CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

978 WOMEN’S PrEP KNOWLEDGE, ATTITUDES, PREFERENCES AND EXPERIENCE IN CHICAGO Lisa Hirschhorn 1 , Rayna Brown 1 , Eleanor E. Friedman 2 , Cathy Christeller 3 , George J. Greene 1 , Alvie Bender 2 , Alida Bouris 2 , Laxmi Modali 4 , Amy K. Johnson 5 , Jim Pickett 6 , Jessica Ridgway 2 1 Northwestern University, Chicago, IL, USA, 2 University of Chicago, Chicago, IL, USA, 3 Chicago Women’s AIDS Project, Chicago, IL, USA, 4 Unaffiliated, Chicago, IL, USA, 5 Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA, 6 AIDS Foundation of Chicago, Chicago, IL, USA Background: Black women in Chicago are disproportionately affected by HIV, but few are on PrEP. We report the results of a mixed methods study of knowledge, attitudes, experience, and preferences for PrEP among cis-gender women in Chicago. Methods: We administered a survey to 370 HIV(-) women visiting either a public Sexually Transmitted Infection clinic or an Emergency department and conducted focus groups with 16 PrEP-naive women and in-depth interviews with 7 PrEP-using women. Survey data were analyzed using descriptive statistics and multivariate logistic regression as well as thematic analysis for qualitative data. Results: Majority of women identified as black (83%) and had a regular source of healthcare (71%). In the last 6 months, 83% had vaginal or anal sex and 93% inconsistent condom. Women had low rates of perceived HIV risk (90% low/no). Only 30% (112) had heard of PrEP before the survey. The only factor associated hearing about PrEP was knowing someone on PrEP (OR 15.6 95%CI (3.0-80.3)). One third (29%(105)) considered starting PrEP in the next 6 months, with protecting health (77%) and reducing HIV worry (58%) most common reasons. Most (81%) had concerns about taking PrEP with side effects (68%)) and incomplete protection (25%) most common;72%would need some form of support. Most preferred source for information and PrEP was their primary care site, with cost (25%), clinic familiarity (23%) and confidentiality (24%) most important. Factors associated with starting PrEP included being Latina (OR 3.5 95%CI (1.2-10.0), recent STI (OR 2.6 95%CI (1.3, 5.0)), more worry about HIV (OR 1.2 95%CI (1.0-1.5)) and higher belief in PrEP effectiveness (OR 2.1 95%CI (1.4, 3.3)). Qualitative themes aligned with survey results including the lack of PrEP knowledge, viewing PrEP as beneficial, and importance of trusted health providers. FGs also found disconnection with current PrEP advertisements, need for community-level PrEP education and outreach, and differing understandings of HIV risk/vulnerability. PrEP-users offered insights into current pathways into PrEP and need for increased awareness and access. Conclusion: Despite significant PrEP work in Chicago, only 29% of women in our study had heard of PrEP. However PrEP attitudes among these women were positive, and once made aware of PrEP, one third considered starting in the near future. Translating these results into interventions which reflect women’s preferences and barriers are critical to increase PrEP uptake by cisgender women in Chicago. 979 HIV RISK AND CHARACTERISTICS OF WOMEN SEEKING PrEP IN A US DEMONSTRATION PROJECT Jill Blumenthal 1 , Sheldon Morris 1 , Sonia Jain 1 , Feng He 1 , Margaret R. Caplan 2 , Eric Ellorin 1 , Ryan M. Kofron 3 , James F. Rooney 4 , Gifty Ntim 3 , Katya Calvo 2 , Jamila Stockman 1 , K. Rivet Amico 5 , David J. Moore 1 , Raphael J. Landovitz 3

977 DETERMINANTS OF PREEXPOSURE PROPHYLAXIS CASCADE AMONG NIGERIAN MSM Habib R. Omari 1 , Nicaise Ndembi 2 , Blessing Kayode 2 , Ashley Shutt 1 , Charlotte A. Gaydos 3 , Julie Ake 4 , Trevor A. Crowell 4 , Stefan Baral 5 , Rebecca G. Nowak 1 , Man Charurat 1 , for the For the TRUST/RV368 study Group 1 University of Maryland, Baltimore, MD, USA, 2 Institute of Human Virology Nigeria, Abuja, Nigeria, 3 Johns Hopkins University, Baltimore, MD, USA, 4 US Military HIV Research Program, Silver Spring, MD, USA, 5 Johns Hopkins Hospital, Baltimore, MD, USA Background: Pre-exposure prophylaxis (PrEP) is efficacious in preventing human immunodeficiency virus infection among men who have sex with men (MSM). Here we characterize engagement and correlates of the HIV PrEP cascade among Nigerian MSM Methods: The TRUST/RV368 cohort employs respondent-driven-sampling to recruit MSM into HIV/STI prevention and treatment services in Abuja and Lagos, Nigeria. 515 HIV negative MSM at the Abuja site who completed a survey instrument on awareness and willingness to use PrEP were approached for PrEP initiation. To understand gaps at different levels of PrEP uptake, we categorized study participants (i) educated about PrEP (ii) showed interest (iii) successfully contacted (iv) scheduled appointment (v) attended scheduled appointment (vi) initiated PrEP. Multivariate logistic regression models were used to assess correlates of the HIV PrEP cascade. Results: Of 515 participants, 469 (96.3%) showed interest taking PrEP every day and/or after a sexual act, 349 (67.8%) were successfully contacted and 271 (52.6%) scheduled an appointment, 242 (50.0%) attended scheduled appointment and 226 (43.9%) initiated PrEP (figure 1). Younger MSM, [≤19 years vs. ≥ 25 years (adjusted odds ratio (aOR) 0.6; 95% CI 0.4 to 0.9)] and religion, (Muslims vs. Christians, aOR 0.5; 95% CI 0.3 to 0.9) were associated with decreased odds of PrEP initiation. Having received information on HIV prevention in the past 12-months was associated with increased odds of PrEP initiation, (aOR 1.4; 95% CI 1.1 to 2.1). Furthermore, Muslims were significantly less likely to be successfully contacted and scheduled for an appointment (p < 0.05). Younger MSM had decreased odds of being successfully contacted (aOR 0.6; 95% CI 0.3 to 1.1) and attending an appointment (aOR 0.6; 95% CI 0.4 to 1.0) although associations were not statistically significant. Larger number of sex partners, > 5 vs. ≤ 5 was associated with increased odds of scheduling an appointment (aOR 1.8; 95% CI 1.1 to 3.0) and PrEP initiation (aOR 1.9; 95% CI 0.9 to 3.0). Of those successfully contacted and did not engage, 30% lost interest, 27% promised to engage and 18% perceived low HIV risk. Conclusion: Engagement in PrEP in this population is relatively low with younger MSM less likely to engage in PrEP. Reinforcing HIV prevention education and facilitating young MSM to engage in PrEP is critical in order to prevent HIV transmission. Muslims lag behind Christians at different levels of PrEP uptake. Better support among Muslim gay men is needed.

Poster Abstracts

CROI 2019 383