CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

2022, respectively. In multivariable models, having public insurance versus all other types of insurance (excluding private), was associated with greater all-cause mortality RR = 1.55 (95% CI: 1.13, 2.13) (P<0.01). Non-Hispanic Black people, compared to White people, had higher non-AIDS-related mortality rates (P<0.05), but not all-cause mortality. Other factors positively associated with overall mortality (P<0.05) were a history of injection drug use, and any of cardiovascular disease, renal disease, hypertension, smoking or cancer. However, the magnitude of association with mortality was greatest for HIV-related clinical factors (Figure) i.e., low CD4 cell count, and included HIV non-suppression. Sex and obesity were not associated with death rates in adjusted analyses. Conclusions: HOPS mortality rates remained low among ART-treated PWH. Non-AIDS causes of death predominated but the greatest risks for death remained HIV-related factors i.e. lower CD4; even low-level viremia remained a significant factor. Interventions to further optimize lifespan among aging PWH will require improvement in prevention and management of comorbidities and tight maintenance of viral control and immune health.

and 245,500 White (26%) PWDH in the U.S. by 2040, with 70%, 73% and 82% of each group, respectively, aged ≥ 50 years. Conclusions: If rates of decline in Dx and PWDH MR remain stable, by 2030 the absolute number of PWDH in the U.S. will increase, with 57% aged ≥ 50 years. Greater decreases in Dx with reduced MR decreases the absolute number of PWDH by 2040, but the fraction aged ≥ 50 years could increase to > 70%. Demand for aging-related resources will be especially needed to care for more and older PWDH in coming years, including Black/African American and Hispanic/Latino PWDH.

1163 WITHDRAWN

Poster Abstracts

1162 Reducing HIV Diagnoses and Mortality Rate Further Increases Aging Resource Needs for PWH Into 2040 Siobhan M. O'Connor, Ruiguang Song, Alex Viguerie, Kate Buchacz, Paul Farnham, Cynthia M. Lyles, Scott Grytdal, Angela B. Hutchinson, John T. Brooks Centers for Disease Control and Prevention, Atlanta, GA, USA Background: Increased survival has changed the age distribution of people with HIV in the United States (U.S.). Over 2010-2022, the fraction of people with diagnosed HIV (PWDH) aged > 50 years increased to 54%. Forecasts of future age distributions are needed to inform resource planning. Methods: We used a life table model with age-specific mortality to predict future age distributions of PWDH in the U.S. by age from 2021-2030 and 2021 2040 under multiple scenarios by varying annual percentage changes (APC) in HIV diagnoses (Dx) and PWDH mortality rates (MR). National HIV Surveillance System data provided the number of PWDH aged ≥ 13 years at year-end 2020, HIV Dx in 2021, and PWDH deaths in 2021; and 2021 U.S. Life Tables provided population-based mortality estimates. We report estimated age distributions of PWDH (overall and by race/ethnicity) from 2021 (n = 1,053,300) to 2030 for two scenarios: A) held APC in Dx at -3% (proximate pre-COVID trend) with stable MR (0% change); and B) set APC in Dx to -22.3% to reach the Ending the HIV Epidemic (EHE) goal of 90% decrease in Dx by 2030 (from 2017 EHE baseline), and reduced MR linearly each year to reach the general population MR in 2030. For 2021-2040, we used the same values for Scenario A. For Scenario B we set APC in Dx at -11.2% to reach the 90% decrease in Dx by 2040, and linearly decreased MR to reach the general population MR by 2040. Results: By 2030, Scenario A estimates there will be 1,116,600 PWDH; 57% (n = 640,100) aged > 50 years and 27% aged > 65 years. Under Scenario B, there will be 1,016,800 PWDH in 2030; 64% aged > 50 years and 31% aged > 65 years. By 2040, Scenario A estimates there will be 1,057,500 PWDH; 64% aged > 50 years and 33% aged > 65 years. Under Scenario B, there will be 929,800 PWDH in 2040; 75% aged > 50 years and 42% aged > 65 years (Fig 1). Scenario B also predicts 354,300 Black/African American (38%), 250,600 Hispanic/Latino (27%),

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