CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

significant improvements were observed along the HIV care continuum among FSW participating in the intervention and control arms. A positive trend (RR 1.05), but non-significant difference across arms, was found in viral suppression among FSW in the intervention (40% to 50.6%) vs. control (35.9% to 47.4%) community. Conclusion: Project Shikamana, a community-driven combination HIV prevention intervention developed by FSW in Iringa, Tanzania, was effective in significantly reducing HIV incidence. It is one of the first rigorously evaluated implementation models proven effective in reducing the heightened HIV risk among FSW in Africa.

of care and an effective tool in HIV prevention. There is no evidence to suggest that MAT was preferentially prescribed to any group based on sociodemographic traits or results of 9-item risk assessment.

954 LINKAGE TO CARE IN THE PARTNER SERVICES PRE-EXPOSURE PROPHYLAXIS (PS-PrEP) STUDY

Poster Abstracts

Daniel S. Teixeira da Silva 1 , Alida Bouris 1 , Olivia Blocker 1 , Billy Davis 1 , James Harris 1 , Ramona Bhatia 2 , John A. Schneider 1 1 University of Chicago, Chicago, IL, USA, 2 University of Illinois at Chicago, Chicago, IL, USA Background: Partner services is a public health intervention that contacts people who were exposed to sexually transmitted infection, including HIV. Black men who have sex with men (BMSM) have low uptake of pre-exposure prophylaxis. The Partner Services Pre-Exposure Prophylaxis (PS-PrEP) study tested the feasibility of integrating a tailored, in-person and mobile intervention into partner services to increase linkage to PrEP care for BMSM. Methods: This single-blinded randomized control trial recruited HIV seronegative, PrEP-naïve BMSM aged 18-40 years old from partner services, network-based testing or health department STI testing sites. Inclusion criteria were being PrEP eligible, owning a cell phone, and living in metropolitan Chicago. The intervention consisted of an in-person session that used best linkage to care practices in tandemwith cognitive-behavioral therapy and motivational interviewing techniques to develop a tailored Linkage Roadmap. This session was followed by 4 booster sessions for 12 weeks, with an optional in-person session for men reporting major barriers to PrEP care. The control group received a low threshold intervention through a phone-based PrEP linkage service that provided PrEP information and offered to schedule an initial PrEP visit. Men completed surveys and linkage to care was defined as having a PrEP care clinic visit within 3 months of enrollment. The difference between groups was determined by chi-squared test, p-value of 0.10, and effect size was determined using Cohen’s h. Results: The study population (n=143) had a mean age of 26 years (SD=4.5), most identified as gay (62%), were employed full- or part-time (65%) and had a high school education or more (91%). Overall, 85% of the intervention group (n =75) completed the booster sessions and none had an optional in-person session. Analyses comparing intervention to control showed that a greater proportion of the intervention group were linked to PrEP care compared to the control group (n = 68) (23% vs 12%; p = 0.08; cohen’s h = 0.36). Conclusion: This study demonstrated the feasibility of integrating a tailored PrEP linkage intervention into partner and network testing services. PS-PrEP increased linkage to PrEP care, and borderline statistical significance is likely due to a small study sample. Future studies that scale-up the PS-PrEP intervention with adequate power may be more likely to evaluate PS-PrEP’s efficacy, and further improve linkage to PrEP care among BMSM at increased risk for HIV infection.

953 INTERDISCIPLINARY INTERVENTION FOR HOSPITALIZED PWID MAY INCREASE MAT USE Ellen F. Eaton , AndrewWestfall, Eddie A. Mathews, Cayce Paddock, Peter Lane, Michael Saag, Michael J. Mugavero, Karen Cropsey, Rachael A. Lee University of Alabama at Birmingham, Birmingham, AL, USA Background: Medication assisted therapy (MAT) can prevent HIV in persons who inject drugs (PWID). For PWID, acute bacterial infections are one of the few conditions for which they seek medical care. The UAB Hospital Intravenous Antibiotics and Addiction Team (IVAT) uses a 9-item risk assessment to classify one’s risk for continued IV drug use (i.e., low, moderate, or high) and inform discharge planning. We hypothesized that IVAT may improve MAT prescriptions on discharge, especially for “high” risk patients. Methods: We compared outcomes of hospitalized PWID in the period before and after the IVAT. In the pre-IVAT period (January 2015-February 2016), we analyzed admissions in which IV antibiotics were received for ≥ 14 days by patients with a history of IVDU. In the post-IVAT period (October 2016-February 2018), all patients referred for IVAT consultation were included. MAT use on discharge included methadone, buprenorphine and naltrexone prescriptions. Specific substances used were defined by self-report and/or urine drug screen. Because the intervention included a risk assessment, we used logistic regression to determine if “high” risk participants were more likely to receive MAT on discharge in the post-IVAT era. Results: A total of 37 and 98 patients met criteria in the pre and post-IVAT periods, respectively. 84% of pre-IVAT were opioid users compared to 80% post- IVAT. Most common bacterial infections in the pre and post-IVAT periods were endocarditis (57 and 34%, respectively) and vertebral osteomyelitis/ abscess (13 and 17%). In the pre- and post-IVAT periods, Hepatitis C was present in 68 and 80%, respectively, and HIV was present in 3 and 5%, respectively. Percentages with an ID consult (97% vs 94%) and Addiction Medicine (78% vs 84%) consult remained unchanged. Although MAT prescriptions increased, the percentage receiving MAT did not (32% pre and post IVAT). There was an increase for those deemed “high risk” for continued IVDU (55%). In univariate logistic regression models of those receiving IVAT, neither risk category, age, race, gender, length of stay, or insurance status was associated with MAT prescription. Conclusion: An interdisciplinary hospital-based intervention may increase the number of MAT prescriptions for PWID, a critical step in the opioid cascade

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