476. Sexual Risk Behavior and Viral Suppression among HIV-infected Adults Receiving Medical Care in the New York City (NYC), 2013-2015
Session: Poster Abstract Session: HIV and STI Prevention
Thursday, October 27, 2016
Room: Poster Hall
Posters
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  • Background: Adherence to antiretrovirals, and subsequent viral load (VL) suppression, improve health outcomes for people living with HIV (PLWH) and greatly reduce HIV transmission. We examined correlations between sexual risk behaviors and VL detection in a sample of PLWH in care in NYC.

    Methods: Data were derived from electronic medical records at 4 NYC HIV primary care clinics, 4/2013-5/2015. Included patients were sexually-active (past 3 mos.), adult PLWH with at least one completed sexual risk screen and one VL measurement within 12 mos. of the screen. The standardized sexual risk screen comprised report of condomless sex (last sex), and multiple partners, sex while under the influence (of drugs/alcohol; SUI), STI diagnoses, and sex in exchange for money/drugs (all past 3 mos.). Correlations were examined between sexual behavior (patients’ first recorded screen) and VL detectability (≥50 copies/mL; most proximal VL measurement). Demographic factors (gender, age, race/ethnicity) and sexual partnering were examined as potential covariates. Correlations were analyzed using logistic regression. Multivariable models included risk behaviors and demographic factors bivariately correlated with VL detectability (p<.05), controlling for clinic.

    Results: Almost half (n/N =1720/3697; 47%) PLWH with risk screen and VL data were sexually active; among them, 32% were virally detectable. Report of any risk behavior was 54.2% vs. 46.7% among detectable vs. other patients, respectively. In bivariate analysis, the following were correlated with VL detection: any risk behavior (odds ratio (OR) 1.35, 95% confidence interval (CI), 1.10-1.66), condomless sex (OR 1.33, CI 1.06-1.68), SUI (OR 1.88, CI 1.45-2.43), multiple partners (OR 1.31, CI 1.05-1.63), recent STI (OR 1.57, CI 1.10-2.22) and age≤35 (OR 2.09, CI 1.69-2.58). In adjusted analysis, being virally detectable remained correlated with SUI (adjusted OR 1.59 CI: 1.21-2.08) and age≤35 (aOR 1.99 CI: 1.60-2.48).

    Conclusion: Sexual activity and risk were prevalent among PLWH in NYC HIV clinics. Sexual risk, particularly SUI, was correlated with VL detectability. This correlation, as well as that with younger age, underscores the importance of routine screening and education on risk reduction strategies, combined with support for VL suppression.

    Nana Mensah, MPH1, Jaime Martin, MPH1, Shruti Ramachandran, MPH, MID2, Matt Baney, MS2, Jameela Yusuff, MD, MPH, FACP3, David Rubin, MD4, Demetre Daskalakis, MD, MPH1, Zoe Edelstein, PhD, MS1, Kent a. Sepkowitz, MD, FIDSA, FSHEA5 and Julie Myers, MD, MPH1, (1)Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, Long Island City, NY, (2)Institute for Advanced Medicine, Mount Sinai Health System, New York, NY, (3)Division of Infectious Diseases, STAR Program, SUNY Downstate Medical Center, Brooklyn, NY, (4)Infectious Disease, New York Hospital Queens, Flushing, NY, (5)5Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY

    Disclosures:

    N. Mensah, None

    J. Martin, None

    S. Ramachandran, None

    M. Baney, None

    J. Yusuff, None

    D. Rubin, None

    D. Daskalakis, None

    Z. Edelstein, None

    K. A. Sepkowitz, None

    J. Myers, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.