CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

report baseline PrEP choices among PLP enrolled in the study, acceptability of their initial choice within 3 months of enrollment, and theoretical preferences regarding the dapivirine vaginal ring (expected to be approved for use by PLP pending safety review). We used Fisher’s Exact to compare responses by pregnancy status. Results: From February to August 2024, we enrolled 58 PLP (n=30 pregnant, n=28 breastfeeding). Mean age was 22.5 years (SD=4.0). 23 pregnant participants (77%) initiated CAB-LA and 7 (23%) oral PrEP, while among breastfeeding participants, 25 (89%) initiated CAB-LA and 3 (11%) oral PrEP (Table). Reasons for CAB-LA selection included convenience and perceived side effects of oral PrEP (e.g., nausea and vomiting). Of enrolled PLP, 36 (n=14 pregnant, n=22 breastfeeding) completed the acceptability survey. Of these, 83% (n=12/14 pregnant, n=19/22 breastfeeding) chose and received CAB-LA, and the remaining (n=5) chose and received oral PrEP. PLP who received CAB-LA liked its ease of use (65%; n=20/31) and long-acting protection (45%; n=14/31). More breastfeeding CAB-LA users disliked side effects (e.g., injection site pain) than pregnant women (68% vs 17%, p=0.009), although 39% of PLP (n=12/30) described no CAB-LA dislikes. Almost all (97%; n=29/30) PLP currently using CAB-LA were interested in continuing CAB-LA, and all PLP using oral PrEP reported interest in trying CAB-LA in the future. 86% of all surveyed PLP (n=31/36) did not want to try the dapivirine vaginal ring. Conclusions: Our population of PLP had a strong preference for CAB-LA over oral PrEP, and CAB-LA was found to be highly acceptable among PLP. Further study is needed to evaluate the effect of offering choice of PrEP methods, including CAB-LA, on PrEP continuation among pregnant and lactating people.

by doxyPEP use. There was more doxyPEP use among those reporting a bSTI in the past year (aOR=2.6, 95% CI=1.63-4.14) and lower uptake of doxyPEP in the Midwest (aOR=0.81, 95% CI=0.69-0.95) and South (aOR=0.86, 95% CI=0.75 0.98) vs. the Northeast and Pacific regions. No sociodemographic characteristics were associated with doxyPEP awareness. Of 353 respondents eligible for doxyPEP per CDC guidelines, only 20% were currently prescribed doxyPEP and 31% remained unaware of doxyPEP. Of the 413 respondents unaware of doxyPEP, 83% were interested in doxyPEP and 80% of those not on doxyPEP stated they would start if offered at their HIV care clinic. Conclusions: DoxyPEP awareness was associated with VS and HIV care engagement in the U.S. and high interest in doxyPEP highlights the potential importance of comprehensive integrated HIV/sexual health care. Although knowledge of doxyPEP was similar among MSM across the U.S., there were regional disparities in uptake. Continued research on doxyPEP and HIV outcomes is necessary to ensure doxyPEP implementation and rollout among MSM with HIV appropriately targets groups most impacted by the STI epidemic.

Poster Abstracts

1359 Characteristics of People With HIV Prescribed Long-Acting Cabotegravir/ Rilpivirine in a US Cohort Sita Lujintanon 1 , Catherine Lesko 1 , Matt Hickey 2 , Lauren Zalla 1 , Lucas Hill 3 , Edward Cachay 4 , Heidi M. Crane 5 , Kenneth Mayer 6 , Sarah E. Rutstein 7 , Greer Burkholder 8 , George Yendewa 9 , April C. Pettit 10 , Allan Rodriguez 11 , Mallory O. Johnson 2 , Katerina Christopoulos 2 1 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 University of California San Francisco, San Francisco, CA, USA, 3 University of California San Diego Medical Center, La Jolla, CA, USA, 4 University of California San Diego, La Jolla, CA, USA, 5 University of Washington, Seattle, WA, USA, 6 The Fenway Institute, Boston, MA, USA, 7 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 8 University of Alabama at Birmingham, Birmingham, AL, USA, 9 Case Western Reserve University, Cleveland, OH, USA, 10 Vanderbilt University Medical Center, Nashville, TN, USA, 11 University of Miami Miller, Miami, FL, USA Background: Long-acting cabotegravir/rilpivirine (LA-CAB/RPV) has the potential to reduce medication burden for people with HIV (PWH) and improve outcomes in PWH who struggle to achieve or maintain viral suppression, reflected in recent guideline changes regarding use in PWH with adherence challenges. Equity in early implementation of LA-CAB/RPV is a priority. Methods: We used electronic medical record data from 8 clinics of the Center for AIDS Research Network of Integrated Clinical Systems (CNICS), a cohort of ~15,000 PWH active in care across the US, to describe the characteristics of PWH prescribed LA-CAB/RPV from January 2021 to September 2023. We reported results stratified by viral load (VL) at time of prescription (12 months prior to 30 days after prescription data): virally suppressed (VS; VL <50 copies/mL) and virally non-suppressed (VNS). Results: 718 PWH were prescribed LA-CAB/RPV. The first prescription was in April 2021. Six clinics prescribed LA-CAB/RPV in 2021, and by 2022, all 8 clinics were prescribing LA-CAB/RPV. New prescriptions per clinic-month increased from 4 (range of new prescriptions per clinic-month: 0-13) in 2021 to 5 (range: 0-32) in 2022. Two clinics in California contributed the majority of PWH (n=325 & 248); clinics in Alabama, Maryland, Massachusetts, North Carolina, Ohio, and Washington each contributed between 10-49 PWH to the analysis. Overall median (Q1-Q3) age was 44 (35-54) years; 13% were cis women, 2% were transwomen, 28% were non-Hispanic Black, 26% were Hispanic, 56% acquired HIV via male-to-male sexual contact, and 12% acquired HIV via injection drug use (IDU; Table). The majority (71%) were VS while 24% were VNS (8% with VL 50-200 copies/mL and 15% with VL>200 copies/mL), and 6% had missing initial VL. Socio-demographics between VS and VNS PWH were similar, except that PWH who acquired HIV via IDU made up 21% of those prescribed LA-CAB/RPV with VNS compared to 9% of those with VS.

1358 Regional Disparities in DoxyPEP Uptake Despite High Awareness Among MSM With HIV in the US Tyler Martinson 1 , Megan J. Heise 1 , Kevin Sassaman 1 , Hannah R. Schmidt 1 , Alexa D'Angelo 2 , Shivani Mahuvakar 1 , Dustin Duncan 3 , Keith J. Horvath 4 , Sabina Hirschfield 5 , Renessa Williams 6 , Mallory O. Johnson 1 , Christian Grov 2 , Adam Carrico 7 , Monica Gandhi 1 , Matthew A. Spinelli 1 1 University of California San Francisco, San Francisco, CA, USA, 2 CUNY School of Public Health, New York, NY, USA, 3 Columbia University Irving Medical Center, New York, NY, USA, 4 SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA, 5 State University of New York Downstate Medical Center Downstate Medical Center, Brooklyn, NY, USA, 6 University of Miami Miller, Miami, FL, USA, 7 Florida International University, Miami, FL, USA Background: The CDC recently issued guidelines recommending doxycycline post-exposure prophylaxis (doxyPEP) for men who have sex with men (MSM) who have had a bacterial sexually transmitted infection (bSTI) in the past year. However, this strategy remains underutilized among some groups. The primary objective of this study was to explore doxyPEP use, prescription within participants’ primary HIV clinics, and the association of doxyPEP use with HIV care continuum outcomes among MSM with HIV in the U.S. Methods: From 11/2023-8/2024, we recruited 936 cisgender MSM with HIV from 46 U.S. states, Washington D.C., and Puerto Rico via Grindr (Fig. 1). Viral suppression (VS) was confirmed via HIV viral load testing and ART adherence was objectively assessed by point-of-care urine tenofovir rapid assay (UTRA). Associations between ART adherence, HIV VS, and engagement in HIV care and the independent variable of doxyPEP awareness and use were explored by logistic regression adjusted for age and race/ethnicity. Results: Overall, 56% of participants were aware of doxyPEP and 12% were prescribed it. Awareness of doxyPEP was associated with increased HIV care engagement (OR=1.7, 95% CI=1.2-2.7) and VS (OR=2.27, 95% CI=1.30-3.70). There were no significant differences in ART adherence rates by UTRA, VS, or attending an appointment with their HIV care provider in the last six months

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