CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

surveillance cohort spanning 34 Ugandan communities. Persons with incident HIV were matched to HIV-negative controls based on age, sex, religion, and community. Sexual partner contact details (name, residence) were elicited; for female sex worker (FSW) partners without complete contact details, venue information was collected. Named and potential FSWs partners at venues were enrolled and tested for HIV and viremia (>1,000 copies/ml). Conditional logistic regression compared sexual networks and risk profiles. Results: We identified 99 women and 87 men with incident HIV and matched them to 186 controls. Male cases elicited 321 partners compared to 188 from male controls. Female cases elicited 183 partners versus 118 from female controls. Male cases lacked complete contact details for most partners (177, 55.1%) in contrast to male controls (60, 31.9%), female cases (60, 32.8%), or female controls (22, 18.6%); most of these 177 partners (62.1%) were venue based FSWs. We enrolled 437 named partners from cases (n=237) and controls (n=200), respectively (Figure). From 27 venues (4-200 FSW/venue) linked to 35 male cases, we enrolled 227 FSWs, of whom 36% (n=80) were living with HIV. Most venues (73%) were unknown to local outreach services. Compared to controls, cases had significantly higher odds of having >=1 partner with HIV (conditional odds ratio [cOR]=9.63; 95%CI:4.65–19.93) and >=1 partner with viremia (cOR=8.00; 95%CI:2.83–22.62). Male cases had 16.5 times higher odds than controls of reporting ≥1 FSW partner (95%CI:3.96–68.76). PrEP use was rare among HIV-negative partners of persons with viremia (2.9%; 2/70) and FSWs (6.9%, 10/144). Conclusions: Incident HIV among men was strongly linked to reporting FSW sexual partners. Many men had no partner contact details beyond venue information. Incorporating venue-based partner elicitation into partner notification services could improve HIV case notification and service outreach. Additionally, low PrEP use among HIV-negative partners of viremic individuals including FSWs highlights a significant unmet need for services and an urgency for targeted intervention. The figure, table, or graphic for this abstract has been removed. 1125 Uncovering Risk for Recent HIV Infections in 9 Provinces: Thailand, 2023-2024 Theerawit Tasaneeyapan 1 , Benjawan Roudreo 2 , Suvimon Tanpradech 1 , Thitipong Yingyong 2 , Supiya Jantaramanee 2 , Panupit Thiengtham 2 , Apiratee Kanphukiew 3 , Wolfgang Hladik 4 , Jennifer Favaloro 4 , Michael Martin 4 , Chunfu Yang 4 , Bharat Parekh 4 , Sanny Northbrook 1 1 US Centers for Disease Control and Prevention Nonthaburi, Nonthaburi, Thailand, 2 Ministry of Public Health, Nonthaburi, Thailand, 3 Thailand Ministry of Public Health–US CDC Collaboration, Nonthaburi, Thailand, 4 Centers for Disease Control and Prevention, Atlanta, GA, USA Background: The use of rapid tests for recent infection (RTRI) alongside CD4 as part of recent infection testing algorithm (RITA) has enabled identification of individuals who may have acquired HIV in the past 12 months (recent HIV infection). Measuring the risk for recent HIV infection is critical for effective public health interventions. We calculated the risk of recent HIV infection per 10,000 at-risk individuals and examined the distribution of recent HIV risk within specific populations. Methods: Newly diagnosed persons living with HIV aged ≥15 years who were treatment-naïve or on treatment <30 days were offered recency testing using the Asante HIV-1 Rapid Recency Assay (Sedia Biosciences, Beaverton, OR, USA). Individuals with an Asante-recent result and baseline CD4>200 from case surveillance (CS) data were defined as RITA-CS recent. Routine HIV testing and RITA-CS recent infection data of individuals from 112 clinics in 9 provinces collected from October 2023 to March 2024 was extracted from the national HIV testing registry and the national surveillance of recent HIV infection database. We calculated the proportion of HIV-positives tested with RTRI and adjusted the number of HIV-negatives by the same proportion to calculate the at-risk population per 10,000 individuals (defined as HIV-negative and RITA-CS recent). We examined the variation of risk by age, sex, and population groups and used the Chi-squared test to detect any statistically significant differences (p<0.05). Results: Of 152,673 individuals tested for HIV, 2,050 (1.3%) were diagnosed with HIV. Of these, 1,022 (49.9%) received an RTRI test and 60 (5.9%) were RITA-CS recent. RTRI testing coverage among newly HIV diagnosed was highest among MSM (86.9%), followed by PWID (80.0%) and 15–24year-olds (67.8%). The risk of recent HIV infection (Table) was highest among MSM (36.8 per 10,000), FSW (20.7 per 10,000), and 15-24 year-olds (14.1 per 10,000) and

1123 HIV Incidence Among Adults With Multiple Sex Partners in Kisumu County, Western Kenya John Owuoth 1 , Chiaka Nwoga 2 , Valentine Sing’Oei 1 , Adam Yates 2 , June Otieno 1 , Erica Broach 3 , Qun Li 3 , Zebiba Hassen 3 , Michelle Imbach 3 , Mark Milazzo 3 , Tsedal Mebrahtu 3 , Merlin Robb 2 , Julie Ake 2 , Christina S. Polyak 2 , Trevor Crowell 2 , for the RV393 Study Group 1 Walter Reed Project–Kisumu, Kisumu, Kenya, 2 US Military HIV Research Program, Bethesda, MD, USA, 3 Henry M Jackson Foundation, Bethesda, MD, USA Background: The HIV prevalence in Kisumu County, Western Kenya, is more than four times the national average. We estimated HIV incidence in a prospective cohort of adults with multiple sex partners in Kisumu County to identify HIV risk factors and evaluate the feasibility of future HIV vaccine and therapeutic clinical trials. Methods: We enrolled male and female participants aged 18-35 years who reported sex with at least 2 partners in the preceding 3 months. Visits occurred every 3 months for up to 24 months and included medical history, physical exams, and HIV counseling and testing. Every 6 months, visits included staff-administered questionnaires that collected socio-demographic, general health, and sexual activity information. Demographic and other characteristics ascertained at enrollment were examined for differences between participants who did and did not acquire HIV using Chi-square tests of association. Bivariate Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV acquisition over time. Results: Between January 2017 and August 2021, 619 participants without HIV were enrolled, followed, and analyzed. Of these, 45% were female, 47% aged 25 years and older, 66% single or widowed, and 46% had some secondary education. A total of 11 incident HIV cases occurred over 1117.9 person-years (PY), yielding an incidence rate (IR) of 9.84/1000PY (95%CI: 5.22-17.03). Eight participants acquired HIV during the first year of follow-up (IR: 13.84/1000PY, 95%CI: 6.53-26.11). Unadjusted analyses identified 4+ sexual partners (HR: 4.39, 95%CI: 1.10-17.55), females (HR: 3.44, 95%CI: 0.91-12.98), and forced participation in sexual activity (HR: 9.15, 95%CI:1.17-71.51) as factors associated with HIV seroconversion. Conclusions: We observed unexpectedly low HIV incidence among sexually active adults in Kisumu, which could be a result of effective HIV prevention programs or possibly the impact of COVID-related behavioral changes. Marginally higher HIV incidence among women may suggest gaps in access and uptake of risk reduction strategies. Diminished HIV risk during the later follow up period may suggest a beneficial cohort effect from routine engagement and education. These results may inform future efforts to engage people who are vulnerable to HIV but not actively receiving HIV prevention interventions. 1124 Contact Investigation of Incident HIV in a Population Cohort: Implications for Case Finding and PrEP Robert Ssekubugu 1 , Aleya Khalifa 2 , Griffin J. Bell 3 , Josephine Mpagazi 1 , Laura Beres 3 , Anthony Ndyanabo 1 , Godfrey Kigozi 1 , Hadijja Nakawooya 1 , Gertrude Nakigozi 1 , Ronald Galiwango 1 , Caitlin E. Kennedy 3 , Steven J. Reynolds 4 , Joseph Kagaayi 1 , Larry W. Chang 5 , M. Kate Grabowski 3 1 Rakai Health Sciences Program, Kalisizo, Uganda, 2 Columbia University, New York, NY, USA, 3 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 4 National Institute of Allergy and Infectious Diseases, Baltimore, MD, USA, 5 The Johns Hopkins University School of Medicine, Baltimore, MD, USA Background: Representative data on HIV transmission networks and incident infections are rare but essential for targeting HIV prevention services. We conducted a contact tracing investigation of individuals with incident HIV. Methods: From 2021-24, a matched case-control study was nested within the Rakai Community Cohort Study, a population-based longitudinal HIV

Poster Abstracts

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