CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1100 Differential Impact of Social Determinants of Health by Sex in HIV for COVID-19 Hospitalizations Dimple Vaidya 1 , Kenneth Wilkins 2 , Eric G. Hurwitz 3 , Zachary Butzin-Dozier 4 , Elaine Hill 5 , Pooja Maheria 6 , Jessica Islam 7 , Jing Sun 8 , Dongmei Li 5 , Sandra Safo 9 , Marlene Camacho-Rivera 10 , Charisse Madlock-Brown 11 , Rena C. Patel 12 , for the National COVID Cohort Collaborative (N3C) 1 University of Washington, Seattle, WA, USA, 2 National Institutes of Health, Bethesda, MD, USA, 3 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 4 University of California Berkeley, Berkeley, CA, USA, 5 University of Rochester Medical Center, Rochester, NY, USA, 6 University of Alabama at Birmingham, Birmingham, AL, USA, 7 University of South Florida, Tampa, FL, USA, 8 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 9 University of Minnesota, Minneapolis, MN, USA, 10 SUNY Downstate, Brooklyn, NY, USA, 11 University of Iowa, Iowa City, IA, USA, 12 University of Alabama, Tuscaloosa, AL, USA Background: Our study investigated sex differences in how individual-level social determinants of health (SDoH) affect COVID-19 related hospitalizations among people with HIV (PWH) and without HIV (PWoH) in the U.S. Methods: We analyzed the National COVID-19 Cohort Collaborative (N3C) data from January 2020 to November 2023 to assess how SDoH (healthcare access, economic stability, social cohesion) impact COVID-19 hospitalization risk among PWH and PWoH. We conducted hierarchically-nested additive and adjusted mixed-effects logistic regression models stratified by HIV and sex , adjusting for age, race/ethnicity, comorbidities, data source, and mediation by healthcare utilization. Results: Among our study population of 280,441 individuals from 24 data partner sites, 11.2% were hospitalized due to COVID-19. This hospitalization rate was higher for males (14%) compared to females (9.5%). Overall, females consistently demonstrated higher proportions for issues with access to healthcare (2.1% for females, 1.7% for males), economic stability (11% for females, 9.1% for males), and social cohesion (40.6% for females, 36.4% for males); these proportions were even higher among female PWH. In our initial additive modeling, all three SDoH domains were significantly associated with hospitalizations, with adjusted odds ratios (aOR) ranging from 1.36 to 1.97. Subsequently, our HIV-stratified analyses indicated economic instability was associated with hospitalization among PWH, while all 3 SDoH domains were associated with hospitalization among PWoH (aOR range 1.36 -1.96). Lastly, our fully adjusted, sex-stratified analysis, indicated social cohesion issues were associated with hospitalization across both sex groups (aOR range 1.18 - 2.37) as was HIV positive status (aOR range 1.18- 1.22). Conclusions: Our results reveal that while males had higher initial COVID-19 hospitalization rates, adjusting for SDoH demonstrated a significant association between female and hospitalization. This study demonstrates the importance of investigating individual-level SDoH variables to unpack the intricate interplay between these factors, HIV status and sex in shaping health outcomes.

1099 Impact of COVID-19 Pandemic in Deaths of PLWH From ART Program of a Peruvian Hospital Jorge Tello Arana 1 , Carlos Gonzales Rayme 1 , Silvana Maldonado Berrospi 1 , Alfredo Chiape-Gonzales 2 , Juan Montenegro-Idrogo 3 1 Universidad Científica del Sur, Lima, Peru, 2 Universidad Ricardo Palma, Lima, Peru, 3 Universidad Nacional Mayor de San Marcos, Lima, Peru Background: COVID-19 pandemic decreased accessibility to health services in chronic diseases as HIV, with disruption of the continuum of HIV care. In addition, COVID-19 added more death during first waves before immunization, but in PLWH in ART knowledge about impact in the mortality was poor in studies in follow-up. Methods: Retrospective study from clinical records of PLWH reported dead from a cohort of national hospital enrolled in ART between 2017-2022 years. Causes of death were classified from death certificate as related with: COVID-19, any severe acute respiratory infection (SARI), advanced HIV, infectious disease no related with HIV (ID no-HIV), CNS infection, neoplastic, cardiovascular, and other chronic diseases. Logistic regression model was made including covariates: MSM, sex-working, gender, death in health center, age at HIV diagnosis, time to start ART, abandonment episodes, current abandonment, baseline cd4, CD4 nadir, last ART scheme, viral suppression, tuberculosis background during HIV, and death year. Results: Were recovered 211/240 completed records from PLWH reported as death. Since 2020 deaths were increased in comparison to previous years, but deaths related with advance HIV, SARI, and other no opportunistic ID were increased since 2019 (Figure). In each adjusted regression model by deaths related with COVID-19, advanced HIV and SARI, risk were associated with death in health center (PR: 5.32 CI95%: 2.21-12.82; PR: 2.53 CI95%: 1.01-6.37; PR: 35.17 CI95%: 3.87-319.88 respectively). Additionally, there was less risk of death related SARI with MSM. (PR: 0.39 CI95%: 0.16-0.95); viral suppression or abandonment were not related. Conclusions: COVID-19 pandemic reinforced the trend in deaths due the advanced HIV status, SARI and the same COVID-19 during the first 2 years, period with poor COVID-19 immunization coverage. The health centers probably identified better the death causes and it is the reason of the high risk in the model, but is unexplained the less risk of death due SARI in MSM people, it needs to assess other factors involved.

Poster Abstracts

1101 A Syndemic View of Criminal Justice: Jail’s Impact on HIV, Syphilis, and Overdose in Washington 2023 Steven J. Erly, Danika A. Troupe, Silas M. Hyzer, Rachel M. Amiya Washington State Department of Health, Olympia, WA, USA Background: The syndemic model of HIV prevention frames HIV transmission as a product of complex biological and social factors that intersect with viral hepatitis, sexually transmitted infections (STIs), substance use, and behavioral

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