CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

brown (HR=1.1; 95%CI1.0-1.1); indigenous (HR=1.7; 95%CI1.1-2.7); TCD4+ in the diagnosis among 350-499 cells/mm³ (HR=1.2; 95%CI1.1-1.4); among 200-349 cells/mm³ (HR=1.5; 95%CI1.3-1.6); <200 cells/mm³ (HR=2.3; 95%CI2.1-2.5); and viral load >500 copies (HR=1.8; 95%CI1.7-2.0). Conclusion: Survival was massively increased, from 33% to 89% in 144 months, due to the introduction of more potent therapeutic regimens adopted in the country. HAART, sex, schooling, ethnicity, exposure category, age, TCD4+, and viral load at the time of diagnosis were associated with survival time as an independent prognostic factor.

Poster Abstracts

910 HIGH HIV PREVALENCE AND LOW ART COVERAGE AMONG AGYWWHO SELL SEX: A POOLED ANALYSIS Katherine Rucinski 1 , Sheree Schwartz 1 , Seni Koanda 2 , Iliassou Mfochive 1 , Ubald Tamoufe 3 , Serge Billong 4 , Douada Diouf 5 , Fatou Drame 5 , Vincent Pitche 6 , Simplice Anato 7 , Sindy Matse 8 , John Nkonyana 9 , Nancy Phaswana-Mafuya 10 , Harry Hausler 11 , Stefan Baral 1 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso, 3 Metabiota, Yaoundé, Cameroon, 4 University of Yaoundé, Yaoundé, Cameroon, 5 Enda Santé, Dakar, Senegal, 6 Conseil National de Lutte contre le SIDA, Lomé, Togo, 7 ONG Arc- en-Ciel, Lomé, Togo, 8 Ministry of Health, Mbabane, Swaziland, 9 Ministry of Health, Maseru, Lesotho, 10 Human Sciences Research Council, Pretoria, South Africa, 11 TB HIV Care, Cape Town, South Africa Background: Adolescent girls and young women (AGYW) and female sex workers (FSW) are both at particularly high risk of acquiring HIV in sub-Saharan Africa. The extent to which AGYWwho sell sex engage in HIV care and treatment is not fully understood. We assess age-specific HIV prevalence and antiretroviral therapy (ART) coverage among FSW in West and Southern Africa. Methods: This pooled analysis includes respondent driven sampling (RDS) data from 2011-2016 in sub-Saharan Africa (West Africa: Burkina Faso (n=699), Cameroon (n=2255), Cote d’ivoire (n=466), The Gambia (n=251), Senegal (n=758), and Togo (n=684); Southern Africa: Lesotho (n=744), South Africa (n=410), and eSwatini (n=325)). Women were eligible to participate if they had engaged in sex work as their primary source of income in the past year. Interviewer-administered questionnaires used comparable data collection instruments across sites to assess demographics and prior history of HIV testing and ART use. All women received HIV testing and counseling. Generalized linear mixed effect models were used to calculate age-specific HIV prevalence estimates for West and Southern Africa. Differences in self-reported HIV testing and ART coverage were descriptively compared by age for both regions. Results: A total of 6592 FSWwere included in this analysis (median age: 27 years, IQR 22-33). Pooled HIV prevalence estimates increased with age and varied by region (Figure). In West Africa, estimated prevalence steadily increased from 4% (95% CI 2, 7) to 27% (95% CI 17, 45). Prevalence estimates for Southern Africa were greater by comparison, ranging from 43% (95% CI 35, 53) in very young FSW (≤19 yrs) to 87% (95% CI 80, 94) by ages 30-34. Among 1957 FSW living with HIV overall, 1140 (57%) had received a prior HIV diagnosis; 681 (35%) were on ART. Compared to older FSW living with HIV, young HIV-infected

909 SURVIVAL OF PEOPLE LIVING WITH AIDS IN BRAZIL: BIAIDS-BRAZIL COHORT Mariza V. Tancredi 1 , Carmen S. Domingues 1 , Ione A. Guibu 2 , Eliseu A. Waldman 2 , Fabio A. Pires 2 , Marco A. Gutierrez 2 , Adele Benzaken 3 , Gerson F. Pereira 3 1 Centro de Referência e Treinamento DST/AIDS-SP, São Paulo, Brazil, 2 Universidad de São Paulo, São Paulo, Brazil, 3 Ministry of Health, Brasilia (DF), Brazil Background: Brazil was the first middle-income country to offer universal access to AIDS treatment. Monitoring the impact of this policy is relevant for continuous updating of intervention strategies. This study aimed to estimate the survival of people living with AIDS (PLWA) with > 13 years of age and to investigate predictors of death with a basic AIDS cause, in Brazil, among 2003- 2007, followed up until 2014. Methods: Retrospective cohort. Data from the Brazilian Integrated Base of AIDS Cohort (BIAIDS-BRASIL Cohort) was obtained from a probabilistic record linkage methodology applied to databases of the Ministry of Health: Information System of Notification Diseases, Control of Laboratory Tests, Logistic Control System of Medicines and Mortality Information System. Kaplan-Meier method, Cox model and estimates of the hazard ratios (HR), with 95% confidence intervals (CI = 95%) were used for survival analysis. The main variable was the antiretroviral therapy (ART). To identify factors associated with the outcomes of interest, sociodemographic characteristics, clinical, therapeutic and laboratory evolution were analyzed. Results: During the 2003-2007 period, 104,806 PLWA were reported, with 27,147 deaths. The probability of surviving 144 months was 33% for those who did not use ART, 75% for those with Pre-HAART, 84%with HAART1 and 89% with HAART2. They were associated with AIDS death independent of other exposures: use of HAART1 (HR=2.1; 95%CI1.7-2.4); use of Pre-HAART (HR=4.8; 95%CI2.5-11.7); without ART (HR=5.3; 95%CI4.0-5.6); feminine gender (HR=0.8; 95%CI0.7-0.8), <8 years of study (HR=1.5; 95%CI1.4-1.6); without study (HR=1.8; 95%CI1.6-2.0); age of 30-49 years (HR=0.9; 95%CI0.9-1.0); > 50 years (HR=1.2; 95%CI1.1-1.3); heterosexual (HR=1.2; 95%CI1.1-1.3); injecting drug users (HR=2.1; 95%CI1.9-2.3); black (HR=1.3; 95%CI1.2-1.4);

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