CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

declines of 7.642 tests/10,000 people (95% CI: -11.205 to -4.080) during the same period (Figure 1). Although most groups and regions showed recovered HIV testing rates in the late pandemic period, Latine individuals in the Northeast continued to decline from around 140 to 105. Conclusions: Our findings suggest that the COVID-19 pandemic significantly– but differentially–disrupted HIV testing services across the U.S., exacerbating pre-existing racial/ethnic and regional disparities. The results underscore the need for ongoing efforts to mitigate healthcare inequities and improve access to HIV testing, especially in regions and communities that were most affected by the dual epidemics.

1122 HIV Incidence and Viral Suppression Among Ugandan Males With Female Bar and Sex Worker Partners Xinyi (Cindy) Feng 1 , Gertrude Nakigozi 2 , Caitlin E. Kennedy 3 , Fred Nalugoda 2 , Godfrey Kigozi 2 , Robert Ssekubugu 2 , Larry W. Chang 1 , Andrea L. Wirtz 3 , Arthur Fitzmaurice 4 , Grace Kigozi 2 , Ronald Galiwango 2 , Steven J. Reynolds 5 , Aaron A. R. Tobian 1 , Joseph Kagaayi 2 , M. Kate Grabowski 3 1 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 2 Rakai Health Sciences Program, Kalisizo, Uganda, 3 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 4 US Centers for Disease Control and Prevention Dar es Salaam, Dar es Salaam, United Republic of Tanzania, 5 National Institute of Allergy and Infectious Diseases, Baltimore, MD, USA Background: Female bar and sex workers (FBSWs) in Eastern Africa experience a high burden of HIV. However, there is limited population-level data on HIV seroprevalence, incidence, and viral suppression among their male partners. Methods: Men who had sex with FBSWs were identified through longitudinal population-based HIV surveillance in southern Uganda via the Rakai Community Cohort Study between 2013 and 2020. Surveillance was conducted across five surveys in four Lake Victoria fishing communities (HIV seroprevalence ~40%) and 36 inland agricultural and trading communities (~12%). Primary outcomes included laboratory-confirmed HIV seropositivity, incident infection, viral suppression (<200 copies/ml), and population prevalence of HIV viremia. Prevalence and incidence rate ratios (PR, IRR) were estimated using univariable and multivariable Poisson regressions with 95% confidence intervals (95%CIs). The inverse probability of censoring weights was incorporated into IRR estimates for potential selection biases from differential loss to follow-up. Results: A total of 17,438 male participants contributed 35,273 visits, with 2,408 (13.8%) self-reporting FBSW partners at one or more study visits. Men with FBSW partners tended to be older, have less education and lower income, and never married. Their HIV seroprevalence was significantly higher compared to men without FBSW partners in both inland (21.0% vs 7.5%, PR=2.79, 95%CI=2.41-3.23) and fishing communities (38.6% vs. 23.0%, PR=1.67, 95%CI=1.53-1.84). Moreover, their HIV seroprevalence increased by the number of FBSW partners reported in the past year. Overall, 154 HIV incident events occurred over 27,396 years of participant follow-up. Incidence among men with FBSW partners was 1.93/100 person-years versus 0.44/100 person-years among those without (age-adjusted IRR=4.46, 95%CI=3.09-6.32). Among men with HIV, viral suppression was similar in those with and without FSBW partners. However, the population prevalence of HIV viremia was 1.6 times higher (95%CI=1.41-1.84) among men with FBSW partners due to a higher background burden of HIV infection. Conclusions: Men in Uganda frequently report sex with FBSW partners, which is associated with a significantly higher risk of HIV acquisition. Tailored HIV prevention strategies, including the promotion and uptake of PrEP, are essential to reduce the HIV burden in this male population.

1121 Estimated HIV Incidence in 15-24-year-olds Across 2 Population HIV Impact Assessments (PHIA) Chloe A. Teasdale 1 , Rebecca A. Zimba 1 , Andrea Low 2 , Harriet Nuwagaba Biribonwoha 2 , Felix Ndagije 2 , Lyson Tenthani 2 , Owen Mugurungi 3 , Philip Kreniske 1 , Elaine Abrams 4 1 CUNY School of Public Health, New York, NY, USA, 2 ICAP at Columbia University, New York, NY, USA, 3 Ministry of Health and Child Care, Harare, Zimbabwe, 4 Columbia University Irving Medical Center, New York, NY, USA Background: Adolescents and young adults (AYA) 15-24 years represented more than a quarter of all new HIV infections globally in 2023. Data from two rounds of Population HIV Impact Assessments (PHIA) from four countries were used to estimate HIV incidence and assess progress in reducing incidence in AYA overall and by sex. Methods: PHIAs are nationally representative surveys measuring HIV outcomes. We analyzed data from two rounds of PHIAs in Eswatini (2016-17 & 2022), Lesotho (2016-17 & 2020), Malawi (2015-16 & 2020-21), and Zimbabwe (2015-16 & 2020). Participating household members ≥15 years received rapid antibody HIV testing and blood sample collection. Twelve-month HIV incidence was estimated via Limiting Antigen-Avidity (Lag) enzyme immunoassays and an algorithm identifying recent HIV infections (proxy for incidence). We generated national population-level estimates of new HIV infections in AYA with 95% probability bands (PB) using survey weights with jackknife variance and calculated proportions of new infections among AYA out of all new infections in adults ≥15 years. Rao-Scott tests were used to compare estimates from the two survey rounds. Results: Across the four countries, 21,008 and 21,028 AYA participated in round 1 and 2, respectively. HIV incidence in AYA in round 1 surveys was lowest in Malawi (0.22, 95%PB 0.03-0.40) and highest in Eswatini (1.07, 95%PB 0.48-1.66); there were an estimated 20,900 new infections in AYA across the four countries. In round 2, incidence ranged from 0.25 (95%PB 0.06-0.44) in Malawi to 0.86 (95%PB 0.26-1.45) in Eswatini; with an estimated 25,600 new infections in AYA. No country showed significant change in HIV incidence across the two surveys for all AYA; incidence in females in Lesotho decreased from 1.49 (95%PB 0.58-2.39) to 0.34 (95%PB 0-0.74) (p=0.03). AYA accounted for larger proportions of all new adult infections from round 1 to 2 in Eswatini (39.9% v. 54.2%), Malawi (25.0% v. 46.9%) and Zimbabwe (28.4% v. 41.9%). Conclusions: Despite progress for young females in Lesotho, data from two rounds of PHIA surveys in four countries shows no change in estimated HIV incidence overall in AYA, and indicate this age group accounts for a substantial proportion of all new adult infections. Larger studies are needed to confirm these results as are more effective prevention efforts for this age group.

Poster Abstracts

CROI 2025 364