CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusions: Nearly two years after Cabotegravir received regulatory approval in South Africa, FSW remain largely unable to access LAI-PrEP, despite established efficacy and community interest. As LAI-PrEP products become increasingly available, strategies supporting counseling, education, and diversity in PrEP delivery sites for FSW can optimize implementation and equitable LAI-PrEP uptake and continuation.

1354 Expanding the PrEP Market: Early Insights Offering Oral, Ring, and CAB PrEP in Sub-Saharan Africa Nicolette Naidoo 1 , Mark Conlon 2 , Mu-Tien Lee 2 , Carolyn Akello 2 , Margaret Eichleay 2 , Elizabeth Irungu 3 , Emily Gwavava 4 , Kevin Kórimba 5 , Patriciah Jeckonia 5 , Imelda Mahaka 4 , Rose Wilcher 2 , Saiqa Mullick 1 , Virginia Fonner 2 , Ashley Mayo 2 , Kristine Torjensen 2 , for the CATALYST Study 1 Wits Reproductive Health and HIV Institute, Johannesburg, South Africa, 2 FHI 360, Durham, NC, USA, 3 Jhpiego - Nairobi, Nairobi, Kenya, 4 Pangaea Zimbabwe AIDS Trust, Harare, Zimbabwe, 5 LVCT Health, Nairobi, Kenya Background: Adapting PrEP service delivery to a multi-method market requires real world data on uptake and use patterns. We evaluated method uptake and associated factors, switching and continuation among women offered oral PrEP, the dapivirine ring (PrEP ring), or injectable cabotegravir (CAB PrEP) in the CATALYST study. Methods: The CATALYST implementation study offered women a choice of three PrEP methods in sites across Lesotho, South Africa, Uganda, and Zimbabwe. We describe PrEP uptake among participants offered choice of all 3 methods enrolled between April and September 2024. Logistic regression assessed factors associated with CAB PrEP uptake. Month-1 PrEP continuation was defined as refill/re-injection within 60 days of starting/restarting a method. Results: Of 1574 participants enrolled, 1,326 were eligible for all three methods. Twenty-two percent were 18-24 years; 33% were sex workers. Among participants offered only oral PrEP or PrEP ring prior to April 2024 (n=808), 62% switched to CAB PrEP; among new enrollees (n=518), 86% chose CAB PrEP. Overall, the majority chose CAB PrEP (71%), followed by oral PrEP (20%), PrEP ring (7%), and 2% choosing no method (Figure 1). Those reporting prior PrEP ring or oral PrEP use had lower odds of choosing CAB PrEP than PrEP naive participants [aOR=0.51, 95% CI: 0.32-0.80, p=0.003; aOR=0.45, 95% CI: 0.31-0.67, p<0.001]. Being a sex worker or ≤24 years were not significantly associated with CAB PrEP uptake. Month-1 continuation was 83% for CAB PrEP (n=467), 42% for oral PrEP (n=24), and 31% for PrEP ring (n=13) among enrolees. Conclusions: There is high demand for CAB PrEP, both among existing and new PrEP clients. There are also dedicated PrEP ring and oral PrEP users, even in the context of CAB PrEP. CAB PrEP is popular among both AGYW and sex workers, suggesting broad appeal among priority populations. Initial rates for refill/ reinjection are promising but longer-term follow-up is needed.

1353 HIV PrEP Method Preferences Among Transgender and Gender-Diverse Adults in the United States Dovie L. Watson, Louis Listerud, Ryan A. Drab, Willey Y. Lin, Florence Momplaisir, Jose Bauermeister University of Pennsylvania, Philadelphia, PA, USA Background: The anticipated approval of lenacapavir for HIV pre-exposure prophylaxis (PrEP) may present an opportunity to better address inequitable PrEP implementation among priority populations in the United States (US). We examined potential preferences for long-acting PrEP methods among transgender and gender-diverse (TGD) adults in the US. Methods: From April to June 2022, we conducted an online survey with 304 HIV-negative TGD adults in the US. After presenting a brief description of five PrEP methods, participants were asked to rank their most preferred PrEP methods. Logistic regression was used to examine participant characteristics associated with preferring injectable PrEP every 6 months over the other four methods. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals. Results: Overall, 295 (97%) participants ranked method preferences: median age was 24 years [interquartile range 21—29]; 221 (75%) were assigned female sex at birth; 69 (24%) were assigned male sex at birth; 159 (54%) transmasculine, 96 (33%) nonbinary, 40 (14%) transfeminine; 169 (57%) non Latine White, 44 (15%) Latine, 33 (11%) non-Latine Black, 49 (17%) non-Latine another race; and 63 (21%) reported current or prior PrEP use. Participants’ preferred PrEP methods were monthly oral pill (33%), annual implant (28%), injection every six months (22%), daily oral pill (13%), and injection every two months (4%). The primary outcome, ranking injectable PrEP every 6 months as the most preferred PrEP method, was significantly associated with non-Latine Black race/ethnicity (adjusted odds ratio, aOR: 2.77 [95% CI 1.10, 6.98]) and Latine ethnicity (aOR: 2.39 [95% CI 1.10, 5.18]; both p-values < 0.05. Age, sex assigned at birth, current gender identity, PrEP status, condomless sex, known HIV-positive sexual partner, and sexual partner with unknown HIV status in the past six months were not significantly associated with the primary outcome. Conclusions: PrEP injection every two months was rarely selected as the most preferred method; and non-Latine Black and Latine individuals had higher odds of reporting that an injectable PrEP method administered every six months was their most preferred PrEP method. Future research should prioritize the development of implementation strategies that bolster comprehensive low barrier PrEP services for non-Latine Black and Latine TGD adults, particularly TGD individuals for whom daily oral PrEP and injectable cabotegravir every two months are not desirable.

Poster Abstracts

CROI 2025 452