CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1140 Age-Stratified Sexual Partner Profiles to Characterize HIV Risk Across Lifespan: Botswana and Zambia Kristen A. Stafford 1 , Divya Hosangadi 1 , Hope Sabao 2 , Kesalefa Elliam 3 , Billy Tsima 3 , Wilbroad Mutale 2 , Lloyd Mulenga 4 , Bonaparte Nkomo 5 , Chola Nakazwe 6 , Susan Matroos 7 , Ndwapi Ndwapi 8 , Lillian Okui 8 , Magen Mutepfa 3 , Stella Keipeile 9 , Meagan Fitzpatrick 1 , for the EPI-PLAN-HIV Study Group 1 University of Maryland, Baltimore, MD, USA, 2 University of Zambia, Lusaka, Zambia, 3 University of Botswana, Gaborone, Botswana, 4 Government of Zambia Ministry of Health, Lusaka, Zambia, 5 Botswana Ministry of Health, Gaborone, Botswana, 6 Zambia Statistics Agency, Lusaka, Zambia, 7 Central Statistical Office, Gaborone, Botswana, 8 Botswana University of Maryland School of Medicine Health Initiative (Bummhi), Gaborone, Botswana, 9 National AIDS and Health Promotion Agency, Gaborone, Botswana Background: Accurately predicting the age and sex distribution of HIV over time is critical for precision interventions and resource planning. Progress towards epidemic control and changes in sexual partnership patterns over time impact this distribution. Characterizing age-specific sexual partner matrices may improve prediction accuracy and better inform programming for epidemic control. Methods: We used data from PHIA surveys in Zambia and Botswana to create partner matrices. For respondents with viral nonsuppression (NVLS=copies >1000/mL) we extracted the mean number of partners in the last 12 months, stratified by age, sex, and partner HIV status. Partner matrices in Zambia from 2021 against those from 2016 (prior NVLS data unavailable for Botswana) were compared. Intergenerational partnerships (IP), defined as sexual partner +/-10 years of age, by HIV status, age, and sex, and condomless sex (CS) among PWH with NVLS were estimated. Estimates and 95% confidence intervals (95% CI) are weighted. Results: In Zambia mean number of serodifferent female partners increased among NVLS males in younger age groups and decreased in older males where seroconcordant female partners increased (Figure 1). Mean serodifferent same sex partners decreased among males aged 40-44 and seroconcordant increased among NVLS males 45-49. In Zambia, prevalence of IP increased 23% among males and 28% among females. Prevalence of CS with last partner among NVLS males decreased in Zambia from 48% (43-54) to 14% (11-18) and from 44% (40-47) to 15% (6-25) among NVLS females. CS among males and females with NVLS who were aware of their HIV status was similar over time, 70% (57-81) in 2016 vs 79% (62-96) in 2021 and 73% (66-80) in 2016 vs 67% (19-100) in 2021. In Botswana in 2021, prevalence of IP was 17% among males and 20% among females, similar age pattern as Zambia. Prevalence of CS within NVLS males and females was 10%. Among males and females aware of their status with NVLS CS was 9% (0-19) and 30% (12-49). Prevalence of IP among PWH was higher than among HIV-negative people in both countries regardless of sex. Conclusions: Sexual partner profiles change within and across age/sex specific groups over time which can influence patterns of HIV acquisition risk. Differences in progress towards epidemic control in Zambia and Botswana appear to be reflected in the prevalence of IP and CS among people with a viral load high enough to transmit to their partners. Reaching status aware NVLS PWH is important for epidemic control.

Poster Abstracts

1139 Geospatial Heterogeneity in Potential HIV Transmission Locations Among MSM in Bhopal, India Griffin J. Bell 1 , Steven J. Clipman 2 , Allison M. McFall 1 , Talia A. Loeb 1 , Jiban J. Baishya 2 , Ashwini Kedar 3 , Archit Sinha 3 , A. K. Srikrishnan 3 , Boobalan Jayaseelan 3 , Gregory M. Lucas 2 , Sunil S. Solomon 2 , Shruti H. Mehta 1 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 3 YR Gaitonde Center for AIDS Research and Education, Chennai, India Background: HIV incidence remains disproportionately high among men who have sex with men (MSM) globally and is increasing among MSM in India. To evaluate the feasibility of spatially tailored interventions to interrupt HIV transmission among Indian MSM, we explored the geospatial distribution of locations where MSM meet male sexual partners in Bhopal, India. Methods: We enrolled 752 MSM (aged 18+ with ≥1 male sex partner in the last year) through respondent-driven sampling (RDS) in Bhopal between December 2023-April 2024 and conducted HIV rapid antibody and viral load testing. Participants completed a behavioral survey and identified their residence and up to four additional locations where they met sexual partners most often in the past year. We categorized meeting spaces and used kernel density estimation to identify areas where MSM with HIV viremia disproportionately met sexual partners. All analyses were weighted to account for RDS. Results: Most enrolled MSM completed secondary school (99.5%) and were employed (98.0%). On average, MSM named 3.6 meeting locations, corresponding to 190 neighborhoods, 62 transportation-related locations, 30 commercial locations, 28 parks, and 18 other locations. The overall prevalence of HIV and HIV viremia was 11.6% and 4.4%, respectively. MSM meeting at transportation-related locations had the highest prevalence of HIV (14.9%) and HIV viremia (6.5%). MSM meeting at commercial locations had the lowest prevalence of HIV (6.8%) and HIV viremia (3.3%). We identified a 3.88 km 2 area, west of the main railway station and south of the original 1984 Bhopal Gas Tragedy site, where 45.8% of all MSM with detectable viremia met partners. MSM who met within 1 km of the 1984 site had 14.1% (95% CI: 4.3%, 27.1%) higher HIV prevalence on the absolute scale, 4.3% (-0.6%,14.7%) higher HIV viremia prevalence, more sexual partners (median [IQR]: 15 [5, 28] vs 7 [3, 22]), and 5.3% (-4.8%, 9.2%) higher inconsistent condom use with casual partners, compared to MSM who did not meet within 2 km of the 1984 site. Conclusions: MSM with HIV and HIV viremia disproportionately met in transportation-related locations and specific geographic areas, suggesting that spatially tailored interventions would be efficient in preventing HIV transmission among MSM in this urban Indian setting. Structural disparities, including poverty and stigma, may drive where MSM with HIV choose to meet partners for sex and may be associated with limited access to treatment and prevention services.

CROI 2025 371