CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1104 WITHDRAWN

1105 HIV Diagnosis Following Discharge From Psychiatric Hospitalization: A Claims-Based, Real-World Study Samuel Bunting 1 , Max Hyman 2 , Aniruddha Hazra 1 1 University of Chicago Medical Center, Chicago, IL, USA, 2 University of Chicago, Chicago, IL, USA Background: People living with mental illnesses (PLMI) and substance use disorders experience disproportionate incidence of HIV. Domestic and international policy agendas emphasize developing methods for expanding access to HIV testing, pre-exposure prophylaxis (PrEP), and linkage to care. The purpose of the present study was to quantify new HIV diagnoses following discharge from psychiatric hospitalization as a possible site of intervention for HIV prevention for PLMI. Methods: The MarketScan database of medical and pharmaceutical claims for commercially insured people in the US was used to identify enrollees who were hospitalized with diagnosis-related groups corresponding to a primary psychiatric illness. A conservative approach was used to define the cohort. We excluded enrollees with previous claims-based evidence of HIV (1 inpatient or 2 outpatient claims on different dates), and enrollees with antiretroviral prescriptions for agents other than PrEP. Inclusion required at least 1 year of continuous medical and prescription drug coverage prior to date of psychiatric admission (index date). Enrollees were followed for 1 year after discharge or until HIV diagnosis. We did not include re-admissions. Results: The final cohort included 492,363 individuals who were psychiatrically hospitalized between 2004-2022. There were 277 HIV diagnoses following discharge. New diagnoses were more frequent among males (n=186; 67.2%), in the Western US (n=110; 39.7%). The most common, primary diagnoses at hospitalization were depression (n=101; 36.5%), alcohol use disorder (n=33; 11.9%), bipolar disorder (n=32; 11.6%). Median time to HIV diagnosis was 154 days after discharge (IQR: 61-243). Enrollees who were hospitalized for a primary diagnosis of stimulant use disorder (SUD) had the shortest median time to HIV diagnosis following discharge (40 days; 32-70). (Figure 1) Conclusions: In this retrospective, claims-based study, we identified many new HIV diagnoses in the 1-year follow-up period after discharge from inpatient psychiatry. The mean time to new diagnosis was less than 6-months for all diagnosis groups and the shortest mean duration was identified for enrollees hospitalized primarily for SUD. Future research is needed to better understand screening for PrEP eligibility among patients receiving inpatient psychiatric care and to develop models of care to integrate PrEP prescription in the settings where people with psychiatric illnesses are already engaged in care.

Poster Abstracts

1106 Housing Status and HIV Outcomes Among Reproductive-Age Women Living With HIV in the Southern US Shreya Ganguly 1 , Olivia Christman 2 , Qian Yang 1 , Cyra C. Mehta 1 , Tina T. Tisdale 1 , Ayako W. Fujita 1 , Deborah Konkle-Parker 3 , Maria L. Alcaide 4 , Aadia Rana 5 , Seble Kassaye 6 , Elizabeth F. Topper 7 , Daniel Westreich 8 , Anandi N. Sheth 1 1 Emory University, Atlanta, GA, USA, 2 Rollins School of Public Health, Atlanta, GA, USA, 3 University of Mississippi Medical Center, Jackson, MS, USA, 4 University of Miami Miller, Miami, FL, USA, 5 University of Alabama at Birmingham, Birmingham, AL, USA, 6 Georgetown University, Washington, DC, USA, 7 The Johns Hopkins University, Baltimore, MD, USA, 8 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background: Reproductive-age women are uniquely affected by HIV across their life course. Housing instability has been identified as a modifiable risk factor for worse health outcomes among people living with HIV but is not well examined among reproductive-age women. We evaluated associations

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