CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

between housing status and HIV outcomes among reproductive-age women living with HIV (WLH). Methods: The Study of Treatment and Reproductive Outcomes (STAR) examines cisgender women aged 18-45 years old with and without HIV in six Southern US sites. We analyzed baseline data for WLH enrolled in March 2021-August 2023. Participants were considered unstably housed if they self-reported living in a rooming/halfway house, shelter/welfare hotel, on the street/beach, jail/other correctional facility, residential drug/alcohol treatment facility, car, assisted living, or other unstable housing location. We evaluated associations between housing status and a) viral non-suppression, and b) missed HIV care visits using logistic regression models, adjusting for age, race, socioeconomic status, depressive symptoms, and illicit drug use. Results: Among 473 WLH, median age was 37 (IQR 32-42) years. Participants were predominately non-Hispanic Black (80.1%), unmarried/unpartnered (68.7%), unemployed (52.2%), and high school educated (61.7%); 37.2% reported annual household income of $24,000 or less. Overall, 9.2% reported illicit drug use (excluding marijuana only) and 33.5% reported depressive symptoms. Among WLH, 7.0% reported unstable housing, 16.2% had a missed HIV visit in the last year, and 19.5% were virally non-suppressed. Unstably housed WLH were significantly more likely to be virally non-suppressed than stably housed WLH; this association persisted after adjusting for sociodemographic variables, depressive symptoms, and illicit drug use (OR: 2.92, Cl: 1.08-7.87). Unstably housed WLH were additionally more likely to miss at least one HIV visit in the past year, which also persisted after adjusting for these variables (OR: 2.35, Cl: 1.02-5.42; Table). Conclusions: Housing instability was associated with over two times the odds of adverse HIV outcomes, even after adjusting for sociodemographic and psychosocial risk factors. This emphasizes its role as a key social determinant of health that must be addressed. Further research to assess the potential pathways for this association, such as access to care or comorbid conditions, will inform acceptable and scalable housing interventions to improve outcomes for WLH.

Poster Abstracts

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1108 Recent HIV Acquisition Among Transgender Women From Midwest Brazil Sylvia L. M. Teixeira 1 , Thiago Silva Torres 2 , Bruno Vinícius D. Diniz e Silva 3 , José Henrique S. Pilotto 1 , Ingebourg Georg 2 , Carlos S. Jesus 1 , Paulie Marcelly R. Santos 3 , Karlla Antonieta A. Caetano 3 , Regina Maria B. Martins 3 , Megmar Aparecida S. Carneiro 3 , Monick L. Guimarães 1 , Sheila A. Teles 3 1 Oswaldo Cruz Institute – Fiocruz, Rio de Janeiro, Brazil, 2 Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil, 3 Federal University of Goias, Goiânia, Brazil Background: In Brazil, transgender women (TGW) face a disproportionately high burden of HIV. Research on the patterns of the HIV epidemic in TGW is still lacking in Midwest Brazil. We aimed to evaluate the HIV prevalence and proportion of recent HIV acquisition and to explore factors associated with recent HIV acquisition among TGW from Goiás, Brazil. Methods: We included TGW aged 16-59 from three cities in Goiás, Brazil: Goiânia, Itumbiara, and Jataí. Participants were recruited between Apr-2018 to Nov-2019 using respondent-driven sampling (RDS). HIV testing followed the Brazilian algorithm and the Maxim HIV-1 Limiting Antigen Avidity EIA (LAg) was used to identify recent HIV acquisition in plasma samples. We compared study participants’ characteristics using Pearson’s chi-square and Fisher’s test for categorical variables and the Wilcoxon test for continuous variables: (1) recent vs. longstanding HIV acquisition and (2) recent vs. HIV-negative. We used logistic regression models to assess factors associated with recent HIV acquisition among participants at risk of HIV infection (excluding those with longstanding HIV acquisition). Results: We enrolled 440 TGW: 285 in Goiânia, 74 in Itumbiara, and 81 in Jataí; the median age was 25 years (IQR: 21-30), 312 (71.2%) self-identified as Black, 269 (61.1%) completed secondary school; none of the TGW were on PrEP. From 143 TGW who tested positive for HIV (prevalence: 33.2%), 51 reported current ARV use and were excluded from recency analysis; 87/92 participants (94.6%) had available plasma samples for LAg testing, of which 44 (50.6%) had recently acquired HIV. TGW with recent HIV acquisitions were older and more affected by STI (sexually transmitted infections) than those with longstanding HIV (p=0.041 and p=0.024, respectively) (Table). Logistic regression analysis showed a borderline association between older age and greater odds of recent HIV acquisition (OR: 1.03 [95%CI:0.99-1.07], per 1-year increase, p=0.08).

1107 WITHDRAWN

CROI 2025 359