CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

Methods: The Study of Treatment and Reproductive outcomes (STAR) is a cohort of women ages 18-45 living with and without HIV in Miami FL, Atlanta GA, Birmingham AL/Jackson MS, Chapel Hill NC and Washington DC. Structured interviews are conducted in person at baseline, six, 12, and 18 months, and by phone semiannually thereafter with additional visits for pregnancy and postpartum. Major aims include assessments of mental and oral health on HIV and overall health outcomes, particularly during pregnancy and postpartum. Results: Among 891 women enrolled between March 1, 2021 and April 30, 2024, 526 were WWH (of whom 65 (12%) were pregnant) and 365 were women without HIV (WWoH; 32 (9%) were pregnant). Median age was lowest among pregnant WWH (30 years) and highest among non-pregnant WWH (38 years). Most STAR participants are Black/African American (76%), non-Latina (89%), attended or completed college (56%), never married (54%), have monthly household income <=$1,000 (30%), and had >=3 sex partners in the past year (59%). The majority (98%) of WWH were using ART at baseline. Only 5% of WWoH had used PrEP in the past year. The majority of pregnant women reported alcohol use in the past year (66%), though fewer compared to non-pregnant women (77%). Non-pregnant WWH had highest prevalence of depressive symptoms as assessed via CES-D; (39%) scored >=16 and 28% scored >=21. Almost half (48%) of the cohort had not seen a dentist in the past year and over half (52%) rated the condition of their mouth and teeth as fair or poor. Conclusions: Barriers to healthcare access, such as mental health challenges and substance use, continue to contribute to higher HIV prevalence among women in the southern US. STAR provides critical insights into the intersection of HIV, reproductive health, and social determinants of health among women of reproductive age in the Southern U.S. 1259 Substance Use and Treatment Among Reproductive-Age Women With/ Without HIV in the Southern US Qian Yang 1 , Ayako W. Fujita 1 , Cyra C. Mehta 1 , Tina T. Tisdale 1 , Maria L. Alcaide 2 , Aadia Rana 3 , Deborah Konkle-Parker 4 , Daniel Westreich 5 , Seble Kassaye 6 , Elizabeth F. Topper 7 , Anandi N. Sheth 1 , for the Study of Treatment And Reproductive Outcomes (STAR) Team 1 Emory University, Atlanta, GA, USA, 2 University of Miami Miller, Miami, FL, USA, 3 University of Alabama at Birmingham, Birmingham, AL, USA, 4 University of Mississippi Medical Center, Jackson, MS, USA, 5 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 6 Georgetown University, Washington, DC, USA, 7 The Johns Hopkins University, Baltimore, MD, USA Background: Women with HIV (WWH) who engage in substance use (SU) have poor HIV-related outcomes. Additionally, mortality associated with overdose has recently increased among pregnant and postpartum persons. We characterized SU and treatment among cisgender, reproductive age WWH and women without HIV (WWoH) enrolled in the Study of Treatment And Reproductive Outcomes (STAR). Methods: Baseline data from participants enrolled in STAR 2021-2023 were analyzed to determine current SU (illicit drug use in past year) and accidental overdose in the past year. Tobacco, hazardous alcohol use (Alcohol Use Disorders Identification Test score ≥8), and marijuana use were assessed separately. SU treatment utilization was self-reported use of any drug treatment program in the past year among those with current SU. We assessed the proportion of SU and treatment stratified by pregnancy status, and compared treatment by HIV status using Fisher’s exact test. Postpartum was defined as having had a pregnancy outcome in the past year. Results: Among 759 women (473 WWH, 286 WWoH), median age was 36 years, 75% identified as non-Hispanic Black, 11% were currently pregnant, 6% postpartum, and 62% ≥1 year postpartum. Overall, 84 (11%) reported current SU (9% WWH, 15% WWoH). Current SU was 14% among women who had never been pregnant, 9% among pregnant women, 4% among postpartum women, and 11% among women ≥1 year postpartum. Among women who reported SU, 62% reported crack/cocaine use, 30% benzodiazepines/barbiturates, 13% methamphetamines, 7% opioids, and 8% reported injecting drugs; 70% smoked cigarettes, 41% had hazardous alcohol use, and 61% used marijuana in the past year. Among 667 women without current SU, 25% smoked cigarettes, 10% had hazardous alcohol use, and 43% had used marijuana in the past year. Of the 61 reporting current SU who answered overdose questions, 8 (13%) reported accidental overdose in the past year. Among women with current SU, 18 (21%) utilized treatment (26% WWH, 17% WWoH; p=0.34), including 2/21 who were nulliparous, 2/9 who were pregnant/postpartum, and 14/53 who were ≥1 year postpartum (p=0.28).

Conclusions: In this cohort of reproductive age women in the Southern US, SU was common overall but fluctuated across reproductive life stages. One in five utilized SU treatment, irrespective of HIV status, lower than previously reported from demographically similar women >50 years. SU treatment strategies and overdose prevention targeted towards women in their reproductive years are needed. 1260 Physical, Psychosocial, and Sexual Health in Adults Aged 50+ With and Without HIV in Denmark Ditte Scofield 1 , Morten Frisch 2 , Mikael Andersson 2 , Merete Storgaard 3 , Gitte Pedersen 4 , Isik S. Johansen 5 , Terese L. Katzenstein 6 , Christian Graugaard 4 , Lars H. H. Omland 6 , Nina Weis 1 , Ellen Frøsig Moseholm 1 1 Hvidovre Hospital, Hvidovre, Denmark, 2 Statens Serum Institut, Copenhagen, Denmark, 3 Aarhus University Hospital, Aarhus, Denmark, 4 Aalborg University Hospital, Aalborg, Denmark, 5 Odense University Hospital, Odensen, Denmark, 6 Rigshospitalet, Copenhagen, Denmark Background: With age, people with HIV (PWH) may face higher rates of physical comorbidities, psychosocial challenges and sexual health problems, all of which can impact quality of life and ART adherence. However, research on health among ageing PWH remains limited. This study aimed to examine self reported physical, psychosocial and sexual health outcomes among people aged ≥50 years with and without HIV in Denmark. Methods: We used data from a nationwide cross-sectional study examining different aspects of health among PWH in Denmark. Participants included cisgendered PWH aged ≥50 years recruited across Denmark, and a comparison group of people without HIV from a nationally representative cohort study. Data were collected from 2021 to 2022 via an electronic survey including several validated patient-reported outcome measures. Sex-stratified logistic regression models examined associations between HIV and physical, psychosocial and sexual health outcomes, adjusted for sociodemographic and other confounding factors. Results: A total of 322 men and 67 women with HIV were included and compared to 15,548 men and 13,926 women without HIV. Key sociodemographic differences included fewer PWH in relationships and more PWH with non Danish parentage. Physical health analyses showed that HIV was associated with increased odds of liver diseases (men: aOR 2.43 [95% CI: 1.08-5.46]; women: aOR 5.23 [95% CI: 1.51-18.09]), cardiovascular disease in men (aOR 1.52 [95% CI: 1.06-2.17]), and hypertension (aOR 2.14 [95% CI: 1.02-4.49]) and osteoporosis (aOR 5.56 [95% CI: 1.63-19.04]) in women. Among men, HIV was significantly associated with depressive symptoms (aOR 1.63 [95% CI: 1.07-2.49]) and anxiety (aOR 1.42 [95% CI: 1.00-2.04]). For women with HIV, suicidal tendencies (aOR 1.92 [95% CI: 1.03-3.59]), loneliness (aOR 2.02 [95% CI: 1.15-3.55]) and domestic abuse experiences (aOR 2.38 [95% CI: 1.28-4.42]) were more common. Sexual health analysis showed that men with HIV were more likely to report orgasmic dysfunction (aOR 2.71 [95% CI: 1.51-4.87]) and erectile dysfunction (aOR 2.09 [95% CI: 1.28-3.40]), while lubrication dysfunction (aOR 3.56 [95% CI: 1.25-10.17]) and genital pain dysfunction (aOR 3.98 [95% CI: 1.39 11.37]) were more common among women with HIV. Conclusions: PWH aged ≥50 years in Denmark face significantly more physical, psychosocial and sexual health challenges compared to peers without HIV. Clinical attention to these disparities is crucial for improving the overall health of ageing PWH. 1261 Probability of Anal Human Papillomavirus Infection Following Acute HIV Acquisition in Thailand Supanat Thitipatarakorn, Sujittra Suriwong, Siriporn Nonenoy, Aphakan Klinsukontakul, Sumitr Tongmuang, Piranun Hongchookiat, Napasawan Chinlaertworasiri, Pravit Mingkwanrungruang, Reshmie Ramautarsing, Nipat Teeratakulpisarn, Nittaya Phanuphak Institute of HIV Research and Innovation, Bangkok, Thailand Background: Anal cancer is largely contributed by anal high-risk human papillomavirus (HRHPV) infection, especially human papillomavirus (HPV) 16. This study described HPV progression among individuals with acute HIV acquisition. Methods: From May 2017 to June 2020, participants who initiated antiretroviral therapy during acute HIV acquisition (Fiebig stages 1–5) and consented to anal HPV genotyping and high-resolution anoscopy were enrolled at a sexual health clinic in Bangkok, Thailand. At the time of acute HIV diagnosis, demographic data, sexual history, and baseline laboratory tests were collected. Anal HPV genotyping tests were performed at baseline and every 6 months.

Poster Abstracts

CROI 2025 416