. Sociodemographic, behavioral, and clinical characteristics were compared according to HIV status (Chi-squared/Fisher’s test or Wilcoxon rank-sum test for categorical or quantitative variables, respectively). Results: From June/2022 to September/2024, 711 people with confirmed mpox (3 with suspected reinfection) were enrolled, of whom 98.9% (n=703) had a known HIV status. Among these, 51.6% were people with HIV (PWH) and 38.8% (n=132/340) were on PrEP. The median age was 33 years (IQR:28-40), with the majority being cisgender men (91.2%) who reported sex with men (86.7%). Notably, 60% of participants experienced a delay of more than five days from symptom onset to their first assessment at INI-Fiocruz. Most identified as black/ pardo (61.4%) and had post-secondary education (57.7%). PWH were older, more likely to identify as cisgender men and report sex with men. They also exhibited higher rates of fever, genital lesions, proctitis, active syphilis and HCV coinfection, along with a higher positivity rate for MPXV in anorectal swabs (Table). Among PWH and mpox, 85% had HIV-RNA viral load of less than 200 copies/mL and 87% had CD4+ above 350 cells/mm 3 (median 645 [IQR:468 907]). Despite a significant hospitalization rate of 10.4%, mpox lethality was low at 0.4%. HIV status did not influence mpox-related hospitalization; however, all participants who died were PWH with CD4+ counts below 350 cells/mm³. Conclusions: This study highlights the intersection of mpox and HIV in Brazil, revealing a high prevalence of HIV among those affected. Concurrent STIs may worsen clinical outcomes for individuals living with HIV, emphasizing the need for integrated prevention strategies. Strengthening HIV and STI prevention and care services is essential for managing mpox as a global health emergency, ultimately reducing morbidity and mortality associated with both conditions.

Poster Abstracts

1089 Higher Baseline CD4 and Treatment Initiation Among Contacts of PLHIV: Thailand, 2020-2023 Junya Danyuttapolchai 1 , Suchada Jiamsiri 2 , Plearnpit Prommali 2 , Jennifer Favaloro 3 , Yutthapoom Srikhamjean 2 , Usanee Kritsanavarin 1 , Sumet Ongwandee 2 , Suthat Chottanapund 2 , Cheewanan Lertpiriyasuwat 2 , Somboon Nookhai 1 , Sanny Northbrook 1 1 US Centers for Disease Control and Prevention Nonthaburi, Nonthaburi, Thailand, 2 Ministry of Public Health, Nonthaburi, Thailand, 3 Centers for Disease Control and Prevention, Atlanta, GA, USA Background: In 2020, approximately 50% of newly diagnosed persons living with HIV (PLHIV) had a baseline CD4 <200 cells/µL in Thailand. As a result, the Ministry of Public Health implemented and expanded the national index partner testing (IPT) program to increase early HIV detection (baseline CD4 ≥200 cells/ µL) and rapid antiretroviral (ART) treatment initiation. We analyzed trends in baseline CD4 and ART initiation and investigated factors associated with ART initiation among contacts of PLHIV in 2020-2023. Methods: IPT services were offered to all PLHIV ≥ 1 years of age at 144 health facilities after providing informed consent for health services. Contacts of PLHIV, including sexual and drug injecting contact within the past year, biological children, or biological parents if child was PLHIV, were elicited and offered HIV testing and linkage to ART. We collected contact’s demographic and clinical data using an online monitoring system. Linkage to ART and analysis of factors associated with ART initiation among contacts of PLHIV was conducted for those testing HIV positive. Results: Of 6,541 contacts elicited and tested, 1,683 (25.7%) tested HIV positive. Of these, the median age was 34 years (IQR: 26-43), 1,135 (67.4%) were male, 1,290 (76.6%) were ≥25 years, 529 (31.4%) self-reported as high-risk population (HRP), 1,572 (93.4%) were sexual contacts, 682 (40.5%) were contacts of newly diagnosed PLHIV, 1,487 (88.4% ) initiated ART, and 771 (45.8%) had baseline CD4 information, with 27.8% (214/771) CD4 <200. Baseline median CD4 among contacts was slightly higher in 2023 (351 cells/µL, IQR: 218-479) than in 2020 (318 cells/µL, IQR:182-481) (p=0.23). ART initiation slightly increased from 87.4% (304/348) in 2020 to 88.5% (416/470) in 2023 (p<0.001). Contacts who self-reported as HRP vs. those who did not (Adjusted Odds Ratio [AOR] 2.59; 95% CI: 2.26-2.97), had sex with the index case vs. those who had a biologic relationship (AOR 2.8; 95% CI: 1.18-6.88), had sex and shared needles with the index case vs. those who had a biologic relationship (AOR 2.26; 95% CI: 0.93 – 5.63), and was a contact of index case diagnosed >12 months

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