CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

926 Group Sex: A Cross-Sectional Online Survey Among MenWho Have Sex With Men in China Songyuan Tang 1 ;WeimingTang 1 ; Joseph D.Tucker 2 ; BinYang 3 ;Ye Zhang 1 ;Wei Zhang 1 ; Shujie Huang 3 ; LigangYang 3 ; ChongyiWei 4 ; Chuncheng Liu 5 ;Yilu Qin 1 1 Univ of North Carolina Proj China, Guangzhou, China; 2 Univ of North Carolina at Chapel Hill Inst for Global Hlth & Infectious Diseases, Chapel Hill, NC, USA; 3 Guangdong Provincial Cntr for Skin Diseases and STI Control, Guangzhou, China; 4 Univ of California San Francisco, San Francisco, CA, USA; 5 SESH Global, Guangzhou, China Background: Group sex is relatively common among men who have sex with men (MSM) and plays an important role in the transmission of HIV and other sexually transmitted infections (STIs). However, little attention has focused on this high risk behavior, particularly among Chinese MSM. This study was therefore aimed to determine the frequency and correlates of group sex among Chinese MSM. Methods: MSM participants were recruited from three online portals popular with gay men in China. An online survey was conducted from September-October 2014, collecting data on socio-demographics, sexual behaviors, gay app use and group sex among Chinese MSM. We defined group sex as sex at the same time among three or more people. Participants who reported any use of gay apps to find sex partners in the last six months were categorized as gay app users. Univariate and multivariate logistic regressions were used to determine the factors associated with group sex. Results: Of the 1,424 surveyed MSM, the majority were under 30 years old (77.5%), single (83.8%), with at least a college education (74.0%) and used gay apps (57.9%). Overall, 9.9% (141) of participants reported that they engaged in group sex in the last 12 months. Multivariate analyses showed that HIV-positive MSM were more likely to engage in group sex (adjusted OR=3.74, 95% CI 1.92,7.28). Individuals with riskier sexual behaviors, such as condomless anal intercourse with men in the last three months (adjusted OR=2.88, 95% CI 2.00-4.16) were also more likely to engage in group sex. In addition, we observed a trend towards Chinese MSM gay app users having more group sex (adjusted OR=1.46; 95% CI: 1.00-2.13). Conclusions: Our data suggest that MSM group sex is more common among HIV-infected individuals and those with high risk behaviors. Our data are consistent with an emerging literature suggesting that mobile app-facilitated sex parties among HIV-infected individuals may be facilitating HIV transmission. Future interventions, surveillance programs and research should give consideration to this population as a distinct risk group. 927 Risk Factors for Acute and Early HIV Infection Among MSM, Bangkok, Thailand 2010-2015 WaruneeThienkrua 1 ; Marcel Curlin 2 ; Eileen Dunne 3 ; Kanokpan Pancharoen 1 ; Boonyos Raengsakulrach 1 ;Wannee Chonwattana 1 ;Wanna Leelawiwat 1 ; Philip A. Mock 1 ; Anupong Chitwarakorn 4 ; Timothy H. Holtz 3 1 Thailand Ministry of PH US CDC Collab, Nonthaburi, Thailand; 2 Oregon Hlth and Scis Univ, Portland, OR, USA; 3 CDC, Atlanta, GA, USA; 4 Ministry of PH, Muang Nonthaburi, Thailand Background: Identifying and treating acute and early HIV infection (AEHI) may result in reductions in HIV transmission. We evaluate factors associated with AEHI among HIV- uninfected men who have sex with men (MSM), and transgender women (TGW), in the Bangkok MSM Cohort Study (BMCS). Methods: From 2006 to 2010, we enrolled Thai MSM and TGW aged ≥18 years into the BMCS with 3–5 years of follow-up from date of enrollment. Participants provided socio- demographic and behavioral information by audio computer-assisted self-interview at each 4-month visit. MSMwho had an HIV-1 non-reactive oral fluid test at baseline or at any 4-month follow-up with serologic confirmation were evaluated for AEHI. AEHI was defined as having non-reactive result by oral fluid anti-HIV rapid test, detectable HIV-1 RNA by nucleic acid amplification testing (NAAT), or reactive HIV Ag/Ab by 4th generation enzyme immunoassay (EIA). We calculated the overall prevalence of AEHI (number of acute and early infections per 100 tests), and factors associated with AEHI using generalized estimating equations logistic regression modeling. Results: From February 2010 to June 2015, there were a total of 977 participants with 7383 visits with a non-reactive anti-HIV rapid test. Of these, 6826 visits (92.5%) had testing for AEHI. Overall we detected 52 (5.3%) participants with AEHI at baseline or at follow-up (0.76 per 100 tests, 95% Confidence Interval (CI) 0.56– 0.99). By age (years), AEHI occurred in 1.34 per 100 tests (13/967, 95% CI 0.72– 2.30) among those 18–21, 0.69 per 100 tests (24/3436, 95% CI 0.45–1.04) among those 22–29, and 0.62 per 100 tests (15/2423, 95% CI 0.34–1.02) among those ≥30 years. Independent factors associated with AEHI at the time of the visit included young age (age 18–21 years, adjusted Odds Ratio (aOR) 2.6, 95% CI 1.1–6.1), inconsistent condom use with a steady male partner in the past 4 months (aOR 3.8, 95% CI 1.8–8.3), positive rectal Neisseria gonorrhea (aOR 7.5, 95% CI 1.4–39.1), positive hepatitis A antibody (aOR 5.6, 95% CI 1.5–20.8) and positive hepatitis B core antibody (aOR 14.1, 95% CI 5.6–35.4). Conclusions: We detected AEHI in over 5% of participants in our cohort study, and AEHI was most common in the young as well as those with a history of STIs, inconsistent condom use, and hepatitis A immunity. Given the expense of NAATs and fourth generation EIAs, factors associated with AEHI could be used to target testing to men at greatest risk for early and acute HIV and facilitate early treatment. 928 High Prevalence of HIV AmongWives of Married MenWho Have Sex With Men in India Aylur K. Srikrishnan 1 ; Shruti H. Mehta 2 ; CeciliaTomori 2 ; Santhanam Anand 1 ; Pachamuthu Balakrishnan 3 ; David Celentano 2 ; Gregory M. Lucas 2 ; Sunil S. Solomon 2 1 YRG Cntr for AIDS Rsr and Educ, Taramani, India; 2 Johns Hopkins Univ, Baltimore, MD, USA; 3 YRG Cntr for AIDS Rsr and Educ, Chennai, India Background: Despite global declines in HIV prevalence, control in vulnerable populations such as men who have sex with men (MSM) in low- and middle-income countries (LMICs) remains a challenge. MSM in LMICs continue to have high HIV prevalence and serve as a potential bridge to the general population because a significant proportion marry women (>50% in some settings) to satisfy socio-cultural norms. HIV prevalence among married MSM tends to be higher, likely related to a need to conceal behavior. However, to-date, no data exists on HIV prevalence among wives of MSM. Methods: FromMarch 2015–present, 129 married MSM couples have been recruited across 3 Indian cities – Bengaluru, Hyderabad and New Delhi (target 50 couples/city). To be included, men had to have disclosed their MSM behavior to their wives. Both members of the couple also needed to consent independently and be ≥18 years of age. An additional 149 married MSM who had not disclosed their MSM behavior to their wives were included. All completed a survey and were tested for HIV; men and their wives were interviewed separately. Logistic regression was used to identify factors associated with HIV infection in wives. Results: The median age of MSM and their wives whose data were available at the time of analysis (n=129 couples) was 36 and 31 years, respectively. They were married for a median 15 years. HIV prevalence among disclosed MSM was 47% (95% confidence interval [CI]: 38, 56%) compared to 31% in undisclosed MSM (95% CI: 24, 39%). HIV prevalence among the wives of disclosed men was 28% (95% CI: 20, 37%). Only 6 of 36 HIV positive women had an HIV negative husband. The strongest predictor of HIV infection in wives was husband’s HIV status (Adjusted Odds Ratio: 13.7; 95% CI: 4.41, 42.7). Only 11 (9%) women reported >1 lifetime sex partner (4 had >2 partners). 87% of the wives of HIV positive MSM were aware of their husband’s HIV status and 89%were also aware of their own HIV status. Of women aware of their status, 97% had been linked to care and 80%were on ART. Conclusions: We observed an alarmingly high prevalence of HIV among married MSM and their wives in India. It was encouraging that most wives were aware of their HIV status and engaged in care. However, these couples may represent a select group where MSM have disclosed their MSM behavior, potentially because of their HIV diagnosis. Innovative interventions are needed to reach wives of married MSM and engage them in HIV prevention prior to transmission of HIV. 929 Subsequent HIV Disease Risk Following Syphilis Diagnosis in a Southern MSM Population David Sweat ; Sulaiman Aizezi Shelby County Hlth Dept, Memphis, TN, USA Background: Pathela et al in New York City reported the risk of subsequent HIV infection diagnosis within 30 months among MSM was 1:20, or a 5% overall risk for MSM diagnosed with either primary or secondary syphilis (Clinical Infectious Diseases® 2015;61(2):281–7). We applied the methods described in the Pathela study to reported disease registries for Shelby County, Tennessee, to determine whether our experience was similar to, better than, or worse than the experience reported in New York City. Shelby County is

Poster Abstracts

392

CROI 2016