CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

Results: In a study sample of 1855 individuals, all-cause and liver-related mortality rates (MRs) were 43.0 and 4.2 deaths per 1,000 person-years (PY), respectively. All-cause mortality rates were highest among SR non-drinkers with a provider-documented (PD) recent (<6 months) history of hazardous drinking (MR=79.5 deaths per 1,000 PY) and lowest among SR moderate drinkers with no PD history of hazardous drinking (MR=20.5 deaths per 1,000 PY). Cumulative mortality for liver-related and non-liver-related mortality are shown (Figure). Compared to PD never-drinkers, individuals with a PD history of recent hazardous drinking had higher liver-related mortality (HR=6.48, 95% CI 2.82-14.93 and HR=2.82, 95% CI 1.04-7.66 for SR current nondrinkers and moderate drinkers, respectively). However, SR nondrinkers and moderate drinkers with a PD hazardous drinking history of greater than six months ago showed similar rates of liver-related mortality compared to PD never-drinkers (HR=1.23, 95% CI 0.48-3.17 and HR=1.61, 95% CI 0.36-7.19, respectively). Conclusions: Any hazardous alcohol consumption is associated with all-cause mortality among HIV-infected individuals, while only hazardous consumption within the past six-months is associated with liver-related mortality. Helping individuals with hazardous drinking behavior to stop drinking could improve liver-related outcomes for high-risk individuals.

912 Alcohol Use and Unprotected Sex in HIV-Positive Female Sex Workers in Mombasa Darcy White 1 ; Kate S.Wilson 1 ; Linnet Masese 2 ; GeorgeWanje 1 ;Walter Jaoko 3 ; Kishor Mandaliya 4 ; Barbra A. Richardson 1 ; Jane Simoni 1 ; Scott McClelland 1

1 Univ of Washington, Seattle, WA, USA; 2 Kenya Rsr Prog at the Univ of Washington, Nairobi, Kenya; 3 Univ of Nairobi, Nairobi, Kenya; 4 Coast Province General Hosp, Mombasa, Kenya Background: High levels of alcohol use have been reported in people living with HIV (PLHIV). In addition to adverse health effects, alcohol use could facilitate HIV transmission if it is associated with higher rates of unprotected sex. A number of studies have demonstrated associations between alcohol use and sexual risk behavior, but most have been cross-sectional, relied on self-reported indicators of risk, and used non-standard measures of alcohol use. Few studies have focused on HIV-positive women. We used data from a prospective cohort of HIV-positive female sex workers (FSWs) to test the hypothesis that hazardous or harmful alcohol use is associated with unprotected vaginal sex Methods: Longitudinal data were collected from a cohort of HIV-positive women in Mombasa who reported transactional sex. Hazardous or harmful alcohol use was defined as a score of 7 or higher on the AUDIT, and was measured annually. Unprotected sex was measured by detection of prostate specific antigen (PSA) in vaginal secretions at quarterly examination visits. Generalized estimating equations were used to calculate associations between hazardous or harmful alcohol use in the past year and detection of PSA. Exploratory analyses examined associations with self-reported indicators of sexual risk and STIs. Results: A total of 2,744 visits with PSA samples were accrued by 402 women over 605 person-years of follow-up. In univariate analysis, hazardous or harmful alcohol use was associated with a 50% higher risk of PSA detection (Table 1). This association was attenuated, and no longer statistically significant, after adjusting for age, work venue, intimate partner violence, depression, and partnership status. In exploratory analyses, hazardous or harmful alcohol use was associated with self-report of unprotected sex after adjusting for potential confounding factors. In addition, low-risk alcohol use was associated with a significantly higher risk of STI acquisition. Conclusions: In this longitudinal cohort of HIV-positive FSWs, hazardous or harmful alcohol use was associated with detection of PSA, but this association was confounded by age and other demographic and social covariates. However, reporting any alcohol use was strongly associated with STI acquisition in multivariable analysis. Randomized trials of interventions that successfully reduce alcohol intake are needed to determine whether lowering alcohol use reduces STI incidence and HIV transmission risk.

Poster Abstracts

384

CROI 2016