187 Adherence Among HIV-Positive

WELCOME FROM THE CO-CHAIRS

Welcome to Adherence 2016! This conference marks 11 years of coming together from around the world to share, support, and sustain scientific advances towards fully leveraging available social-behavioral and biomedical treatments to promote health and well-being of people affected by and those living with HIV. This year we continue to focus on adherence to biomedical prevention and treatment strategies, as well as engagement in HIV prevention and care. In line with national and international targets, the content covered through our invited speakers, oral abstracts, and poster presentations comprehensively maps upon prevention and treatment cascades, and the spaces in between.

With delegates from around the world and across the United States, all united in the mission of realizing the end of the epidemic through treatment and prevention, we are looking forward to another collaborative and energizing conference. We anticipate nearly 400 delegates from 25 countries will come together here in Fort Lauderdale, and sincerely thank each of you for making this conference a priority in what are undoubtedly busy schedules and tight budgets. Please take every opportunity to engage with a truly amazing community of diverse delegates. There are a number of added opportunities and events in the program to help to foster such discussions.

We also wish to thank the International Association of Providers of AIDS Care (IAPAC) for their continued support of this unique conference and commitment to strengthening our diverse network of individuals in this important field. This conference would not be possible without considerable contributions from IAPAC as well as from many individuals:

• Intellectual and programmatic guidance from IAPAC President/CEO José M. Zuniga, PhD, MPH, who has facilitated the creation of yet another year of high-quality plenaries and thematic oral sessions. • IAPAC Vice President/Chief Technical Officer Rueben Granich, MD, MPH, and Michael J. Stirratt, PhD, a Program Chief at the National Institute of Mental Health/National Institutes of Health, provided invaluable contributions to developing the scientific program. • All of the IAPAC faculty and ad-hoc reviewers provided essential guidance in their careful scientific review of abstracts submitted to the conference. • IAPAC Conference Manager Jonathan Hess and other staff whose work allows for the successful implementation of the conference.

We are also grateful for our distinguished conference faculty, including our:

• Keynote speaker: Ambassador Deborah L. Birx, MD, the US Global AIDS Coordinator; • Memorial lecturer: Robert Remien, PhD, from Columbia University; and • Invited Speakers: Amy Lansky, PhD, MPH, Acting Director of the Office of National AIDS Policy; Bruce Agins, MD, MPH, from HealthQUAL International; Benjamin Young, MD, MPH, IAPAC’s Senior Vice President/Chief Medical Officer; Jeremiah Johnson from the Treatment Action Group; Kenneth Mayer, MD, from Fenway Health; Phill Wilson and Anna Zakowicz, MPH, MI, from the Black AIDS Institute and AIDS Healthcare Foundation, respectively; Catherine Hanssens, JD and Jason Sigurdson, MPA, LLP, from the Center for HIV Law & Policy and the Joint United Nations Programme on HIV/AIDS, respectively; and Julio Montaner, MD, from the British Columbia Center of Excellence in HIV/AIDS.

We hope that you fully partake of our next three days together, centered around new scientific knowledge and clinical practicum, and return to your communities reinvigorated to further study, implement, and advance the art, science, and practice of HIV treatment and prevention adherence.

K. Rivet Amico, PhD1 Michael J. Mugavero, MD, MHSc2 Co -Chair Co -Chair

1 University of Michigan, Ann Arbor, MI, USA 2 University of Alabama at Birmingham, Birmingham, AL, USA General Information ...... 3

Continuing Education ...... 4

Hotel Map ...... 5

Faculty Roster ...... 6

Conference Program - Monday, May 9, 2016 ��7

Conference Program - Tuesday, May 10, 2016 ��8

Conference Program - Wednesday, May 11, 2016 ��9 TABLE OF CONTENTS TABLE

Oral Abstracts Schedule...... 10

Oral Abstracts ...... 14

Poster Abstracts ...... 50

Author Index ...... 101

Acknowledgements ...... 105

11th International Conference on HIV Treatment and Prevention Adherence 1

CONFERENCE INFORMATION

TARGET AUDIENCE PROGRAM OVERVIEW The target audience for the 11th International Conference on HIV Adherence 2016 will provide a forum where the state-of-the- Treatment and Prevention Adherence (Adherence 2016) includes science for HIV treatment and biomedical prevention adherence physicians, nurses/nurse-practitioners, pharmacists, psycholo- research will be presented, discussed, and translated into evi- gists, behavioral researchers, social scientists, epidemiologists, dence-based approaches. The 3-day program will allow health- social workers, case managers, AIDS service organization (ASO) care and human service professionals to examine scientifically staff, and allied healthcare and lay professionals working in the sound and practical strategies to enhance adherence to HIV field of HIV medicine. treatment and biomedical prevention interventions in a variety of domestic and international settings. STATEMENT OF NEED The preventative and therapeutic benefits of antiretroviral ther- EDUCATIONAL OBJECTIVES apy are only achievable when patients are optimally engaged in After completing this activity, participants will be able to: a continuum of HIV care, including linkage to care, adherence to treatment, and long-term viral suppression through ongoing en- • Summarize evidence-based strategies to optimize the HIV gagement in care. Poor or non-adherence to treatment, as well care continuum as suboptimal linkage to and engagement in care, can lead to • Employ interventions to enhance linkage to and engagement the resumption of rapid viral replication, decreased survival rates, and retention in HIV care, as well as adherence to HIV treat- and virus mutation to treatment-resistant strains of HIV. Similarly, ment, to facilitate long-term viral suppression linkage and adherence to biomedical prevention interventions is • Integrate biomedical prevention interventions, including critical to curbing HIV acquisition rates among at-risk populations. pre-exposure prophylaxis, into clinical practice to decrease HIV acquisition among at-risk populations Implementing evidence-based behavioral, clinical, and structural • Apply harm reduction, mental health, and psychosocial strate- interventions to enhance linkage to and adherence to HIV treat- gies in the management of people affected by and living with ment and biomedical prevention, as well as long-term engage- HIV who are substance users and/or diagnosed with mental ment in the continuum of HIV care, is critical to attain individual, health issues community, and public health objectives. CONTINUING EDUCATION GENERAL INFORMATION

MEETING VENUE INTERNET ACCESS Adherence 2016 is being held at the Diplomat Hotel and Resort. Complimentary Internet access is available for Adherence 2016 Plenary, Oral Abstract, and Breakout Sessions, as well as the Poster delegates. Wireless Internet can be accessed through the follow- Session will be held on the second level (see the Hotel Maps and ing network: the Program Schedule on page 5 and pages 7-9, respectively). Network: Adherence Password: adherence

MEALS SLIDE PRESENTATIONS/ABSTRACTS Complimentary breakfast and lunch will be provided daily in Slide presentations will be available at www.iapac.org post-con- the Foyer, which is located outside of the Grand Ballrooms ference. The Program and Abstracts book will be distributed at East/West. Please refer to the program for scheduled break- registration, and electronic versions will be available at www. fast and lunch times. iapac.org post-conference.

SOCIAL MEDIA If you have not already done so, please “like” our Facebook page (International Association of Providers of AIDS Care) and join the Adher- ence 2016 event for live updates on the conference. Join the conference’s social media conversation: #Adherence2016

QUESTIONS If you have any questions during the conference, please locate an IAPAC staff member at the conference’s Registration Area. If you have any questions post-conference, please contact Jonathon Hess at [email protected].

11th International Conference on HIV Treatment and Prevention Adherence 3 PHYSICIANS, NURSES, AND PSYCHOLOGISTS

CONTINUING MEDICAL EDUCATION

Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accredi- tation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine and the International Association of Providers of AIDS Care (IAPAC). Disclosure of Unlabeled Use The Postgraduate Institute for Medicine is accredited by the ACC- This educational activity may contain discussion of published ME to provide continuing medical education for physicians. and/or investigational uses of agents that are not indicated by the US Food and Drug Administration (FDA). The planners of this Credit Designation activity do not recommend the use of any agent outside of the The Postgraduate Institute for Medicine designates this live ac- labeled indications. The opinions expressed in the educational tivity for a maximum of 18.5 AMA PRA Category 1 Credit(s)™. activity are those of the faculty and do not necessarily represent Physicians should claim only the credit commensurate with the the views of the planners. Please refer to the official prescribing extent of their participation in the activity. information for each product for discussion of approved indications, contraindications, and warnings. Disclosure of Conflicts of Interest The Postgraduate Institute for Medicine (PIM) requires instructors, Disclaimer planners, managers, and other individuals who are in a position to Participants have an implied responsibility to use the newly acquired control the content of this activity to disclose any real or apparent information to enhance patient outcomes and their own professional conflict of interest (COI) they may have as related to the content of development. The information presented in this activity is not meant to this activity. All identified COI are thoroughly vetted and resolved serve as a guideline for patient management. Any procedures, medica- according to PIM policy. PIM is committed to providing its learn- tions, or other courses of diagnosis or treatment discussed or suggest- ers with high quality CME activities and related materials that ed in this activity should not be used by clinicians without evaluation of promote improvements or quality in healthcare and not a specific their patient’s conditions and possible contraindications on dangers in proprietary business interest of a commercial interest. use, review of any applicable manufacturer’s product information, and CONTINUING EDUCATION A Disclosure of Conflicts of Interest handout is inserted in the comparison with recommendations of other authorities. Program and Abstracts book. The handout reflects reports of fi- nancial relationships or relationships to products or devices fac- Evaluation ulty, planners, and managers, or their spouses/ life partners, have Participants may complete an online evaluation at with commercial interests related to the content of this CME ac- www.cmeuniversity.com. On the navigation menu, click on “Find tivity. If you do not find this handout inserted in your Program and Post-Tests by Course” and search by Course ID 11347. Upon Abstracts book, please visit the conference’s Registration Desk. successfully completing the evaluation, a CME certificate will be This activity is supported by an independent educational grant made available to each participant. from Gilead Sciences, Inc. and Merck & Co.

CONTINUING EDUCATION - PSYCHOLOGISTS CONTACT HOURS - NURSES

Psychology Sponsorship Statement Nursing Accreditation Statement Postgraduate Institute for Medicine is approved by the American Postgraduate Institute for Medicine is accredited as a provider of Psychological Association to sponsor continuing education for continuing nursing education by the American Nurses Credential- psychologists. PIM maintains responsibility for this program and ing Center’s Commission on Accreditation. its content. Nursing Credit Designation Psychology Credit Designation This educational activity for 18.5 contact hours is provided by This program offers 18.5 continuing education credits for psy- Postgraduate Institute for Medicine. chologists.

EVALUATION FOR PSYCHOLOGISTS AND NURSES Participants may complete an online evaluation at www.cmeuniversity.com. On the navigation menu, click on “Find Post-Tests by Course” and search by Project ID 11347. Upon successfully completing the evaluation, a CE certificate will be made available to each participant.

4 11th International Conference on HIV Treatment and Prevention Adherence THE DIPLOMAT HOTEL AND RESORT R R E E OO OO TERR AC TERR AC OUTD OUTD R E HOTEL MAP OO TERR AC OUTD

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11th International Conference on HIV Treatment and Prevention Adherence 5 Bruce Agins, MD, MPH Michael Horberg, MD, MAS Robert Remien, PhD HEALTHQUAL International Kaiser Permanente Columbia University New York, NY, USA Rockville, MD, USA New York, NY, USA

Moisés Agosto-Rosario Jeremiah Johnson Sarah Rowan, MD National Minority AIDS Council Treatment Action Group Denver Health and Hospital Authority Washington, DC, USA New York, NY, USA Denver, CO, USA

Josef Amann, MD, MPH Amy Lansky, PhD, MPH Jorge Saavedra, MD Centers for Disease Control and Prevention Office of National AIDS Policy AIDS Healthcare Foundation Atlanta, GA, USA Washington, DC, USA Los Angeles, CA, USA

K. Rivet Amico, PhD Albert Liu, MD, MPH Jeffrey Schouten, MD, JD University of Michigan San Francisco Department of Public Health University of Washington Ann Arbor, MI, USA San Francisco, CA, USA Seattle, WA, USA

Ambassador Deborah L. Birx, MD Darius Massie Jason Sigurdson, MPA, LLB Office of the Global AIDS Coordinator Brothers Living Authentically Creating Change Joint United Nations Programme on HIV/AIDS Washington, DC, USA Miami, FL, USA Geneva, SWITZERLAND

George Butchko Kenneth Mayer, MD Michael J. Stirratt, PhD AIDS Healthcare Foundation Fenway Health National Institute of Mental Health FACULTY ROSTER FACULTY Fort Lauderdale, FL, USA Boston, MA, USA Bethesda, MD, USA

Amanda Castel, MD, MPH Eugene McCray, MD, MPH Evelyn Ullah, BSN, MSW George Washington University Centers for Disease Control and Prevention Broward County Health Department Washington, DC, USA Atlanta, GA, USA Fort Lauderdale, FL, USA

Jennifer Cocohoba, PharmD, MAS LaTrischa Miles Ira Wilson, MD, MSc University of California, San Francisco Kansas City CARE Clinic Brown University San Francisco, CA, USA Kansas City, MO, USA Providence, RI, USA

Maureen Connolly, MD Julio Montaner, MD Phill Wilson Henry Ford Health System BC Center for Excellence in HIV/AIDS Black AIDS Institute Detroit, MI, USA Vancouver, BC, CANADA Los Angeles, CA, USA

Heidi Crane, MD, MPH Tia Morton, RN, MS Joey Wynn University of Washington National Institute of Allergy and Infectious Empower U Seattle, WA, USA Diseases Miami, FL, USA Bethesda, MD, USA Dázon Dixon Diallo, MPH, DHL Benjamin Young, MD, PhD SisterLove Michael Mugavero, MD, MHSc International Association of Atlanta, GA, USA University of Alabama, Birmingham Providers of AIDS Care Birmingham, AL, USA Washington, DC, USA Thomas P. Giordano, MD, MPH Baylor College of Medicine Kenneth Ngure, PhD, MSc Anna Zakowicz, MI, MPH Houston, TX, USA Jomo Kenyatta University of AIDS Healthcare Foundation Agriculture and Technology Amsterdam, NETHERLANDS Alex Gonzalez, MD Nairobi, KENYA Fenway Institute Carmen Zorrilla, MD Boston, MA, USA Celso Ramos, MD, MSc University of Puerto Rico Federal University of Rio de Janiero San Juan, Puerto Rico, USA Reuben Granich, MD, MPH Rio de Janiero, Brazil International Association of José M. Zuniga, PhD, MPH Providers of AIDS Care Sindhu Ravishankar, MPhil International Association of Washington, DC, USA International Association of Providers of AIDS Care Providers of AIDS Care Washington, DC, USA Catherine Hanssens, JD Washington, DC, USA The Center for HIV Law & Policy New York, NY, USA

6 11th International Conference on HIV Treatment and Prevention Adherence MONDAY, MAY 9, 2016

TIME ACTIVITY

7:30am-8:45am PRE-CONFERENCE BREAKFAST SESSION: Continuity of Care: Tracking Patients across Health Plans and Clinical Settings Michael Horberg, MD, MAS

9:00am-9:30am Opening Remarks

DATA FOR ACTION • GRAND BALLROOM EAST

9:30am-10:00am PLENARY SESSION: US National HIV/AIDS Strategy: Contending with Disparities, Reaching for Ambitious Targets Amy Lansky, PhD, MPH

10:00am-10:45am KEYNOTE ADDRESS: PEPFAR 3.0: Progress in and Outcomes of Data-Driven Reorientation of HIV Services Ambassador Deborah L. Birx, MD

10:45am-11:30am PLENARY SESSION: Data 4 Care: Using Clinical and CQI Data for HIV Care Continuum Monitoring and Intervention Bruce Agins, MD, MPH

11:30am-11:45am Break/Transition

TIME ACTIVITY GRAND BALLROOM EAST REGENCY 2 REGENCY 3 11:45am-12:45pm Thematic Oral SESSION 1 SESSION 2 SESSION 3 Abstract Sessions PrEP: Prescribing and Social and Structural Structural Programs to Adherence Support Determinants Across the Promote Adherence to Care “Adherence” Spectrum and ART

12:45pm-2:15pm Lunch PROGRAM SCHEDULE

DATA FOR ACTION (Continued) • GRAND BALLROOM EAST

2:15pm-3:15pm PANEL DISCUSSION: Actioning the Data: Multisectoral Perspectives on CQI Data Utility in HIV Medicine Moderator: Michael J. Mugavero, MD, MHSc Panelists: Bruce Agins, MD, MPH; Josef Amann, MD, MPH

3:15pm-4:15pm PANEL DISCUSSION: Fast-Track Cities: Using Data to Optimize Local HIV Care and Prevention Continua Moderator: Sindhu Ravishankar, MPhil Panelists: Reuben Granich, MD, MPH; Albert Liu, MD, MPH; Sarah Rowan, MD

4:15pm-4:30pm Break/Transition

TIME ACTIVITY GRAND BALLROOM EAST REGENCY 2 REGENCY 3 4:30pm-5:30pm Thematic Oral SESSION 4 SESSION 5 SESSION 6 Abstract Sessions PrEP Perceptions: Access, Leveraging Technology to Linkage to Care Across Uptake, and (Dis)use Promote ART Adherence and Contexts and Cultures Treatment Success TIME ACTIVITY LOCATION

5:30pm-6:30pm Poster Session & GRAND BALLROOM WEST Exhibit Session

6:30pm Adjourn

OPENING RECEPTION • GRAND BALLROOM WEST

6:30pm-8:00pm Welcome to Fort Lauderdale!

11th International Conference on HIV Treatment and Prevention Adherence 7 TUESDAY, MAY 10, 2016

TIME ACTIVITY

7:30am-8:45am PRE-CONFERENCE BREAKFAST SESSION: Setting Up a PrEP Clinic: The ABCs of Integrating PrEP into Clinical and other Settings Alex Gonzalez, MD

OPTIMIZING THE HIV CARE CONTINUUM • GRAND BALLROOM EAST

9:00am-9:30am GARY S. REITER, MD, AND ANDREW KAPLAN, MD, MEMORIAL LECTURE: Ending AIDS: Considering the Human Element Robert Remien, PhD

PLENARY SESSION: New Directions in HIV Treatment: Implications for Antiretroviral Therapy Adherence 9:30am-10:00am Benjamin Young, MD, PhD

Panel Discussion: Put Us in the Driver’s Seat: Community Perspectives on User-Driven HIV Care 10:00am-11:00am Moderator: Moisés Agosto-Rosario Panelists: Darius Massie; LaTrischa Miles; Joey Wynn

11:00am-11:30am Break/Transition

TIME ACTIVITY GRAND BALLROOM EAST REGENCY 2 REGENCY 3 11:30am-12:30pm Thematic Oral SESSION 7 SESSION 8 SESSION 9 Abstract Sessions Making the Strategy a Reality: Adherence Approaches and Care Coordination and PrEP in the USA Interventions Navigation Across the Care Continuum 12:30pm-2:00pm Lunch PROGRAM SCHEDULE 2:00pm-3:00pm Thematic Oral SESSION 10 SESSION 11 SESSION 12 Abstract Sessions PrEP Monitoring and Tracking New Insights in ART Healthcare System and at the Individual and Popula- Adherence Monitoring in Theory-Informed “Adherence” tion Level Vulnerable Populations 3:00pm-3:15pm Break/Transition

OPTIMIZING THE HIV PREVENTION CONTINUUM • GRAND BALLROOM EAST

3:15pm-3:45pm PLENARY SESSION: Paradigm Shift(ing): When Treatment is Prevention, What Then Do We Mean by Prevention? Jeremiah Johnson

3:45pm-4:15pm PLENARY SESSION: PrEP 2016: What Will It Take to Generate Demand, Increase Access, and Accelerate Uptake? Kenneth Mayer, MD

4:15pm-5:15pm PANEL DISCUSSION: Sex-Positive Dialogue and Comprehensive HIV Prevention: A Packaged Deal Moderator: K. Rivet Amico, PhD Panelists: Maureen Connolly, MD; Dázon Dixon Diallo, MPH, DHL; Kenneth Ngure, PhD, MSc; Robert Remien, PhD

5:15pm-5:30pm Break/Transition

TIME ACTIVITY LOCATION

5:30pm-6:30pm Poster Session & GRAND BALLROOM WEST Exhibit Session

6:30pm Adjourn

8 11th International Conference on HIV Treatment and Prevention Adherence WEDNESDAY, MAY 11, 2016

TIME ACTIVITY

7:30am-8:45am PRE-CONFERENCE BREAKFAST SESSION: Enhancing Retention in HIV Care: A State-of-the-Art Intervention George Butchko

LEAVING NO ONE BEHIND • GRAND BALLROOM EAST

9:00am-10:00am MARIO S. COOPER MEMORIAL COLLOQUIUM: The Quest for Dignity, Equity, and Rights for HIV-Affected Communities Phill Wilson; Anna Zakowicz, MI, MPH

10:00am-10:30am PLENARY SESSION: HIV Criminalization: Progress, Challenges, and Perils along a Slippery Slope Catherine Hanssens, JD

10:30am-11:00am PLENARY SESSION: HIV-Related Discrimination and Stigma: How Do We Get to Zero? Jason Sigurdson, MPA, LLB

11:00am-Noon THREE TOP-RATED ORAL ABSTRACTS

Noon - 12:15pm Break/Transition

TIME ACTIVITY GRAND BALLROOM EAST REGENCY 2 REGENCY 3 12:15pm-1:15pm Thematic Oral SESSION 13 SESSION 14 SESSION 15 Abstract Sessions Treatment Adherence and ART Initiation, Persistence, and Correlates and Predictors of Epidemiology Adherence at a US Population Retention in Care Level 1:15pm-2:45pm Lunch PROGRAM SCHEDULE TIME ACTIVITY GRAND BALLROOM EAST REGENCY 2 REGENCY 3 2:45pm-3:45pm Late-Breaker Oral SESSION 1 SESSION 2 SESSION 3 Abstract Sessions Prevention and Treatment Perceptions and Daily Data to Care (D2C): “Real- Continuum Potpourri Experiences with ART World” Lessons Learned 3:45pm-4:00pm Break/Transition

ENDING AIDS AS A PUBLIC HEALTH THREAT • GRAND BALLROOM EAST

4:00pm-4:30pm PLENARY SESSION: The Devil’s in the Details: What Do We Mean by Ending AIDS as a Public Health Threat? Julio Montaner, MD

4:30pm-5:30pm PANEL DISCUSSION: Through a Wide Angle Lens: Perspectives on Ending AIDS as a Public Health Threat Moderator: K. Rivet Amico, PhD Panelists: Ambassador Deborah L. Birx, MD; Julio Montaner, MD; José M. Zuniga, PhD, MPH

5:30pm-6:00pm RAPPORTEUR SESSION: Highlights from Adherence 2016 Michael J. Stirratt, PhD

6:00pm Adjourn

11th International Conference on HIV Treatment and Prevention Adherence 9 MONDAY, MAY 9, 2016

THEMATIC ORAL ABSTRACT SESSIONS

SESSION 1 SESSION 2 SESSION 3 PrEP: Prescribing and Adherence Social and Structural Structural Programs to Promote Support Determinants Across the Adherence to Care and ART 11:45 a.m. – 12:45 p.m. / Grand Ballroom East “Adherence” Spectrum 11:45 a.m. – 12:45 p.m. / Regency 3 Moderator: Kenneth Mayer, MD Moderator: Amanda Castel, MD, MPH 11:45 a.m. – 12:45 p.m. / Regency 2 200 Adverse Implications of Heterosexism Moderator: Celso Ramos, MD 146 Improved Adherence to Care and Treat- ment for People Living with HIV and Partic- for PrEP Clinical Decision-Making and 90 Adherence to PrEP among HIV-Negative ipating in a Comprehensive Nutrition Food Considerations Regarding Provider Women Attempting Conception with Support Program in the San Francisco Bay Education HIV-Positive Male Partners in the US Area: A Longitudinal Qualitative Study Sarah Calabrese presenting Erika Aaron presenting Lee Lemus Hufstedler presenting 84 Associations with PrEP Prescribing 155 Socio-Structural and Psychosocial 25 PLWHA Who Delay, Decline, or Discontinue and Adherence to Clinical Guidelines Factors Associated with Antiretroviral Among New York City Providers, 2015- ART: A Mixed Methods Study to Understand Therapy Adherence by Gender in the Mechanisms of Action of a New Effica- 2016 British Columbia, Canada Paul Salcuni presenting cious Intervention to Increase ART Initiation Cathy Puskas presenting Marya Gwadz presenting 140 HIV Pre-Exposure Prophylaxis Contin- 29 Factors Associated with Medical Care uum of Care in Patients Presenting to 24 Stable Housing Placement and Viral Engagement, ART Adherence, and Suppression after Rapid Rehousing an Urban STD Clinic Viral Suppression among Persons Grace Marx presenting for Homeless Persons with HIV: Data Living with HIV Infection (PLH) in St. for Action from the Enhanced Housing 130 The Important Role of the PrEP Petersburg, Russia Placement Assistance (EHPA) Random- Specialist in a Multidisciplinary Team Jeffrey Kelly presenting ized Controlled Trial in New York City Approach to PrEP at a Community 19 Age Differences in Viral Suppression, Ellen Wiewel presenting Health Center ART Use, and Adherence among 125 The MAX Clinic: A Structural Healthcare Sally Holt presenting HIV-Positive MSM Receiving Medical Systems Intervention Designed to Care in the United States, Medical Engage the Hardest-to-Reach Persons Monitoring Project, 2009-2013 Living with HIV/AIDS Nicholas DeGroote presenting Julia Dombrowski presenting

SESSION 4 SESSION 5 SESSION 6 ORAL ABSTRACTS SCHEDULE PrEP Perceptions: Access, Uptake Leveraging Technology to Linkage to Care Across Contexts and (Dis)use Promote ART Adherence and and Cultures 4:30 p.m. – 5:30 p.m. / Grand Ballroom East Treatment Success 4:30 p.m. – 5:30 p.m. / Regency 3 Moderator: Carmen Zorrilla, MD Moderator: Evelyn Ullah, BSN, MSW 4:30 p.m. – 5:30 p.m. / Regency 2 66 Changing Attitudes to PrEP Among Moderator: Benjamin Young, MD, PhD 160 Improvements in HIV-Related Outcomes Sexually Risky Men who have 32 An iPhone App/Game Improves ART Among Homeless HIV Patients Using an Sex with Men Adherence and Increases Condom Use Intensive Trauma-Informed-Care-Based Conall O’Cleirigh presenting Laura Whiteley presenting Intervention Jessica Davila presenting 118 Why I Quit: A Mixed Methods Examina- 95 Utilizing Real-Time Adherence Monitoring tion of the Reasons Gay and Bisexual Devices Among HIV-Positive Pregnant and 92 Costs and Consequences of HIV Linkage- Men Give for Stopping a PrEP Regimen Postpartum Women: Challenges Encoun- to-Care Strategies Implemented in Urban Thomas Whitfield presenting tered in the Uganda WiseMama Study and Rural South African Settings Mary Bachman DeSilva presenting Kristen Little presenting 101 Healthcare Access and PrEP Contin- uation in San Francisco and Miami 56 Real-Time Adherence Monitoring with 151 Identifying MSM and Transgender Following the US PrEP Demo Project Follow-up Improves Adherence Com- Women who Have Poor Linkage to HIV Susanne Doblecki-Lewis presenting pared to Electronic Monitoring Alone: A Care in Lima, Peru Quasi-Experimental Analysis Angela Primbas presenting 44 “I am Happy to Take PrEP so that Jessica Haberer presenting She Does Not Feel Alone”: Integrated 168 Higher Levels of Internalized HIV Stigma Delivery of PrEP and ART Facilitates 163 A Telemedicine-Delivered Cognitive at Clinic Intake Paradoxically Predict More ART Initiation and Adherence Behavioral Therapy for Adherence and Successful Linkage to Primary Care Emily Pisarski presenting Depression (CBT-AD) in HIV-Infected Katerina Christopoulos presenting women in the Deep South Mirjam-Colette Kempf presenting

10 11th International Conference on HIV Treatment and Prevention Adherence TUESDAY, MAY 10, 2016

THEMATIC ORAL ABSTRACT SESSIONS

SESSION 7 SESSION 8 SESSION 9 Making the Strategy a Reality: Adherence Approaches and Care Coordination and Navigation PrEP in the USA Interventions Across the Care Continuum 11:30 a.m. – 12:30 p.m. / Grand Ballroom East 11:30 a.m. – 12:30 p.m. / Regency 2 11:30 a.m. – 12:30 p.m. / Regency 3 Moderator: Thomas P. Giordano, MD, MPH Moderator: Tia Morton, RN, MS Moderator: Jorge Saavedra, MD

104 PrEP Uptake Among Cisgender Women at 18 A Randomized Controlled Trial of 48 A Comparison Group Analysis Aimed an Urban, Community-Based STI Clinic Rise, a Culturally Tailored Behavioral at Assessing HIV Care Coordination Oni Blackstock presenting Adherence Intervention for African Program Effectiveness Americans Living with HIV Denis Nash presenting 211 Uptake of Pre-exposure Prophylaxis Laura M. Bogart presenting (PrEP) in Young Men Who Have Sex with 86 The Impact of Patient Navigation Men is Associated with Race, Sexual 117 Testing the Health Care Empowerment Services for HIV-Positive Individuals on Risk Behavior and Network Size Model Among Persons Living with HIV Retention in HIV Care and Viral Suppres- Lisa Kuhns presenting for Medication Adherence sion in Virginia Jacob van den Berg presenting Lauren Yerkes presenting 161 Enhancing PrEP Access for Black and Latino Men Who Have Sex with Men 100 “We’re Not Just HIV Infection”: 88 Integrating the ONE CALL Statewide HIV Corina Lelutiu-Weinberger presenting Promoting Antiretroviral Adherence CALL Center: An Innovative Approach to Among HIV-Positive Women through a Linkage and Re-engagement for HIV Care 128 Expanding PrEP Implementation as Group Clinical Visit Intervention Tyffany Evans Coleman presenting a Key Initiative of the Getting to Zero Oni Blackstock presenting (GTZ) Consortium in San Francisco 61 Medication Adherence Self-Efficacy me- Albert Liu presenting 173 Survival Needs and ART Adherence diates the impact of Patient Navigation among Young HIV-Infected MSM of + Contingency Management on HIV Viral Color in Oakland Suppression Janet Myers presenting Daniel Feaster presenting

SESSION 10 SESSION 11 SESSION 12 PrEP Monitoring and Tracking at New Insights in ART Adherence Healthcare System and Theory- the Individual and Population Level Monitoring in Vulnerable Informed “Adherence” ORAL ABSTRACTS SCHEDULE 2:00 p.m. – 3:00 p.m. / Grand Ballroom East Populations 2:00 p.m. – 3:00 p.m. / Regency 3 Moderator: Jennifer Cocohoba, PharmD, MAS Moderator: Michal J. Mugavero, MD, MHSc 2:00 p.m. – 3:00 p.m. / Regency 2 78 Prevention-Effective Adherence per Short Moderator: Ira Wilson, MD, MSc 16 Increasing Antiretroviral Therapy Initia- Message Service (SMS) Surveys within 62 Pharmacy Refill Data are Poor Predic- tion Among Those Who Have Delayed, a Demonstration Project of Pre-Exposure tors of Virologic Treatment Failure in Declined, or Discontinued Medication: Prophylaxis (PrEP) among HIV Serodiscor- Adolescents Applying Critical Race Theory to Under- dant Couples in East Africa Elizabeth Lowenthal presenting stand Barriers and Inform Intervention Jessica Haberer presenting Strategies 73 A Self-Reported Adherence Measure Marya Gwadz presenting 22 Prospective Use of Urine Tenofovir to Screen for Elevated HIV Viral Load in Assay to Monitor Adherence to PrEP Pregnant and Postpartum Women on 67 Atmosphere of Risk or Family-Like Sup- Helen Koenig presenting Antiretroviral Therapy port?: Alternative Patient Experiences of Decentralized Care in North Central 54 Short Message Service (SMS) Surveys Tamsin Phillips presenting Nigeria Assessing Pre-Exposure Prophylaxis 79 Use of Unannounced Telephone Pill Grace Kolawole presenting (PrEP) Adherence and Sexual Behavior Counts to Measure Medication Adher- are Highly Acceptable among HIV-Un- ence among Perinatally HIV-infected 207 HIV-Related Stigma in Healthcare infected Members of Serodiscordant Young Adults Settings and Health Outcomes among Couples in East Africa Jeannette Raymond presenting People Living with HIV Timothy R. Muwonge presenting Whitney Smith presenting 137 Daily Text Message Responses as 71 Adapting National Estimates of Popu- Compared to Retrospective Self Report lations at Risk for HIV to Calculate the of Antiretroviral Adherence among Number of Persons with Indications for HIV-Infected Methamphetamine Users PrEP at the State Level David Moore presenting Jennifer Donnelly presenting

11th International Conference on HIV Treatment and Prevention Adherence 11 WEDNESDAY, MAY 11, 2016

THREE TOP-RATED ORAL ABSTRACTS

11:00 a.m. – Noon / Grand Ballroom East • Moderator: K. Rivet Amico, PhD

2 Increases in ART Use and Viral Suppres- 80 Prevention-Effective Adherence in a 99 A Randomized Controlled Trial of an sion among HIV-Infected Young Adults in Demonstration Project of Pre-Exposure Intervention to Maintain Suppression of the United States, 2009-2013 Prophylaxis (PrEP) among HIV Serodis- HIV Viremia Following Prison Release Linda Beer presenting cordant Couples in East Africa through Linkage to Community Care: Jessica Haberer presenting The imPACT Trial David Wohl presenting

THEMATIC ORAL ABSTRACT SESSIONS

SESSION 13 SESSION 14 SESSION 15 Treatment Adherence and ART Initiation, Persistence, Correlates and Predictors of Epidemiology and Adherence at a US Retention in Care Population Level 12:15 p.m. – 1:15 p.m. / Grand Ballroom East 12:15 p.m. – 1:15 p.m. / Regency 2 12:15 p.m. – 1:15 p.m. / Regency 3 Moderator: Heidi Crane, MD, MPH Moderator: Eugene McCray, MD, MPH Moderator: Kenneth Ngure, PhD, MSc

141 A 5-item HIV-Affect Management 103 Implementation of Antiretroviral 136 Cars, Chaos and Grief: Women of Color Scale (H-AMS): Evaluating a Novel Therapy Improved between 2001 and Report Reasons for Missed HIV Care Visits Theory-Based Construct Situated to 2010 in the US: Population Level Data Anna Finestone LeViere presenting HIV Treatment Adherence Contexts from the Medicaid Beneficiaries in Laramie Smith presenting the 13 States with the Greatest HIV 204 The Effect of Depression on Missed HIV Prevalence Medical Visits among Patients in the 15 Retention in Care Services among HIV Bora Youn presenting CFAR Network of Integrated Systems Primary Care Providers in the United (CNICS) Cohort in the United States States – National HIV Provider Survey, 105 Persistence with Antiretroviral Brian Pence presenting 2013-2014 Therapy Improved between 2001 and Jason A. Craw presenting ORAL ABSTRACTS SCHEDULE 2010 in the US: Population Level Data 201 Who Will Show? Predicting Missed from the Medicaid Beneficiaries in Visits in the CFAR Network of Integrated 159 High Mortality and Low Rates of Long the 13 States with the Greatest HIV Systems (CNICS) Cohort of Patients in Term Engagement in Care Following Prevalence HIV Care in the United States Delivery Among HIV infected Women in Bora Youn presenting Brian Pence presenting Mississippi Aadia Rana presenting 208 Nonadherence and Unsuppressed Viral 177 Predictors of Retention in HIV Care and Load across Stages of Adolescent De- HIV Viral Load Suppression One Year 11 Inpatient Hospitalizations among velopment in US Youth with Perinatally after Being Hospitalized while Out of HIV People with HIV/AIDS in New York City, Acquired HIV in the Pediatric HIV/AIDS Care 2013 Cohort Study: A Longitudinal Analysis Thomas Giordano presenting Rachael Lazar presenting Deborah Kacanek presenting

12 11th International Conference on HIV Treatment and Prevention Adherence WEDNESDAY, MAY 11, 2016 (Continued)

LATE-BREAKER ORAL ABSTRACT SESSIONS

SESSION 1 SESSION 2 SESSION 3 Prevention and Treatment Perceptions and Daily Data to Care (D2C): “Real-World” Continuum Potpourri Experiences with ART Lessons Learned 2:45 p.m. – 3:45 p.m. / Grand Ballroom East 2:45 p.m. – 3:45 p.m. / Regency 2 2:45 p.m. – 3:45 p.m. / Regency 3 Moderator: Michael J. Stirratt, PhD Moderator: Jeffrey Schouten, MD, JD Moderator: Reuben Granich, MD, MPH

169 PrEP and Sexual Health Services 3 Participants’ Perceived Barriers to 127 Lessons Learned in the Provision for Young Urban Men who have Sex Adherence vs Empirically Based of Technical Assistance to Health with Men Barriers to Adherence: Do they Agree? Departments on Using HIV Surveillance Janet Myers presenting John Sauceda presenting Data to Improve the HIV Care Continuum Kathleen Ruth presenting 158 Testing and Linkage to Care for People 5 Participants’ Perceived Barriers to Ad- Who Injects Drugs (PWID) in Kenya: herence vs Empirically Based Barriers 190 New York City’s Efforts to Make Data to Challenges and Successes to Adherence: Do they Differ by Age Care More Efficient: Lessons for Other John Lizcano presenting and Race and Ethnicity? Jurisdictions John Sauceda presenting Shakara Brown presenting 77 Seek, Test, Treat, and Retain (STTR) for People Who Inject Drugs (PWID) 50 Would HIV-Positive MSM Use a Home 180 Identifying Out-of-Care Key Populations in Kenya: An Update of this Stepped Viral Load Test? in Tijuana, Mexico: A Comparison Wedge Study Sabina Hirshfield presenting of Data-to-Care and More Traditional John Lizcano presenting Methods 89 The Critical Influence of Daily Laramie Smith presenting 156 Substance Use and the HIV Care Experiences of Internalized HIV Stigma Cascade: Findings from an HIV on Medication Non-Adherence for HIV- Community-Based Test and Treat Positive Gay and Bisexual Men Initiative H. Jonathon Rendina presenting Laramie Smith presenting ORAL ABSTRACTS SCHEDULE

11th International Conference on HIV Treatment and Prevention Adherence 13 14 2

regarding effortstoimproveoutcomesforthisvulnerablepopulation. Nevertheless, ourresultssuggesttheremaybecauseforoptimism period.not seesignificantincreasesinadherenceovertheobservation maybewarranted,to improveadherenceinthispopulation aswedid to increasesin ART prescription. ofeffectivestrategies Implementation HIV-infected youngadultsincare, whichmaybepartiallyattributable Conclusion: 69-74%, respectively). amongyoungadultsoverthetimeperiod(range 70-82%and utilization 0.04, P theviralsuppressiontrend( attenuated prescription somewhat increased from29%to46%( Results: lyzed temporaltrendsinviralsuppression(allloadspastyear). 18-24)collected6/2009-5/2014,from 636youngadults(aged weana ORALreceiving medicalcareintheUnitedStates. UsingweightedMMPdata ofHIV-infected estimates adults tem designedtoproducerepresentative Methods: this hascontributedtoimprovementsinviralsuppression, isunknown. increased ART prescription, adherence, andcareutilization, andwhether renewed focus. beenaccompaniedby Whether thesechangeshave ABSTRACTSdeveloped. alsoreceived youngadultsincarehave Effortstoengage prescription of ART andsimpler, been moretolerableregimenshave suppressed. recommenduniversal guidelinesnow CurrentHIVtreatment (ART),adults totakeantiretroviraltherapy beadherent, andbevirally Background: US CentersforDiseaseControlandPrevention, Atlanta, GA, USA R. LukeShouse Linda Beer(presenting) Adults intheUnitedStates, 2009-2013 TREND Suppression amongHIV-Infected Young Increases inART UseandViral From 2009to2013, viralsuppressionamongyoungadults sys The MedicalMonitoringProject(MMP)isasurveillance 0.02). There wasnosignificanttrendinadherenceorcare We foundsignificant increasesinviralsuppressionamong HIV-infected youngadultsarelesslikelythanolder , ChristineMattson, Bradley, Heather β =0.05, P TREND 0.01). Accounting for ART0.01). Accounting

β = 11th International Conference on 11th International - - 3 John Sauceda(presenting) to Adherence:DoTheyAgree? to investigate barrierstoadherenceandmobiletechnologies.to investigate The survey advertisedonsocialmedia(e.g.,adults usinganonlinesurvey Facebook) Methods: ART interruption. treatment importanceofmultiplebarriersinthepredictionfour-daythe relative forgetting” isasimportantotherbarrierstoadherencebyassessing in adherence-promotinginterventions. We whether evaluated “simply is acommonlyself-reportedadherencebarrierandthusaddressed Background: 2 1 Saberi Parya and substance use treatment asavehicleand substanceusetreatment toimproveadherence. overtime.dissipate supportthecalltoimprovementalhealth These data include that smalleffectsizesandbenefits that adherence interventions of andovercomingthelimitations is criticaltooptimizingHIVtreatment Conclusion: (OR =1.16, p<05). interruption. Treatment with interruptionwasinturnassociated VL status depressed yieldedthelargesteffectsize(OR=2.6, p<01)ontreatment fects weremoreimportantthansimplyforgetting. Ofthese, feeling events, drinkingalcoholandusingdrugs, side-ef andwantingtoavoid interruption, sleepingthroughdoses, feelingdepressed, day-to-daylife er, inpredictionoftreatment theresultingdominanceanalysisfoundthat commonly citedreasonfor ART non-adherence(19%, n=232). Howev non-Latino White andcollegeeducated. Simplyforgettingwasthemost Results: importance). interruption, whichresultsinarankingofdominanceweights(i.e., another intheiruniquecontributiontothepredictionofatreatment ofbarriercomparisons.combinations Eachbarrieriscomparedtoone testsallpossible that analysis isaregression-basedpairwiseapproach tionnaire plussixpsychosocialbarriersanddemographics. Dominance and barriersto ART adherenceusingthe ACTG Adherence BarrierQues least 1inthepastthreemonths), viralload(undetectablevs. detectable) assessed self-reportedfour-day interruptions(0versusat treatment University ofCalifornia, SanFrancisco, CA, USA Center for AIDS PreventionStudies, SanFrancisco, CA, USA Adherence vsEmpiricallyBasedBarriers Participants’ Perceived Barriersto The sample(N=1,217)waslargelymale, gayidentified, fromHIV-positive analyzeddata This cross-sectionalstudy Identifyingthemostimportantbarriersto ART adherence

2 “Simply forgetting” (ART) totakeantiretroviraltherapy

HIV Treatment andPreventionAdherence

1 , TorstenNeilands 2 , Johnson Mallory 2 , - - - 5 11th International Conference on 11th International their efficacy. mustaddressmentalhealthproblemstoimprove ence interventions important. barrierswerevery and substanceuse-related Thus, adher tobea majorbarrier,forgetfulness doesnotappear while mentalhealth characteristics.based onthetargetpopulation foundthat The data Conclusion: adults itwas adultsitwas middle-aged barrier foryoungadultswas alcohol orusingdrugs life events on thesizeofdominanceweights)differedbygroupings: adults (>50years). The singlemostimportantadherencebarrier(based groups:age young(18-29years), (30-49years), middle-age andolder White (n=929), (n=148), Latino andBlackadults(n=110), andthen Results: dominance weights(i.e., importance). interruption,the predictionofatreatment whichresultsinarankingof Each barrieriscomparedtooneanotherintheiruniquecontribution ofbarriercomparisons. testsallpossiblecombinations that approach and demographics. Dominanceanalysisisaregression-basedpairwise ACTG Adherence BarrierQuestionnaireplussixpsychosocialbarriers the pastthreemonths), viralload(undetectablevs. detectable)andthe self-reported four-day least1in interruptions(0versusat treatment barriers toadherenceandmobiletechnologies. assessed The survey advertisedonsocialmediatoinvestigate adults usinganonlinesurvey Methods: race andethnicity. and byage toexaminetheimportanceofbarriersstratifying approach person’s orraceandethnicity. age We usedanempiricallybasedanalytic basedona aboutwhetherthemostimportantbarriersvary is known Background: University ofCalifornia, SanFrancisco, CA, USA Saberi Parya John Sauceda and Ethnicity? Adherence: DoTheyDifferbyAgeandRace herence vsEmpiricallyBasedBarriersto Participants’ Perceived BarrierstoAd The barrierstoadherencewereexaminedbyraceandethnicity: fromHIV-positive analyzeddata This cross-sectionalstudy

for Whites, It is critical to understand how barriers to adherence vary barriers toadherencevary Itiscriticaltounderstandhow

sleeping throughdoses. Barriersto ART adherenceareextensivelystudied, yetlittle

(presenting)

sleeping throughdoses for African Americans. The singlemostimportant feeling depressed/overwhelmed , Torsten Neilands, Johnson, Mallory drinking alcoholorusingdrugs

HIV Treatment andPreventionAdherence for Latinos, and

day-to-day , andforolder . For drinking

- - 11 The matched dataset included dataset eventsfor16,648 The matched 27,049hospitalization to2013SPARCStically matched hospitals. recordsforNYCinpatient Methods: amongPWHA. hospitalization careandreasonsfor ofPWHAreceivinginpatient for characterization allowed Linking SPARCS withNYCHIVsurveillance data hospitalization tem (SPARCS) maintainsdischargerecordsforallhospitalizedpatients. reporting. New York’s Sys PlanningandResearchCooperative Statewide test ofpeoplewithHIV/AIDS(PWHA)viaHIV-related laboratory status Background: New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, Rachael Lazar(presenting) City, 2013 improve access and engagement in HIV primary care. inHIVprimary improve accessandengagement hospitalized PWHAwithHIVprincipaldiagnoses, theneedto indicating ditions. subgroupswereoverrepresentedamong Certaindemographic 14% ofallNYCPWHA. Mostwerehospitalizedfornon-HIV/AIDScon records identified16,648NYCPWHAhospitalizedin2013, anestimated Conclusion: high povertyareas. of HIVwashigherforBlacks, peoplewith AIDS, andthoselivinginvery leastoneprincipaldiagnosis proportion ofallhospitalizedPWHAwithat wereassignedto86%ofhospitalized PWHA.principal diagnoses The (26% vs17%), with andbediagnosed AIDS (72%vs59%). Non-HIV/AIDS high povertyarea(37%vs27%), ofinjectiondruguse ahistory have (56% vs48%), (87%vs77%), BlackorLatino/Hispanic livinginavery PWHA weremorelikelytobefemale(37%vs28%), 50andolder ages with diagnosed AIDS (72%). ComparedwithallNYCPWHA, hospitalized (38%),or Latino/Hispanic livinginhigherpovertyareas(69%), and Results: Revision, codes. ClinicalModification were classified ofDiseases, Classification usingInternational Ninth hospitalized PWHAandreasonsforhospitalizations. Principaldiagnoses wereanalyzedtodeterminecharacteristicsof and event-leveldata asof12/31/2013.PWHA aliveasof1/1/2013anddiagnosed Patient- HospitalizedNYCPWHAweremostlymale(63%), Black(49%) Patient-level data from HIV surveillance weredeterminis fromHIVsurveillance Patient-level data People withHIV/AIDSinNewYork Inpatient Hospitalizationsamong A match between NYC HIV surveillance and state hospital andstate betweenNYCHIVsurveillance A match New York monitorstheclinical City(NYC)HIVsurveillance , SarahBraunstein, LauraKersanske

- - - ORAL ABSTRACTS 15 16 1

management. fewerpatients,have areprivate, fundingoronsitecase andlackRWHAP mayparticularlybeneededinfacilitiesthat of recommendedservices services. navigation monitoringofretentionanddeliveringpatient conducting systematic ment inadoptingrecommendedretentionservices, particularlyfor Conclusion: (40%), substanceabuse(36%), problems(34%). andtransportation werementalhealth commonly perceivedbarrierstocareamongpatients monitoringofretention. ordosystematic services gation Providers’most navi werelesslikelytoprovide patient without onsitecasemanagement non-Ryan practices,White HIV/AIDSProgram(RWHAP)-funded andthose or moreretentionservices. smaller(400), Providersat private, and services. Fifty-five percentofferedfourormoreand84%three monitoringofretention, systematic navigation and33%offeredpatient ment reminders, 82%performedmissedvisitfollow-up, 53%used visits,96% reinforcedimportanceoffollow-up 89%providedappoint providedallfiveretentionservices: facilitiesthat 15-26%) practicedat Results: and non-response. their patients. wereweightedforunequalselectionprobabilities Data ofproviders’perceivedbarrierstoHIVcareamong weighted percentages analysesbyfacility/practicecharacteristics.stratified We alsoestimated withintheirpracticeandconducted who offeredfiveretentionservices adults incare. ofHIVcareproviders We weightedpercentages estimated Monitoring Project(MMP), ofHIV-infected probabilitysurvey anational ORAL infacilities sampledfortheMedical providers (64%responserate) Methods: services. lacking ontheextenttowhichprovidersofferrecommendedretention retainedincare.to increasetheproportionofpatients However, are data ing theimportanceofHIVcareprovidersofferingrecommendedservices (IAPAC) recentlyissuedguidelinesemphasiz have andfederalagencies ABSTRACTSBackground: 3 2 1 T.Brady West Jason A. Craw 2014 Survey,States –NationalHIVProvider 2013-

Survey ResearchCenter,Survey UniversityofMichigan, Ann Arbor, MI, USA Altarum Institute, Ann Arbor, MI, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA 5 Of1,234providerssurveyed, 21%(95%confidenceinterval:

Data werecollectedin2013-2014from1,234HIVcare Data Primary Care Providers intheUnited CareProviders Primary amongHIV Retention inCareServices Ourfindingssuggestconsiderableroomforimprove 3 , ChrisDuke The International The International ofProviders Association AIDS Care

(presenting) Increased dissemination of tools facilitating uptake oftoolsfacilitating Increaseddissemination 2 , LindaBeer 1 , Heather Bradley Heather 1 , John Weiser, 1 , GarrettGremel 1 2 , - 11th International Conference on 11th International

- - - 16 African (referredtoas Americans/Blacks andLatinos/Hispanics “PLHA decline, (ART), ordiscontinueantiretroviraltherapy mainlylow-income Background: 4 3 2 1 Noelle Leonard Alexandra Kutnick Gwadz(presenting) Marya Strategies Barriers andInformIntervention toUnderstand Applying CriticalRaceTheory layed, Declined, orDiscontinuedMedication: solutions, forthisimportantsubgroup. canimproveinterventions ing themulti-levelfactorsdrivingthispublichealthproblem, andtheir historical andculturalcontext. The perspectivesofPLHAcolorregard Conclusion: barriers tocare. peerrolemodels,incorporating andassistanceovercomingstructural the meaning/emotionalsignificanceof ART, addressingsubstanceuse, ART andbarrierscommontoPLHAofcolor, providingtimetoprocess support ofautonomy, reasonstodecline oflegitimate acknowledgement toinitiate fostering motivation ART included anon-judgmentalstance, take ART, whichhasacounter-productive effecton ART initiation. Factors aspects.negative to Providersareexperiencedaspressuringpatients imens. bothpositive and withhealthcareprovidershave Relationships inaneraofless-effectivereg andnormsshaped due inparttoattitudes psychosocialbarriersto thegreatest before proteaseinhibitorshave ART, terpreted asevidencethat ART istoxic. OlderPLHAandthosediagnosed “conspiracy beliefs.” Fear ofsideeffects, acommonbarrier, isoftenin for PLHA’s understandingof ART, bycontributingtomedicaldistrustand system andpresent-daystructuralracism. asafilter This contextserves most importantlypastabusesofpeoplecolorbythemedical/research Results: theory. Transcripts contentanalysis. wereanalyzedusingsystematic guidedbyamulti-levelsocial-cognitive semi-structured interviews study.from alargerintervention Participants completedaudio-recorded onHIVindices Black) werepurposivelysampledformaximumvariation Methods: adherence. of unpack barrierstoandfacilitators ART withsustainedgood initiation of color”). CriticalRace applies to study The presentqualitative Theory New York University, New York, NY, USA New York, NY, USA New York UniversityCenterforDrugUse&HIVResearch, Hunter CollegeSchoolofSocial Work, New York, NY, USA New York UniversityCollegeofNursing, New York, NY, USA Barriersto ART emergefromahistoricalandculturalcontext, Adult PLHAnottaking ART (N=37;78% African American/ Initiation amongthosewhohaveDe Therapy Increasing Antiretroviral Barriersto ART emergefrom, andareexperienced in, a Almost halfofpersonslivingwithHIV(PLHA)delay, 1 , CharlesCleland 3 , SylvieHonig HIV Treatment andPreventionAdherence 1 , ElizabethSilverman 1 4 , Amanda Ritchie , Amanda 1 2 , RebeccadeGuzman, , RobertFreeman,

- - - - 18 11th International Conference on 11th International promotesoptimaladherenceamong that African Americans. withaculturallytailoredintervention community-based organizations Conclusion: group(OR=2.26, intheintervention time wasgreater p=.02). Based onallfourfollow-ups, theoveralllikelihoodofadherenceover 2.27, p=.02), 4.5(OR=2.56, p=.009), and6(OR=3.91, p=.0005). months3(OR= adherence amongRiseparticipants(versuscontrols)at covariates,adherence andsocio-demographic wefoundsuperior least85%ofdosestaken)withbaselineself-reported adherence (at (86 intervention, 85control;73%men). Results: baselineandmonth6. were administeredat EventMonitoringSystem(MEMS)caps. electronic Medication barriers (e.g., stigma, medicalmistrust). counselor workedwithclients toovercomeculturallyrelevantadherence adherence. lower more sessionsprovidedtothosewhoshowed consisted of6-10individualcounselingsessionsover6months, with ortoausual-carecontrolcondition.ized totheRiseintervention Rise reported missing asself-identification African American/Black, (3)prescribed ART, and(4) advertisements. Eligibilitycriteriaincluded: (1)age tostaffandclients,study flyers, provider and clinicscommunity-based organizations ofthe viapresentations Methods: can-Americans livingwithHIV. wasculturallytailoredtoaddresstheneedsof that intervention Afri controlled trialofRise, adherence education amanualizedtreatment tailored totheneedsofthispopulation. of otherraces/ethnicities, rarelybeen have yetadherenceinterventions (ART)antiretroviral therapy andworsehealthoutcomesthanindividuals Background: 7 6 5 4 3 2 1 Nikki Rachal J.David Klein Laura M. Bogart(presenting) Living withHIV forAfrican-Americans herence Intervention AIDS ProjectLos Angeles, CA, USA AIDS HealthcareFoundation, Los Angeles, CA, USA University ofMissouri, KansasCity, MO, USA University ofCaliforniaLos Angeles, CA, USA University ofSouthernCalifornia, Los Angeles, CA, USA UniversityDominguezHills,California State CA, USA RAND Corporation, Santa Monica, CA, USA (19%),After accountingforattrition thefinalsamplewas174 A totalof216participantswererecruitedthrough a CulturallyTailored BehavioralAd A RandomizedControlledTrial ofRise, 6 Rise was very effective inimprovingadherence, Risewasvery providing , KelseyNogg 1 HIV-positive African adherenceto lower Americans have , William E. Cunningham ≥ 1 doseinthepastmonth. Participants wererandom 7 , GlennJ. Wagner 1 , G. Matt Mutchler HIV Treatment andPreventionAdherence 4 We conductedarandomized , Goggin Kathy Inlogisticregressionspredicting Adherence wasmonitoredwith referrals, andradioprint

1 2 , McDavitt Bryce ≥ 18 years, (2) 5 , SeanLawrence Surveys Surveys The - 3 - ,

2 -

, 19 Methods: notbeenfullyexplored. have lacking, anddifferencesbetweenyoungolderHIV-infected MSM use andadherence. However, are oftheseindicators estimates national (ART)men (MSM)achieveviralsuppressionthroughantiretroviraltherapy HIV transmission, HIV-infected sexwith itisessentialthat menwhohave Background: US CentersforDiseaseControlandPrevention, Atlanta, GA, USA Joseph Prejean Nicholas DeGroote(presenting), ect, 2009-2013 the UnitedStates, MedicalMonitoringProj HIV-Positive MSMReceivingMedicalCarein be beneficial. amongMSM,age may tailoredadherenceinterventions suggestingthat betweensubstanceuseandnonadherencedifferedby The association steps intheHIVcarecontinuumamongthishighlyaffectedpopulation. OMSM, supportingtheneedforcontinuedefforts toimprovethelast prevalence ofviralsuppression, ART use, andadherencecomparedto Conclusion: with nonadherenceamongallMSM. OMSM. ART sideeffectsandlower ART self-efficacy wereassociated were76%and90%among compared to76%ofothers;theseestimates among OMSM. Among YMSM, 79%ofstimulantuserswereadherent were84%and90% herent comparedto78%ofothers;theseestimates OMSM, butnot YMSM. Among YMSM, 75%ofbingedrinkersweread withadherenceamong stimulant useweresignificantlyassociated use, ART sideeffects, andlower ART self-efficacy. Bingedrinkingand YMSM weremorelikelythanOMSMtoreportbingedrinking, stimulant compared toOMSM(ART use: 77%vs94%, adherence: 77%vs89%). among thosetaking ART among werealsosignificantlylower YMSM YMSM comparedtoOMSM(39%vs72%). ART useandadherence Results: (significance:adherence differedbyage p<0.05). betweenMSM’s theassociation then assessedhow characteristicsand 25orolder(OMSM). 18-24(YMSM)and9,635MSMaged MSM aged We mL, past12months), ART use, andadherenceamong361HIV-infected sustainedviralsuppression(allloads<200 copies/ to estimate Sustained viral suppression was significantly lower among Sustained viralsuppressionwassignificantlylower We from 2009–2013 usedMedicalMonitoring Projectdata sion, ART Use, andAdherenceamong Age DifferencesinViral Suppres HIV-infected YMSM inmedicalcarehadsignificantlylower To ensureoptimalhealthanddecreasethelikelihoodof Linda Beer, ChristineMattson, -

- -

ORAL ABSTRACTS 17 18 22

benefit. tothosewhocouldmost and totargetadherencesupportinterventions highriskofHIV,in acommunityclinic very at settingamongpatients Conclusion: previous week. in thepreviousweek, and 3(8.3%)hadnottakenany TDF/FTC inthe taken TDF/FTC, leastsomebut notdaily 2(5.6%)hadtakenat TDF/FTC week8,36 subjectswithameasurementat 31(86.1%)hadrecently urine suggestingcompletenon-adherenceinthepreviousweek. Outof daily TDF/FTC inthepreviousweek, and2(4.3%)hadno TFV intheir had urine takensomebutnot suggestiveofhaving TFV concentrations consistentwithrecentadherence,concentrations 7 (15.2%) week 4,subjects withameasurementat 37(80.4%)hadurine TFV 4weeks(n=28). 2weeks(n=19)orevery collected every Outof46 hadupto 11thusfar.collected whileothershave Urinesampleswere their firstsamplecollected. hadonly1sample Somesubjectshave sample collected, yettohave and3wererecentlyenrolledhave Results: sexwithmen. 18-30whohave ages weeks to assess adherence to PrEP among men and transgender women ng/ml). Inthisprospectivecohortstudy, 2or4 urinewascollectedevery non-adherence asdefinedbylastdosemorethanoneweekprior(<10 by somebutnotdaily TDF inthelastweek(>10to<1,000ng/ml), and a doseof TDF within48hours(>1,000ng/ml), adherenceasdefined low theassaycoulddistinguishbetweenrecentadherence asdefinedby that (PPV 0.88, 95%CI, 0.69-0.97;NPV0.88, 95%CI, 0.47-0.99), suggesting ng/ml washighlypredictiveofpresence TFV inplasma(>10ng/ml) (Abstract975,validation CROI2015), urine >1,000 TFV concentration ng/ml to>10,000witha24hrturn-aroundtime. Inaprevious TFV todetermine between <10 inlogcategories TFV concentrations withhighsensitivity/specificityfor massspectrometry chromatography Methods: ORAL sexwithmen.young menandtransgenderwomenofcolorwhohave Here weutilizethisassayprospectivelytoassessadherencePrEPin aurineassaytomeasuretenofovir(TFV)inHIV-negative subjects.dated assessadherenceinaclinicaccurately setting. We developedandvali current measurements(self-report, to plasmatenofovir)areinadequate taken dailyaspre-exposureprophylaxis(PrEP). Adherence iscritical, but Background: ABSTRACTS5 4 3 2 1 Athena Zupp S. CaitlinConyngham Ganesh Moorthy Helen Koenig(presenting) Harvard Kennedy SchoolofGovernment, Kennedy Harvard Cambridge, MA, USA Hospital oftheUniversityPennsylvania, Philadelphia, PA, USA Duke University, Durham, NC, USA Children’s HospitalofPhiladelphia, PA, USA Philadelphia FIGHT, Philadelphia, PA, USA Fifty subjectswereenrolled(Table least1urine 1);47hadat We urineassayusingliquid developedasemi-quantitative Assay toMonitorAdherencePrEP Prospective UseofUrineTenofovir 2 Urine ustomonitoradherencePrEP TFV testingallowed , JessicaSima TDF/FTC (Truvada) iseffectiveinHIVpreventionwhen 2 , DevonClark 1 , KaramMounzer 1 2 , LindenLalley-Chareczko 1 , CarolineSloan 1 , GiffinDaughtridge 3 , Pablo, Tebas 1 ,

5 , 4

11th International Conference on 11th International - 24 be complexbutreduceshomelessnessandimprovesHIVother Background: 4 3 2 1 Jesse Thomas Rachel Johnson Vivian Towe Trial inNewYork City Assistance (EHPA) Randomized Controlled tion fromtheEnhancedHousingPlacement for HomelessPersons withHIV: DataforAc assistance at achievingtheseoutcomesamonghomelessadults. assistance at isbetterthanstandardhousingplacement ing withcasemanagement viral suppressionthanusualservices. Conclusion: ratio=1.96, 95%CI=1.06-3.63). maintain suppressionbetweenbaselineandsixmonths(adjustedodds [CI]=1.02-2.18),dence interval andweretwiceaslikelytoachieveor [AHR]=1.49, ofplacement(adjustedhazardsratio rates 95%confi 25% placedby134daysvs. 238days, respectively), had49%higher clients clients wereplacedmorequicklythanusual-services (p=0.04; years old, disabledorunemployed, andchronically homeless. EHPA Results: pression (viralload placement, measureslogisticregressioninHIVviralsup andrepeated proportional hazardsmodelsintimefromenrollmenttostablehousing armsinbaselinecharacteristics,study andCox curves Kaplan-Meier 24 monthspost-enrollment. through databases (forviralloads)andotheradministrative registry camefrombaselinequestionnaires,Data andtheNYCHIVsurveillance ment from22emergency housingfacilitiesforsingleadultswithHIV. Methods: HIV emergency housingresidentsareeligible, andcomparedoutcomes. services, i.e., referraltoanNYChousingplacement programforwhichall house theclient or2)usual andprovide12monthsofcasemanagement (EHPA), i.e., re- torapidly assignmenttoacasemanager immediate New York City(NYC)toeither1)EnhancedHousingPlacement Assistance living withHIV(PLWH) andwithhighsingle-room-occupancy in utilization areevolving. approach and subsequentlyprovidesupportservices. (permanent supportiveorindependent)housingasquicklypossible health outcomes. RDE Systems, Clifton, NJ, USA University of Washington, Seattle, WA, USA New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, RAND Corporation, Santa Monica, CA, USA Most study participantsweremale,Most study BlackorHispanic, PLWH wererecruitedin2012-2013viadoor-to-door recruit Suppression afterRapidRehousing Stable HousingPlacementandViral 1 , EHPA resultedinquickerhousingplacementand greater Ellen Wiewel(presenting) 4 Providing stablehousingtounstablyhousedpersonscan , JohnRojas 3 , LauraMcAllisterHollod Rapid re-housingaimstoconnectpeoplestable Rapid ≤ 200 copies/mL). We homelesspersons randomizedlow-income HIV Treatment andPreventionAdherence 2 Chi-square assesseddifferencesbetween rapid-rehous This suggeststhat 2 2 , JoanneHsu , YaoyuZhong Bestpracticesforthis 2 , 2 ,

≥ 40 -

- - - - 25 11th International Conference on 11th International vulnerable population. overcome barriersto ART forthis uptakecanimproveinterventions Conclusion: sustain ART, barriers. andtoaddressancillary emergence ofdurable, and toinitiate high-quality intrinsicmotivation hadutility.individualized approach Mechanismsofactionincluded the ical decision-makingstyleandbarriersto ART varied, theintervention’s werebeneficial.mental health/substanceusetreatment Because med Further, to exposuretosuccessfulpeerrolemodelsandnavigation These elementswereseenaslargelymissingfrommedicalencounters. personal decisions;andunpackingbarriersspecifictoPLHAofcolor. emotionalbarrierssuchasfear;supportofautonomy/ to tacklepowerful time Interviewing); pressure orjudgment(consistentwithMotivational ofreasonsfornottaking examination encouraging ART, withoutapplying Results: content analysis. were analyzedusingsystematic in-depthinterviews. transcripts on HIVindicesforqualitative Interview of malesgay/bisexual)waspurposivelysampledformaximumvariation size. A proportion(N=37;78% African American/Black; 60%male; significant changesinviralloadlevelsover8months, withalargeeffect Interviewing, andusingMotivational whichproduced nitive theory groups co-ledbysuccessfulpeers, guidedbysocial-cog navigation) (3individualsessions, intervention multi-component behavioral support in arandomizedcontrolledtrialofculturallytargeted, individualized, Methods: perspective ofthisvulnerablepopulation. data,ingredients andmechanismsofactionusingqualitative fromthe andexploresitspotentialactive describestheintervention present study increase ART uptakeandadherence, whichwasfoundefficacious. The use, andmentalhealthproblems. We to recentlytestedanintervention include fearofsideeffectsandstigma, medicaldistrust, substance low-income African Americans/Blacks andHispanics. Barriersto ART delay, decline, (ART), ordiscontinueantiretroviraltherapy mainly Background: 3 2 1 Alexandra Kutnick Noelle Leonard Nadim Salomon Initiation toIncreaseARTNew EfficaciousIntervention Understand theMechanismsofActiona Hunter CollegeSchoolofSocial Work, New York, NY, USA New York University, New York, NY, USA Mount SinaiBethIsrael, New York, NY, USA We foundtheintervention’s activeingredientsincluded: Adult PLWHA ofcolor(N=95)nottaking ART participated tinue ART: AMixedMethodsStudyto PLWHA whoDelay, Decline, orDiscon to The perspectivesofPLHAcoloronstrategies halfofpersonslivingwithHIV(PLWHA)Approximately 2 , ElizabethSilverman 1 , Marya Gwadz(presenting) Marya 2 , Amanda Ritchie , Amanda 2 , RebeccadeGuzman, SylvieHonig 3 , RobertFreeman, HIV Treatment andPreventionAdherence 2 , CharlesCleland

2 ,

- - - 2 29 ART adherence. participants’ viralsuppression, recentmedicalcareengagement, and sample ofPLHIVinSt. Petersburg with andexaminedfactorsassociated transmission continuestoincrease. recruitedacommunity This study fewer PLHIVarevirallysuppressed, mortalityishigh,AIDS-related and in Russia. ART thaninmostotherregions, uptakeinRussiaislower Background: 2 1 Sergey Tarima Wayne DiFranceisco Yuri Amirkhanian HIV (PLHIV)inSt. Petersburg, Russia Viral SuppressionamongPersons Livingwith and publichealthoutcomes. CD4+decline thanawaiting rather inordertoimproveclinicaldiagnosis needed. At astructural andpolicy level, ART inRussiashouldbeginupon men. are HIVandeffectivesubstanceabuseinterventions Integrated with substance(andparticularlyalcohol)use, especiallyamongyoung level, andadherencewerestronglyassociated poorcareengagement high proportionofPLHIVwithunsuppressedviralload. At anindividual Conclusion: be virallysuppressed. older age, lessfrequentdrinking, andatrendforfemalestomoreoften self-efficacy.medication-taking with Viralsuppressionwasassociated was predictedbymorefrequentdrinking, anxiety, state lower andpoorer arecentHIVmedicalcarevisit.predicted nothaving ART nonadherence Alcohol use, frequentdruginjection, independently andyoungerage timal adherence, and55%ofthesamplewerenotvirallysuppressed. Results: the past6months. ml), ses usedthesevariablestopredictundetectableviralload(<75copies/ attitudes,treatment andpsychosocialdistress. Multipleregressionanaly history,assessing HIVtreatment ART adherence, substanceuse, HIV Participants measures providedbloodsamplesandcompletedbehavioral online venues. SeedsthenrecruitedtheirPLHIVfriendsintothestudy. inwhichHIV-positiveology “seeds” incommunityand werelocated Methods: Botkin HospitalforInfectiousDiseases, St. Petersburg, Russia Medical Collegeof Wisconsin, Milwaukee, WI, USA ≥ 90% ART adherence inthepast30days, andHIVmedicalvisitsin 26%ofparticipantswereoutcare, 18%on ART hadsubop 241PLHIVwererecruitedusingasocialnetworkmethod Engagement, ART Adherence, and Factors AssociatedwithMedicalCare Russia’s still-expandingHIVepidemicisdrivenbythe More than 1 million HIV infections have been diagnosed beendiagnosed Morethan1millionHIVinfectionshave 1 , Anastasia Meylakhs , Anastasia 1 , Jeffrey Kelly(presenting) 1 , AlexeiYakovlev 2 2 , Timothy McAuliffe 1 , Anna Kuznetsova, Anna 1 ,

2 , - - - ORAL ABSTRACTS 19 20 32

YLWH withawiderangeofgaminginterestandexperience. to game canbeplayedbyparticipantsonaniPhoneandisappealing game canimprove ART adherenceanddecreaseHIVriskbehaviors. The Conclusion: follow-up. <0.05), andmorefrequentcondomuse(54%vs27%, final p=0.08)at improved adherenceto ART asmeasuredby Wisepill (57%vs43%, p overthecourseof16weeks (n=18)showed IMB GamingIntervention Compared tosubjectsinthecontrolgroup(n=18), participantsinthe withtheIMBinformedgame),data waswellliked, andappealing. Results: and HIVriskbehavior. comparedtoacomparisongrouponadherence,the gamingintervention tive, efficacy day)examinedthepreliminary of 28%playedgamesevery 22.1, 94% African American, 72%non-heterosexual, 100%sexuallyac among36participantson tion and4-weekfollow-up) ART (meanage Methods: and enhancegameplay. ORAL tobothmeasureadherence intotheapp/game (Wisepill) isintegrated and buildskills(e.g. condomuse). A smartpillbottlemonitoringdevice (e.g.motivation action-figuresexperiencehealthbenefitsofadherence), abouttheirhealth(e.g.mation about knowledge ART andHIV), improve increaseinfor experience absorbingaction-orientedadventuresthat Skills(IMB)Model.tion-Motivation-Behavioral While gaming, participants includessmartphone app/game contentconsistentwiththeInforma game topromote ART adherenceamong YLWH intheUnitedStates. The ABSTRACTS (ART).to antiretroviraltreatment We developedthefirstiPhone have young adultslivingwithHIV(YLWH) ofadherence suboptimalrates have Background: 3 2 1 Laura Whiteley(presenting) Laura Beauchamps Bologna Estefany Mississippi State DepartmentofHealth,Mississippi State Jackson, MI, USA Rhode IslandHospital, Providence, RI, USA University ofMississippiMedicalCenter, Jackson, MI, USA The IMB adherence intervention (integrating (integrating The IMBadherenceintervention Wisepill adherence (12-weekinterven A smallrandomizedcontrolledpilotstudy Adherence andIncreasesCondomUse ARTAn iPhoneApp/GameImproves An interactive, engaging, IMB-consistent, HIV-specificapp/ Despitetheneedforconsistentadherence, youthand 1 , Trisha Arnold 1 , LeandroMena 2 1 , Virginia Curtis , Virginia 3 , Brown Larry 2 , LaceyCraker 2 ,

2 ,

11th International Conference on 11th International - - - - 44 initiation andadherenceinHIV-infectedinitiation partners. influenced thisstrategy toexplorehow We ART data usequalitative partners untilviralsuppressionintheHIV-infected partnerwasachieved. ART toHIVserodiscordantcouples. PrEPwasofferedtoHIV-uninfected ofdeliveringpre-exposureprophylaxis(PrEP)and strategy an integrated facilitate ART initiation. The Partners Projectimplemented Demonstration and preventingnewHIVinfections.may strategies delivery Innovative a majorobstacle toachievingthegoalsofuniversaltestandtreat Background: 2 1 Norma Ware Edith Nakku-Joloba Initiation andAdherence ofPrEPandARTDelivery Facilitates ART in HIV-infected partnersinanumberofways. ofandadherenceto initiation dan serodiscordantcouplesfacilitated ART Conclusion: HIV-infected partnerssustain ART adherence. challenges. asenseofsolidarity, Sharedcircumstancescreated helping and provideemotionalsupportwhentheirpartnersfacedadherence experiencewithantiretroviralstoempathize users drewontheirown each othertotakepillsandsolvedpracticalproblemstogether. PrEP tiretrovirals concurrently, coupleschosethesamedosingtime, reminded egies evidencedthesame “couples-based” emphasis. When usingan the HIV-uninfected partnertotransitionoff PrEP. ART adherence strat HIVtransmission;and(3)enable protectionagainst method forgreater initiated ART inorderto: theirhealth;(2)addaprevention (1)preserve the dyad. Reasonsforinitiating ART reflectedthis. HIV-infected partners asameansofbenefiting wereapproached prevention andtreatment to experience ART usetogether. Uptake ofandadherenceto ART for Results: descriptive categories. partners’ experiences. werecodedusing Data Atlas.ti andorganizedinto wereexaminedforcontent,data yieldinginsightintoHIV-infected andusing experiences initiating ART andPrEP, andadherence. Interview interviews. topicsincludedqualitative experiences, Interview study site ofthePartners Projecttookpartinmultiple, Demonstration in-depth Methods: Harvard MedicalSchool,Harvard Boston, MA, USA Makerere University, Kampala, Uganda The integrated strategy positionedserodiscordantcouples strategy The integrated Forty-eight serodiscordantcouplesfromtheKampala, Uganda She DoesNotFeel Alone”:Integrated “I amHappytoTake PrEPSothat 2 ofPrEPand strategy An integrated ART forUgan delivery , Monique Wyatt , Delayed uptake of antiretroviral therapy (ART) Delayeduptakeofantiretroviraltherapy represents 1 ,Muwonge Timothy HIV Treatment andPreventionAdherence 2 , Emily Pisarski(presenting) 1 , EllyKatabira 1 , Melanie Tam, 2 - 2 - , -

48 11th International Conference on 11th International thosewhoaremostlikelytobenefit. up targetedtoward scale- practice settingssuggeststhepublichealthvalueofintervention Conclusion: 1.73, 2.11). baselinehadthehighestRRof VLS at (1.91; 12-monthfollow-up VLS at (1.73; 1.64, 1.83), withneitherEiCnor andCCP(vsnon-CCP)patients 12-monthfollow-up baselinehadthehighestRRofEiCat without EiCat with pre-enrollmentEiCand VLS status. CCP(vsnon-CCP)patients 1.23) thannon-CCPpatients. EiCand variedgreatly follow-up VLS at [CI]1.20,confidence interval 1.24)and VLS(RR=1.20;95%CI1.16, EiC(RR=1.22;95% weremorelikelytodemonstrate CCP patients (N=7,030). non-CCPpatients similar tomatched After 12months, Results: risks(RRs)ofEiCand relative we estimated 12-monthfollow-up. VLS at propensity forCCPenrollment. ComparingCCPandnon-CCPpatients, onbaselineEiCand CCPandnon-CCPpatients then matched VLS and tests For theyearbeforeandafterenrollment, weassessedEiC( distribution. withadistributionmimickingtheCCPenrollmentdate dates criteria, werandomlyassignednon-CCPindividualspseudo-enrollment meetingCCPeligibility selecting acomparisongroupofnon-CCPpatients onallpersonsreceivingHIVcareinNYC. anddemographics data After (CD4andviralload[VL])test containinglongitudinallaboratory Registry Methods: similar HIVpatients. among CCPenrollees(2009-2013)toEiCand groupof VLS inamatched We incare(EiC)andviralload suppression(VLS) compared engagement riskforsuboptimalHIVoutcomes. amongpersonsat engagement topromotecareandtreatment multiplestrategies Program (CCP)applies Background: 2 1 Denis Nash(presenting) Stephanie Chamberlin Sarah GorrellKulkarni Program Effectiveness New York, NY, USA New York CityDepartmentofHealth&MentalHygiene, City UniversityofNew York, NY, USA ≥ 90 days apart) and 90 daysapart) VLS (VL CCP patients (N=7,030)wereclinicallyCCP patients anddemographically We withNYC’s mergedCCPenrollment data HIVSurveillance at AssessingHIVCareCoordination A ComparisonGroupAnalysisAimed EvidenceofCCPeffectivenessoverusualcareinreal-world The New York City(NYC)Ryan White HIVCareCoordination 1 2 , Levi Waldron, , McKayleeRobertson 1 , Irvine Mary ≤ 200 copies/mL on latest test).200 copies/mLonlatest We 1 , SarahBraunstein HIV Treatment andPreventionAdherence 2 1 , RebekkahRobbins 2 ,

≥ 2 laboratory 2 laboratory 2 ,

50 Results: report significant(p<.01)analyses. todetermineeligibilityforavideo-basedintervention.health survey We completedanonline 11,863) recruitedfromgay-orientedwebsites/apps Methods: MSM. assessed perceivedlikelihoodofusingahome VL testbyHIV-positive to transmitHIV, thereisaneedtomonitorviralload(VL). This study (ART) antiretroviraltherapy adherenceandmaybemorelikely low Background: 2 1 Martin Downing Richard Teran unengaged, tocare. prioritypopulations ART adherence, preventforwardHIVtransmission, andlinktraditionally developing ahome VL testmayprovideanimportantnewtooltomonitor a home VL test. self-care, Inaneraofincreasingtechnology-based likely toreportsuboptimal ART adherencebutalsomorelikelytoendorse Conclusion: with endorsingahome VL test. (AOR =1.41), (AOR=1.59)wereassociated andpast-yearHIVdiagnosis 1.77; other AOR =1.65), adetectable having VL/suboptimal adherence <30 (AOR=1.84), beingnon-White(Black AOR =2.10;Hispanic AOR = (OR=2.17).and past-yearHIVdiagnosis Inmultivariableanalysis, age suboptimal adherence(Ref:undetectable/optimalOR=1.58), = 2.53;HispanicOR2.04;other1.96), adetectable having VL/ vs. withage<30 associated 30+(91%vs. 80%), non-White(BlackOR a home VL testifonebecomesavailable. Endorsingahometestwas an undetectable VL oroptimaladherence. Most(83%)endorsedusing (OR=1.71)thanmenwith likely toreportapast-yearHIVdiagnosis likely tobenon-White(BlackOR=1.39;Hispanic1.27), andmore suboptimal adherencewereyounger(18-29[53%])vs30+[39%]), more 19% reportedapast-yearHIVdiagnosis. MSMwithadetectable VL/ detectable VL orsuboptimaladherence(<90%on Wilson scale), and a past-yearHIV VL test, 92%weretaking ART, 42%reportedapast-year Hispanic, 3%other. Byself-report, allmenwereHIV-positive; 96%had Public HealthSolutions, New York, NY, USA Columbia University, New York, NY, USA Median age was41;54%were Medianage White; 29%Black, 14% From 06/01/2015-12/31/2015, U.S. HIV-positive MSM(n= Viral LoadTest? Would HIV-Positive MSMuseaHome Young HIV-positive BlackandHispanicMSMweremore 1 As HIV-positive men who have sex with men (MSM) have As HIV-positive sexwithmen(MSM)have menwhohave , Irene Yoon, 2 , Sabina Hirshfield(presenting) 2 , StevenHouang 2 , Mary Ann Chiasson 2 2 ,

ORAL ABSTRACTS 21 22 54

the contextofPrEPuse. considered forfurtherstudies(andpossiblyclinical care)tounder of serodiscordantcouplesinEast Africa. shouldbe Similarsurveys wasgenerallyhighamongHIV-uninfectedand sexualbehavior members Conclusion: (p<0.001). with surveys surveys. Participants >35yearswere morelikelytoreportchallenges majority ofparticipants(92%)didnotneedassistancetorespondthe “questions wereoffensive” (3%), andtechnicalproblems(2%). The and timeinvolved(4%). Dislikes were “questions wererepetitive” (4%), the mobilenetwork(37%), phoneitself(26%), airtimeincentive(15%), comparedtoclinicsurveys visits. to Reportedchallengeswere related number ofquestions, throughSMS and79%preferredprovidingdata was “easy,” 74%had “no challenges,” 59%were “comfortable” with completingtheSMSsurveys Ninety-four percentofparticipantsfeltthat were male, numberofyearsinschoolwas10(SD3.5). andtheaverage completed exitsurveys. was31.2years(SD8.9), age The average 62% Results: PMAP participants. exitinaconveniencesampleof acceptability wereconductedafterstudy completion.was providedforsurvey Questionnaires onSMSsurvey visit.each scheduledquarterlystudy A smallincentive(~$0.50airtime) were sentdailyfortwoweeksaround adherence andsexualbehavior high-risk HIV-1 serodiscordant African couples). onPrEP SMSsurveys projectofantiretroviral-basedHIV-1demonstration preventionamong ofthePartners Project(anopen-label,a sub-study Demonstration pilot couples enrolledinthePartners Mobile Adherence toPrEP(PMAP)Study, Methods: however, isunclear. ORALAcceptability ofquestionsonPrEPadherenceandsexualbehavior, collectioninresearchstudies. areapromisingmethodfordata surveys Background: 5 4 3 2 ABSTRACTS1 Elly Katabira Grace Kimemia Timothy R. Muwonge(presenting) Africa Members ofSerodiscordantCouplesinEast Highly AcceptableamongHIV-Uninfected (PrEP) AdherenceandSexual Behaviorare University of Washington, Seattle, WA, USA MedicalResearchInstitute,Kenya Nairobi, Kenya Massachusetts GeneralHospital, Boston, MA, USA Universityof Jomo Kenyatta Agriculture and Technology, Juja, Kenya Infectious DiseaseInstituteMakerereUniversity, Kampala, Uganda Ofthe393participantsenrolledinPMAPstudy, 104(26%) Participants wereHIV-uninfected membersofserodiscordant Assessing Pre-ExposureProphylaxis (SMS)Surveys Short MessageService 1

Acceptability for SMS surveys assessingPrEPadherence Acceptability forSMSsurveys , ReneeHeffron Given the wide availability ofcellularphonesglobally,Given thewideavailability SMS 2 , BridgetFrances O’RourkeBurns 5 , JaredM. Baeten 1 , KennethNgure 5 , JessicaE. Haberer 3 , NellyMugo 2 , BettyNankya 4 ,

11th International Conference on 11th International stand 3 1 , 56 Jessica Haberer(presenting) Quasi-Experimental Analysis Compared toElectronicMonitoringAlone:A Rural Treatment OutcomesStudy), HIV-infected adultsweremonitored Methods: onsustainedinterruptionsisunknown.real-time follow-up viral reboundandcanbedetectedinreal-time;however, theimpactof Background: 4 3 2 1 Jeffrey Martin Yap Boum costing studiesarealsoneeded. onvirologicoutcomes; of real-timeadherencemonitoringinterventions initiating ART areneeded toassesstheimpact withlong-termfollow-up withincreasedadherence.associated Randomizedtrialsofparticipants ence monitoringlinkedtohomevisitsforsustainedinterruptionswas Conclusion: mean adherence92%;p=0.35). toring (N=112)versusnoMEMSmonitoringpriorto Wisepill (N=255, was seenin Wisepill adherenceforparticipantswithpriorMEMSmoni suppression weresimilarinthetwomonitoringperiods. Nodifference clinic, depression, alcoholuse, socialsupport, foodinsecurity, andviral bytimeonstratified ART. ART regimen, education, wealth, distanceto 84% to93%(p<0.001);thisdifferencewasmaintainedinananalysis fromMEMSto switched Wisepill, meanadherenceincreasedfrom pre-ART CD4countwas141cells/ml. afterparticipants Immediately adherence monitoring. was36years, Medianage 68%werefemaleand Results: priorMEMSmonitoring.pants whohadordidnothave switch. We alsocomparedmean Wisepill adherencebetweenpartici Wisepill andcomparedittotheirobserved Wisepill adherenceafterthe to sion modelingtoprojectMEMSadherenceforparticipantsswitched monitoring with<1dayinbetweenperiods. We usedregres forparticipantswhohad>6monthsofbothMEMSand data Wisepill regimen, andHIVRNAwereassessedquarterly. We analyzedadherence andphlebotomy).visits (briefinterviews data, Socio-demographic ART Wisepill monitoring, sustained(>48hour)interruptionstriggeredhome 2011), byelectronicmonitoring(Wisepill;2011-2015). followed During for ART adherence using standardelectronicmonitoring(MEMS;2005- University ofCaliforniaSanFrancisco, CA, USA Epicentre UgandaResearchCenter, Mbarara, Uganda Mbarara UniversityofScienceand Technology, Mbarara, Uganda Massachusetts GeneralHospital, Boston, MA, USA 112 participantshad6monthseachofMEMSand Wisepill In a longitudinal observational cohort study (Uganda cohortstudy Inalongitudinalobservational AIDS 3 , BoscoMwebesaBwana with Follow-Up Improves Adherence with Follow-UpImproves Real-Time AdherenceMonitoring Inthisquasi-experimentalanalysis, real-timeadher Sustained adherence interruptions are associated with Sustainedadherenceinterruptionsareassociated 4 , Bangsberg David HIV Treatment andPreventionAdherence 1 , NicholasMusinguzi 1 2 , ConradMuzoora 2 , AlexanderTsai 2 , Peter Hunt - 4 , - 1 , - - 61 11th International Conference on 11th International target isrecommended. population, toadherenceself-efficacy increasingattention asaproximal the likelihoodofviralsuppression. arerefinedforthis As interventions Conclusion: significant(b=0.075,was statistically p=.014). = 0.142, p<.001). effect ofPN+CMonviralsuppression The mediated 12-months(b withviralsuppressionat to sixmonthswasassociated controlling forbaseline. Change inadherenceself-efficacy frombaseline self-efficacy asusual(b=0.532, scoresovertreatment p=.007), Results: controlled forage, gender, andrace. education baselineand6-months. wasmeasuredat HIV medications) 12-month follow-up. HIV care. The outcomewasHIVviralsuppression(200copies/mL)at in designedtoreducedruguseandincreaseparticipation in behaviors the PN+CMconditionalsoearnedamaximumof$1,160forengaging navigator.ipants receivedupto11sessionswithapatient asusual. (PN+CM)ortreatment management andcontingency (PN), navigation navigation ofpatient acombination included that patient were assignedtoasix-monthintervention Network ofNIDA. in July2012from11hospitalsacrosstheU.S. throughtheClinical Trials Methods: among individualswithHIVandsubstanceabusecomorbidities. improvesviralsuppression or contingency intervention management and/ self-efficacy navigation asamechanismthroughwhichpatient adherence. to medication for adherencetoHIVmedications, atheoreticallyimportantprecursor for thispopulation. tives (contingency arepossibletools toimproveoutcomes management) substance abusecomorbidities. andfinancialincen Patient navigation itive individuals, andcanbechallengingtoachieveforindividualswith Background: 8 7 6 5 4 3 2 1 Carlos delRio Jain Raul Mandler Viral Suppression igation +Contingency ManagementonHIV University ofMiami, FL, USA San Francisco DepartmentofHealth, SanFrancisco, CA, USA University,Emory Atlanta, GA, USA University of Birmingham,Alabama at AL, USA University of Texas SouthwesternMedicalCenter, Dallas, TX, USA Johns HopkinsBayviewMedicalCenter, Baltimore, MD, USA Columbia University, New York, NY, USA InstituteonDrug National Abuse, Bethesda, MD, USA 4 , Batey David PN+CM, butnotPNalone, improvedsix-monthadherence Mediates theImpactofPatient Nav Medication AdherenceSelf-Efficacy Participants wererecruitedoveratwo-yearperiodbeginning PN+CMcanimproveadherenceself-efficacy and increase 1 forHIV-posViral suppressionisthegoalofinterventions 6 , LaurenGooden , Ahnalee Brincks , Ahnalee

The 801HIV-positive, substanceusingparticipants 5 mayimproveself-efficacyThese interventions , Wendy Armstrong Adherence self-efficacy (i.e., confidencetaking

testedchangeinadherence This study 2 , LisaMetsch 8 , Daniel Feaster (presenting) 6 HIV Treatment andPreventionAdherence ,Matheson Tim 2 , MaxineStitzer PN andPN+CMpartic 7 , Allan Rodriguez , Allan Those in

Analyses 3 , Mamta 8 - - - - 8 , 62 cents is unknown andmaydifferfromadultsbecausethey maynotbe cents isunknown The utilityofpharmacy adoles intreatment-experienced refilldata outcomes. toreflectvirologictreatment beenshown have refill data methods oftrackingadherencearedesirableandinadults, pharmacy herence isamajorcause. settings, Inlow-resource low-cost, simple non-ad risenbetween2001and2012medication have deaths Background: 3 2 1 (presenting) Harriet Okatch Robert Gross Adolescents access tovirologictesting. highlights theurgentneedformore The lackofviablealternatives sensitivity andspecificityforidentifyingvirologicfailureinadolescents. Conclusion: were 60%(95%CI: 46-74%)and60%(95%CI: 53-66%). 68% (95%CI: 62-74%);thesamemeasuresforrefillnon-adherence failure were64%(95%CI:in predictingvirologictreatment 50-77%)and 0.17)). Sensitivityandspecificityforthestrengthofimmunologicfailure virologicfailure(AUCsof0.66and0.60,for indicating respectively(p= ability failure andrefillnon-adherencehadsimilarlypoordiscriminative twenty-eight (44%)adolescentshadrefillnon-adherence. Immunologic hundred nineadolescents(37%)hadimmunologicfailure. Onehundred Results: herence wasdefinedastwoconsecutiverefilladherencemeasurements ≥ failure,treatment definedastwoconsecutiveviralloadmeasurements (ART)therapy inBotswana. The mainoutcomemeasurewasvirologic Methods: medication-taking. responsible forpickingupmedications, autonomyover their buthave 400 copies/mLduring24-monthsoffollow-up. Pharmacy refillnon-ad Children’s HospitalofPhiladelphia, PA, USA Gaborone, Botswana Children’sBotswana-Baylor ClinicalCentreofExcellence, University ofPennsylvania, Philadelphia, PA, USA Fifty-three (18%)adolescentsexperiencedvirologicfailure. One tors ofVirologic Treatment Failure in Pharmacy RefillDataare Poor Predic We evaluated data from291adolescentsonantiretroviral We data evaluated 1 1 Both immunologic failure and refill non-adherence had low Both immunologicfailureandrefillnon-adherencehadlow , Gabriel Anabwani , Adolescents aretheonlygroupforwhich AIDS-related 3 , JenniferChapman 2 , Ontibile Tshume , 3 , LeahGenn 3 , Elizabeth Lowenthal 2 , Tafireyi Marukutira

- - - 2 , - ORAL ABSTRACTS 23 24 66 to supportPrEPuptakeamongsexuallyriskMSM. alcohol/substance usethesemaysuggestausefulfocusofinterventions of andpatterns perceptions ofPrEPdifferbasedupontraumahistory ness, andinterestinPrEParesignificantlymore positiveovertime. As of MSM, perceptionsofPrEPasapreventionstrategy, PrEPeffective Conclusion: 74), p=0.01, respectively). denied thesetraumas(t=-4.06(df76), p<0.001andt=-2.57(df comparedtothosewho as confidentinPrEPapreventionstrategy partnerviolencewerenot and thosewhoexperiencedsexualintimate p =0.026). Those whoexperiencedchildhoodsexualabuseandthose thanthosewithoutsubstanceusedisorders(t=2.275(df76),strategy substance usedisordersconsideredPrEPtobeabetterprevention than thoseenrolledearlier. Among recentparticipants, participantswith alland4=extremely;t-3.35(156),(scale 0=notat p=0.001) = 0.049). Similarly, recentparticipantsthoughtPrEPwasmoreeffective those enrolledearlier(1=excellentand4poor;t1.98(df189), p than participants thoughtPrEPwasabetterHIVpreventionstrategy to 60%ofearlierparticipants( Seventy-nine percentofrecentparticipantshadheardPrEPcompared percent hadtakenPrEPand18%plannedtotakeinthefuture. Hispanic. ormore.Thirty-five percenthadacollegeeducation Three 12). Sixty-sixpercentidentifiedaswhite, 20%asblack, and16%as Results: and t-tests. n=81), versusthoseenrolledearlier(6/2012-3/2013, n=116)using ORALparticipants, (4/2013-4/2014, thoseenrolledinthelastyearofstudy Methods: 6/2012-4/2014. sample ofHIV-uninfected MSMinNewEngland collectedbetween landscape, perceptionsof PrEPwereexaminedamongacommunity (MSM). To changing to PrEPwithinarapidly betterunderstandattitudes ABSTRACTSprevention efficacy, sexwithmen particularlyamongmenwhohave Background: 4 3 2 1 Samantha Marquez Conall O’Cleirigh(presenting) with Men University ofMiami, FL, USA University,San DiegoState SanDiego, CA, USA Fenway Health, Boston, MA, USA Massachusetts GeneralHospital, Boston, MA, USA The sample was 199 MSM; mean age 37-years-old(SD= The samplewas199MSM;meanage Perspectives ofPrEPwerethencomparedbetweenrecent Sexually RiskyMenwhohaveSex Changing AttitudestoPrEPamong withinthiscommunitysample These findingssuggestthat Pre-exposure prophylaxis (PrEP) has demonstrated HIV Pre-exposureprophylaxis(PrEP)hasdemonstrated 2 , Aaron Blashill , Aaron χ 2 =7.88(df1), p=0.005). Recent 1 , Abigail Batchelder , Abigail 3 , StevenSafren

4 1 , KennethMayer ,

11th International Conference on 11th International χ 2 - 2 67 Grace Kolawole (presenting) Grace Kolawole Nigeria ences ofDecentralizedCareinNorthCentral receiving care at decentralizedclinics.receiving careat of experiencesofchallengesandadvantages examinedpatient study (PLWHIV) carecloser inhaving totheircommunities. This qualitative forpeoplelivingwithHIV little isunderstoodabouttheimplications acrosssub-Saharan critical roleinscalingupservices Africa. However, Background: 4 3 2 1 Becky Genberg decentralized clinics. ofqualitycare,interpretations in therebyimprovingretentionrates relationships. maypositivelyimpactpatient These relationships management, clinics canuselocalpositioningtopromotefamily-like the riskofunwanteddisclosure. However, provider withpatient-specific Conclusion: as groupmeetingsandpositivelivingdiscussions. careand organizingactivitiessuch byofferingpatient-centered patients enforced bystaff, and whetherstafffostersocialinteractionamong clinic, whether “ground rules” forconfidentialityareestablishedand of riskorfamily-likesupport. determine whetheradecentralizedHIVclinic anatmosphere creates “family-like” ofsupportwithintheclinic. atmosphere Underlyingfactors leadtounwanteddisclosurecan alternately orpromotea ofHIVstatus ofpredictableclinic asituation forPLWHIVcreates attendance that fewer HIVpatients, HIVclinics runonspecificdaysoftheweek. This the experienceofcareforpatients. Becausedecentralizedsiteshave Results: identify recurrentthemesanddevelopdescriptivecategories. tion andexperiencesofdecentralization. wereanalyzedto Resultingdata preferences forcare, receivedperceivedimpactofdecentraliza services from alarge, urbanHIVclinic. topicsaddressedaccesstoand Interview infourfocusgroups.= 23)participated All participantshadtransferred 23(N tookpartinindividualopen-endedinterviews; (N =39)patients State,Plateau northcentralNigeria, sites. asstudy served Thirty-nine Methods: AIDS Prevention Initiative inNigeria,AIDS PreventionInitiative NigeriaLtd., Nigeria University,Brown Providence, RI, USA MedicalSchool,Harvard Cambridge, MA, USA Jos University Teaching Hospital, Jos, Nigeria Receiving care at clinics Receivingcareat inlocalcommunities’shapes located Four decentralizedclinics insmallcommunityhospitals Support?: AlternativePatient Experi Atmosphere ofRiskorFamily-Like Decentralizedclinics withincommunitiescanpose located Decentralization of HIV care and treatment hasplayeda ofHIVcareandtreatment Decentralization 3 , Oche Agbaji , HIV Treatment andPreventionAdherence These include: physical layoutofthe 1 , ProsperOkonkwo 1 , HannahGilbert 2 , NancinDadem 4 , Norma Ware, 2

1 ,

- - 71 11th International Conference on 11th International rece minority populations steps include using sub-calculations ensure optimalimpactofthisefficaciousbiomedicalintervention. forpublichealthplanningand willhelprefinestrategies These estimates bers ofhigh-riskindividualswhocouldbenefitfromPrEPinourstate. Conclusions: of theHIVburdenexists. (6.3%), residingmostlyinColorado’s highprevalenceareaswheremost including 16,094MSM(53%), 5,010PWID(58.9%), and55,164HRH high-riskforHIVandcouldbenefitfromPrEP 76,268 peopleareat 10,844 heterosexuals(0.4%). 7,500 MSM(24.7%ofHIV-negative MSM), 1,571PWID(18.5%), and high-riskforHIVandcouldbenefitfromPrEPincludingin Coloradoareat Results: forHIV.number ofHIV-negative individualsat-risk to subtractthenumbersofindividualslivingwithHIVdetermine risk group. foreach percentages todevelopstate-specific theseestimates applied forMSM, (NHBS)riskdata Surveillance PWIDandHRH.Behavioral We HIV usinglocalNational estimates population-level alternate created for PrEPusingCDCestimates. number ofpersonswithindications drugs (PWID)andhigh-riskheterosexuals(HRH). We the thencalculated sexwithmen(MSM), ofmenwhohave populations personswho inject Methods: might benefitfromPrEP. theproportion ofpersonsinColoradowho methodologies toestimate publichealthPrEPprogramming. toevaluate estimates We utilizedtwo with PrEPindications. theproportionofhigh-riskgroups Prevention (CDC)recentlyestimated toreduceHIVincidence. tervention Background 3 2 1 Deem Sarah Rowan at theStateLevel Number ofPersons withIndicationsforPrEP Gilead Sciences, Denver, CO, USA Colorado DepartmentofPublicHealth, Boulder, CO, USA Denver PublicHealth, Denver, CO, USA 2 , Jennifer Donnelly(presenting) Applying CDCmethodology,Applying 19,915persons that weestimate Census data and literature review were used to estimate reviewwereusedtoestimate andliterature Census data For wasused data bothestimates, HIVsurveillance state lations atRiskforHIVtoCalculatethe Adapting NationalEstimatesofPopu : Pre-exposureprophylaxis(PrEP)isacriticalbiomedicalin 1 , AliaAl-Tayyib We usedpractical, num real-worldmethodstoestimate Health departments need tools to adapt national national Healthdepartmentsneedtoolstoadapt ive specificsupportforPrEP. 1 , Kelly Voorhees, Utilizing risk data fromNHBS, Utilizingriskdata weestimate The CentersforDiseaseControland health equity approaches toensure health equityapproaches HIV Treatment andPreventionAdherence 2 2 , Mark Thrun ,

3 , Thomas Next We - - - 73 on ART in Cape Town,Cape in South Africa. on ART HIV viralload(VL)amongHIV-infected pregnantandpostpartumwomen betweenreportedadherenceandelevated theassociation investigated resourcesettings.adherence presentsasignificantchallengeinlow We (PMTCT). However, maternal ART adherenceisaconcernandmonitoring mended policy forpreventionofmother-to-child transmissionofHIV Background: 3 2 1 Allison Zerbe Ira Wilson Therapy tiretroviral in PregnantandPostpartum Women onAn low resourcesettings. low routine care, thissimplescalemayadd valuetoadherencemonitoringin intheeraofuniversal attention ART, within andwithfurthervalidation resourcessettingsrequiresmore adherencemonitoringinlow Maternal adherencescreener.ceiling effectandhaspotentialasafirststage reduced ing settingandthissimpleself-reportadherencescaleshowed Conclusion: ≥ scale was0.599, 0.656and0.642usinga VL cut-offof forthe medianadherencescoresandtheareaundercurve lower <1,000 copies/mL. araised Having with VL wasconsistentlyassociated adherence (score=100)ontheself-reportscale, while92%hada VL 28years,age assessment), 33%pregnantat only12%reportedperfect bach Results: analysis. Characteristics(ROC)curve Receiver Operating the adherencescalescorewasassessedusinglogisticregressionand after 16weekson ART wasincluded. between The association VL and weeks postpartum. The firstadherenceand VLmeasureforeachwoman visitsfrom uptothreestudy at ART duringpregnancy initiation tosix cognitive interviewing, and VL (AbbottRealTime HIV-1) weremeasured using ofascaleoriginallydevelopedintheUnitedStates translation into theMCH-ART study. Reportedadherence, usinganisiXhosa Methods: 10,000 copies/mL, respectively. Columbia University, New York, NY, USA University ofCape Town, South Africa University,Brown Povidence, RI, USA α =0.79). Among 452womenincluded intheanalysis(median The scaleachievedgoodpsychometriccharacteristics(Cron 1 ART wereenrolled eligiblewomen enteringPMTCTservices , LandonMyer to ScreenforElevated HIVViral Load A Self-ReportedAdherenceMeasure This wasthefirstuseofthisscaleinanon-Englishspeak 3 Lifelong antiretroviral therapy (ART) therecom Lifelongantiretroviraltherapy isnow , KirstyBrittain 2 , Elaine Abrams , 2 , Tamsin Phillips(presenting) 3 , RobertRemien ≥ 50, 3 ,

2 ≥ 1,000 and - - - - ORAL ABSTRACTS 25 26 77

ART andretention. initiation ously diagnosed.effectivefor tocarebyPCMshasbeenvery Linkage for findingPWIDwithHIVandHCV infection, including thosenotprevi PWID. testingisaneffectivestrategy ofRDSandrapid The combination Conclusion: retained incare(70/72retained). continued on ART, 0stoppedtaking ART, and0died. Thus 97.2%were to aPCMandinitiate ART. Ofthose, 72initiated ART, 70successfully (17.4%) wereHCV-positive. 74participantswereeligibletobeassigned byourstudy.those withHIVinfectionwerenewlydiagnosed 288of1658 years. 252of1659(15.2%)wereHIV-positive. About 5.6%(n=14)of rangedfrom18to82years.age firstinjectionwas28 at Medianage enrolled participantsweremale(88.6%). was32years; Medianage period with1,659foundtobeeligibleandenrolled(98.9%). Most Results: visits [RETAIN]. receive smallconditionalcashtransfersforPWIDadherencetoHIVcare cells/μL tolink ART withadherence[TREAT]. BothPCMsandPWID (PCMs)tothosewithCD4<500 and assignmentofpeercasemanagers HIV andHCVtesting[TEST], forHIV-positives, POCCD4determination sites rollout, including collectedusingtablets, data behavioral rapid [SEEK]. ORAL Cvirus(HCV)prevalenceandviralloaddetermination and hepatitis used respondent-driven-sampling(RDS)toreachPWIDsforHIV-1 Methods: testing, andretentioninHIVcareofPWIDKenya. linkage PWID. toimprove sciencestudy We fromanimplementation presentdata high-riskoftransmissionincludingviral suppressionamongpersonsat ABSTRACTS (ART)(WHO) recommendedearlierantiretroviraltherapy toenhance among peoplewhoinjectdrugs(PWID). The World HealthOrganization Background: 3 2 1 John Lizcano(presenting) Charles Cleland Kenya: AnUpdateofaSteppedWedge Study Yale University, NewHaven, CT, USA ofHealthKenya, Nairobi,Ministry Kenya New York University, New York, NY, USA We collected study data in six-time-periods as PWID service insix-time-periodsasPWIDservice We data collectedstudy 1,677 individuals were screened during the fifth intervention 1,677individualswerescreenedduringthefifthintervention This stepped-wedge-cluster-randomized-design evaluation for People WhoInjectDrugs(PWID)in Seek, Test, Treat andRetain(STTR)

Current Kenyan guidelines facilitated accessto guidelinesfacilitated Current Kenyan ART among HIVinfectionsinsub-Saharan Africa increasinglyoccur 1 , HelgarMusyoki 3 2 , Ann Kurth, Ann 3 , Peter Cherutich

2 ,

11th International Conference on 11th International - 78 Jessica Haberer(presenting) cordant CouplesinEastAfrica sure Prophylaxis(PrEP)amongHIVSerodis within aDemonstrationProjectofPre-Expo Background: 6 5 4 3 2 1 Jared Baeten Nicholas Musinguzi Nelly Mugo to real-time SMS data collection. to real-timeSMSdata additional sexualpartners), tied aswellPrEPadherenceinterventions Africa. Futurestudiesshouldexploreotherrelevant riskfactors(e.g., high amongHIV-uninfected membersofserodiscordantcouplesinEast prevention-effective adherencewasgenerally that risk andindicated Conclusion: p =0.85). daysreportingcondom useornocondom(87%vs85%,for survey not reportingversussex(78%vs85%, p<0.001), butsimilar use was<6months, days forsurvey meanPrEPadherence waslower which timemeanPrEPadherencewas85%(SD28). While partner ART partner ART days, use <6 months)wasreported on 21% of survey during sent.completing 72%ofallsurveys HIVrisk(i.e., condomlesssexand 31 years. (mean47/person), Participants 16,512SMSsurveys answered Results: hours. HIV-infected partneruseof ART wasobtainedthroughself-report. visits, askingaboutPrEPadherenceandsexualactivityintheprior24 weresentfor~7daysbeforeandafterquarterlystudy surveys on interest, personalcellphoneownership, andabilitytouseSMS. SMS enrolled intothePartners Mobile based Adherence toPrEPsub-study ART for>6months. sites,At twostudy HIV-uninfected participantswere totakePrEPuntiltheirHIV-infectedencouraged partnerhadbeentaking serodiscordant couplesinEast Africa. HIV-uninfected participantswere (ART) PrEPandantiretroviraltherapy amonghigh-risk of integrated Methods: short recallperiods. phones, over areapromisingmeansforcollectingthisdata SMSsurveys use ofmultiplepreventionstrategies. Givenwidespreaduseofmobile andconcurrent riskbehaviors ofdynamic adherence requiresknowledge tion toolonlyduringriskexposure. Understandingprevention-effective Mbarara UniversityofScienceand Technology, Mbarara, Uganda University of Washington, Seattle, WA, USA MedicalResearchInstitute,Kenya Nairobi, Kenya Infectious DiseaseInstituteMakerereUniversity, Kampala, Uganda Universityof Jomo Kenyatta Agriculture and Technology, Juja, Kenya Massachusetts GeneralHospital, Boston, MA, USA 393 participants enrolled; 68% were male and mean age was 393participantsenrolled;68%weremaleandmeanage The Partners Projectwasanopen-labelstudy Demonstration Short Message Service (SMS) Surveys (SMS)Surveys Short MessageService Prevention-Effective Adherenceper 4 , EllyKatabira SMS surveys allowed forassessmentofperiodic, allowed SMS surveys dailyHIV 5 Prevention-effectiveadherencedescribesuseofapreven

6 , BridgetBurns HIV Treatment andPreventionAdherence 3 , Bangsberg David 1 , KennethNgure

1 , ReneeHeffron 1 , LaraKidoguchi 2 ,Muwonge Timothy 5 , ConnieCelum 5 ,

5 , 3 - , - - 79 11th International Conference on 11th International intoadherenceassessments. should beintegrated technologies othercommunication challengessuggestthat plementation multi-level barrierstoadherenceimportantforinterventions. Someim Additionally, unlikeotheradherence measures, thisprotocolrevealed the feasibilityofunannouncedtelephonepillcountswithPHIV+ AYAs. proportion ofparticipantsenrolledandcontributeddata, demonstrating es (e.g., unreliablephoneservice, unpredictableschedules), ahigh Conclusion: no healthinsurance, sub-optimalpharmacy levels. services) problems), contextual(e.g., limitedsupportsystems), andstructural(e.g., individual(e.g.,at hoarding, medication disorganization, mentalhealth was 77%(range=0-100%;SD24). Callsrevealedadherencebarriers taken 1-2times/day. past-monthadherenceacrossallcalls Average AYAs whodidandnotprovidedata. ART regimensincluded 1-14pills, (p<.02);therewerenootherdifferencesbetween eligible ence data were lesslikelythannon-Black/African Americans tocontributeadher American; 75% participants contributedadherencedata: 61%female;Black/African six refusedand27hadincomplete/invaliddata. Two-thirds ofeligible (e.g., on ART, phoneaccess, ofthese, therapy); nodirectlyobserved Results: sibility, differencesinparticipation. andsociodemographic/psychosocial resulting inthree ART adherencescores. We examinedacceptability, fea were enrolledinapillcountprotocoloffourmonthlyunannouncedcalls, HIV-infectedperinatally (PHIV+)youthinNYC, participantstaking ART Methods: isthefirsttoexamineitsfeasibilitywithstudy AYAs (18-27years). HIV-infected tobevalid with middle-aged adults.assessment shown This strategies. adherence Unannouncedtelephonepillcountsarealow-cost intervention anddevelopmentofappropriate behaviors cation-taking adherencemeasurespreventfullunderstanding ofmedi Inadequate groups.and lesslikelytoachieveviralsuppressionthanotherage (ART) highriskforsub-optimaladherencetoantiretroviraltherapy at Background: 2 1 Amelia Bucek Elaine Abrams Moira Kalichman Adults ence amongPerinatally HIV-Infected Young Columbia University, New York, NY, USA University ofConnecticut, NewHaven, CT, USA Among 114participantswhocompletedFU5, 102wereeligible At the fifth follow-up (FU5) of a longitudinal study (CASAH)of (FU5)ofalongitudinalstudy At thefifthfollow-up Counts toMeasureMedicationAdher Use ofUnannouncedTelephone Pill challeng Although weidentifiedprotocolimplementation HIV-infected adolescentsandyoungadults(AYAs) are 2 2 , , Elkington Katherine Jeannette Raymond(presenting) ≥ 1 , ClaudeMellins high-school/GEDdiploma. Black/African-Americans 2 , Cheng-ShiunLeu 2 , Patricia, Warne HIV Treatment andPreventionAdherence 2 2 2 , CurtisDolezal , SethKalichman 2 - , - - - 1 - , - 80 Methods: assessing individualandpublichealthbenefits. prevention-effective adherencetoPrEPforHIVpreventioniscritical prevention toolonlyduringriskexposure. A detailedunderstandingof Background: 5 4 3 2 1 Connie Celum Nelly Mugo Jessica Haberer(presenting) cordant CouplesinEastAfrica sure Prophylaxis(PrEP)amongHIVSerodis they have concernsaboutdailyPrEPuseortakefor>6months. they have taking PrEPmayneedadditionalsupportorotherpreventionoptionsif Projectreflectedprevention-effectiveadherence.stration Individuals Conclusion: partner (RR0.77;p=0.001). >6 months(RR0.93;p<0.001), andnolongertogetherwiththestudy p <0.001), pregnancy/pregnancy intention(RR1.05;p=0.03), follow-up withnoreportedconcernsabouttakingdailyPrEP (RR1.24; associated reportedrisk(p<0.01).pant-months withlow Sufficientadherencewas ipant-months withprobableorhighreportedriskand61%ofpartici adherence wasconsideredsufficientforHIVpreventionin83%ofpartic in 87%ofparticipant-months, ofwhich17%werehighrisk. PrEP in themonthbeforeenrollment. RiskforHIVwasconsideredprobable was29years,median age and67%ofcouplesreportedcondomlesssex Results: models. equation generalized estimating usingmultivariable withsufficientadherencewereevaluated sociations ifnosexwasreported.was alsoreported;riskconsideredlow As was reportedbefore6monthsof ART andhighif<100%condomuse studies). RiskforHIVwasconsideredprobableifsexwithinthecouple of4/7dosesperweek(assuggestedbyprior anaverage at estimated this analysis, sufficientadherenceforpreventionofHIVacquisitionwas for >6months. Adherence wasdeterminedbyelectronicmonitoring. For totakePrEPuntiltheirHIV-infectedencouraged partnerhadtaken ART serodiscordant couplesinEast Africa. HIV-uninfected participantswere (ART) PrEPandantiretroviraltherapy amonghigh-risk of integrated Kabwohe ClinicalResearchCenter, Kampala, Uganda Infectious DiseaseInstitute, Kampala, Uganda MedicalResearchInstitute,Kenya Nairobi, Kenya University of Washington, Seattle, WA, USA Massachusetts GeneralHospital, Boston, MA, USA 985HIV-uninfected PrEP;67%weremale, participantsinitiated The Partners Projectwasanopen-labelstudy Demonstration Demonstration ProjectofPre-Expo Prevention-Effective Adherenceina 3 , ElizabethBukusi The majorityofparticipant-monthsinthePartners Demon Prevention-effectiveadherencedescribestouseofa 2 , JaredBaeten 2 3 , EllyKatabira 1 , LaraKidoguchi 4 , Stephen Asiimwe , 2 , ReneeHeffron 5 , 2 ,

------ORAL ABSTRACTS 27 28 84 among newprescribers. protocol development/implementation, andcontinuingmedicaleducation careproviders,outreach toprimary technicalassistanceonPrEP greater CDCguidelines.less thantwo-thirdsfollowed Findings further motivate Conclusion: CI 1.6-13.6). dailyPrEPis 2.2-19.3) andknowing 95% CI1.5-12.2), (aOR=6.5, prescribingPrEPto>5patients 95%CI = 3.7, 95%CI1.1-12.4), firstprescribingPrEPbefore2015(aOR=4.3, (77%). withprescribingPEP(aOR Guidelineadherencewasassociated herence toguidelines, leastfrequentlyadheringtoquarterlyHIVtesting 95% CI1.1-5.3). Among PrEPprescribers, 61%(56/92)reportedad (aOR =6.7, 95%CI2.9-15.5), aPrEPprotocol(aOR=2.4, andhaving care=8.3,(ORHIV versusprimary 95%CI2.7-25.0), prescribingPEP had prescribedPrEP. withproviderspecialty Prescribingwasassociated Results: practice type. examined usinglogisticregression, controllingforproviderspecialtyand (p<0.05)betweencharacteristicsandoutcomes were of association and practicecharacteristics(type, PrEPprotocol). having Significance prescribedPrEP,patients dailyPrEPis andknowing identity, everprescribedPEP, yearfirstprescribedPrEP, numberof provider characteristics(specialty, training, year, graduation sexual screening).semi-annual STIandcreatinine Questionsalsoaddressed testing, adherence/riskreductioncounseling, sideeffectassessment, among prescribers, adherencetoallCDCPrEPguidelines(quarterlyHIV request. assessedtwooutcomes:The survey everprescribingPrEPand, ORALcampaigns or, amongarandomsample, viaInternetsearchorphone email (12/2015-01/2016). Emailaddresseswereobtainedduringthe Methods: guidelines. we examinedPrEPprescribingandadherencetoCDCPrEP-related prescribing, HIV. targetingpracticesdiagnosing survey, Inafollow-up ABSTRACTSpublic healthdetailingcampaigns(10/2014-4/2015)topromotePrEP under-prescribed. The New York City(NYC)HealthDepartmentconducted Background: 2 1 Sarit Golub Paul Salcuni(presenting) among NewYork CityProviders, 2015-2016 Hunter College, CUNY, New York, NY, USA New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, was32%(191/604).The responserate Overall, 59%(100/169) Detailed providers were recruited for the online survey via Detailedproviderswererecruitedfortheonlinesurvey 2 and AdherencetoClinicalGuidelines Associations withPrEPPrescribing , Arjee Restar , Arjee InasampleofNYCproviders, mosthadprescribedPrEPbut Pre-exposureprophylaxis(PrEP)preventsHIVyetremains 1 , ZoeEdelstein 1 , JulieMyers ≥ 90% efficacious(aOR=4.7, 95% 1 1 , DemetreDaskalakis ≥ 90% efficacious)

1 ,

11th International Conference on 11th International - 86 sociodemographic factors,sociodemographic client type, ofthe location andgeographic between in calendaryear(CY)2015wereanalyzedandrelationships analyzed (n=572). Overallretentionincareandviralsuppressionrates 1, fromJanuary sites acrossthestate 2014-December31, 2014, were Methods: on retentionandviralsuppression. (PN)forPLWH navigation examinestheimpactofpatient study in Virginia playanincreasinglyimportantroleinHIVcare.Patient Navigators This outcomes forpersonslivingwithHIV(PLWH) andforpublichealth. Background: Virginia DepartmentofHealth, Richmond, VA, USA Gilmore,Kate in Virginia Retention inHIVCareandViral Suppression longer-term outcomes. care. Furtheranalysiswillexploreinteractionsamongvari toHIV PNprogramsmaybeparticularlyusefulforinitiallinkage that programs. suggest Findings population amongthenewlydiagnosed aremuchhigheramongclients byPN suppression rates served Conclusion: urban programs(CI, 1.4-2.9). at times morelikelytobevirallysuppressedin2015thanthoseserved programs were1.6timesmorelikelytoberetained(CI, 1.1-2.4)and2.0 in 2015(CI, 1.2-4.3)comparedtonon-Hispanics. byrural Clientsserved retained (CI, 1.8-10.4)and2.2timesmorelikelytobevirallysuppressed (CI),fidence Interval 1.3-4.7). Hispanicswere4.3timesmorelikelytobe likely toberetainedin2015comparedclients losttocare, (95%Con rally suppressedin2015. clients Newlydiagnosed were2.4timesmore included inthisstudy, 71.9%wereretainedincareand68.2%vi Results: and outcomesin2015. betweenthesefactors regression wasusedtodeterminetherelationship PN programonHIVoutcomeswereexamined. logistic Multivariate Of the 572 patients enrolledinPNprograms Of the572patients Virginia in2014 HIV care outcomes from clients served with PN services at six at HIV careoutcomesfromclients withPNservices served vices forHIV-Positive Individualson The ImpactofPatient NavigationSer ComparedtoallPLWH in Virginia, retentionandviral Retention inHIVcareandviralsuppressionarecritical Lauren Yerkes (presenting)

HIV Treatment andPreventionAdherence , Anne Rhodes , Anne ables and - - - 88 11th International Conference on 11th International the uptakeofcallline. process,especially insettingswithoutanactivelinkage could increase instrument, and continuousmarketing, onlineHIVproviderdirectory ilarly toONECALL’s HIVreferralline. survey anadaptable Incorporating Conclusion: re-engagement. callers whohadneverseenanHIVproviderandneedingcare during thesametimeofONECALLpossiblyreducednumber effectiveness inreferralstocare. referralprocessesimplemented State referrals toanHIVmedicalproviderand/orSBC, theprogram’s indicating never seenanHIVmedicalprovider. Ofthesecallers, 94%accepted or toboth(n=44/122, 36%). Importantly, 13%(n=16)ofcallershad (n=80/122, BridgeCounselor(SBC)foradditionalservices State 66%) Most callerswerereferredtoanHIVmedicalprovider(n=68/122, 56%), 21%and7%, werethemostfrequentat prior mistreatment respectively. 43%). Among callerswhoreportedbarrierstocare(n=70), costsand of HIV-infected individualshadnoreported barrierstoHIVcare(n=52, African Americans (n=77, 63%), andmales(n=72, 59%). Nearlyhalf 15% fromnon-HIVmedicalproviders. Callvolumeswerehighestamong Results: callers’ needs. HIV providerlistwithdetailedclinic asaresourcetoaddress information nurses. Additionally, anupdated, wecreated comprehensivestatewide fromtrained casemanagers employed HIV careprovidersand/orstate intervention,ate counseling, barrierassessment, andtailoredreferralsto inNorthCarolina. to identifyHIVcareservices toll-free HIVreferrallineforPLWH andtheirnon-HIVprovidersforhelping Methods: HIVcare. beensuccessfulinfacilitating have living withHIV(PLWH) fromaccessingHIVcare. Nurse-ledinterventions Background: Hill, Chapel University ofNorthCarolinaat NC, USA Anna Finestone LeViere, EvelynByrdQuinlivan Tyffany Evans Coleman(presenting) for HIVCare Approach toLinkageandRe-Engagement Of 122callsreceived, initiated, 85%werepatient comparedto From 2013-2015, ONECALLwasimplementedasastatewide, HIV CallCenter:AnInnovative Integrating theONECALL Statewide Existing call center infrastructures could be leveraged sim Existing callcenterinfrastructurescouldbeleveraged Perceived stigmaandstructuralbarrierspreventpersons

HIV Treatment andPreventionAdherence , CynthiaGay, Callersreceivedimmedi

- - 89 HIV-positive GBMcollectedaspartofathree-week prospectiveonline Method: adherence thanindividual-level(trait)stigma. ofdaily maybeabetterindicator fluctuations (state) ARTsituational ever, acrosssituations, experiencesofstigmacanfluctuate andthese (ART). worseadherencetoantiretroviral therapy HIV stigmahave How Background: 2 1 Jeffrey T.Parsons H. JonathonRendina(presenting) Gay andBisexual Men Medication Non-AdherenceforHIV-Positive meaningful improvementsin ART adherenceforHIV-positive GBM. be designedtorecognizeincreasedinternalizedHIVstigmamayprovide individual-level (trait)measuresofboth. can that Mobileinterventions odds ofnonadherenceto ART, evenafteradjustingforsocialstigmaand guilt, withsignificantlyhigher shame)fromday-to-daywereassociated Conclusion: (internalized andsocial)werenotassociated. experiences ofsocialstigmaandindividual-level(trait)measureseach level(AOR=3.50,their average 95%CI[1.04, (state) 11.79]);situational internalizedHIVstigmaabove (state) a 1-unitincreaseinsituational oddsofnon-adherenceondayswherethey experienced times greater non-adherence wasreportedon7.6%ofdays. Participants had3.5 was10(media=9).mean yearssincediagnosis Overall, medication 32% collegeormore). was38years(median=33.5)and Meanage 30% full-time), background(68%lessthancollege, andeducational Black, 25%Latino, 25% White), (58%unemployed, status employment Results: non-adherence. andusedtopredictdailyaverages aroundthose fluctuations ART(state) (trait)andsituational intoindividual-levelaverages were disaggregated to hide, aboutjudgement)weregivendaily. worry These dailymeasures internalized stigma(e.g., guilt, shame)andsocialstigma(e.g., wanting since HIVdiagnosis, race, andage. MeasuresofHIV-related formsof structure andrandomintercept, cycle, andadjustedfordayofdiary time study.diary We utilizedmultivariablemodelswithan AR(1) covariance University ofMiami, FL, USA New York, NY, USA Studiesand Center forHIVEducational Training, HunterCollege, CUNY, We usedmultilevel modelingtoanalyze585dailyreportsof40 The samplewasdiversewithregardtorace/ethnicity(35% riences ofInternalizedHIVStigmaon The CriticalInfluenceofDailyExpe Fluctuating (state) levelsofinternalizedHIVstigma(e.g., (state) Fluctuating Studies have found that individualswhoexperiencemore foundthat Studieshave 1 1 , SitajiGurung 1 , StevenSafren 2 - , -

ORAL ABSTRACTS 29 30 90 men who have sexwithmen. men whohave weredevelopedinstudiesof outcomes inwomenasthesecategories determine theclinical forPrEP relevanceoftheseadherencecategories tion wasadherentandSRaccurate. Futurestudiesareneededto thispopula contrast topublishedstudiesinfemalesonPrEPdate toconceiveintheUS.subjective adherencetoPrEPinwomentrying In Conclusion: between DBSandSR(r=0.42, P=0.13). (median =1,096.33;IQR683.47). We correlation foundamoderate week. was1,172.96+/-508.41 state steady MeanDBSdruglevelat tablets/wk, 0/14(0%)2-3tablets/week, and13/14(93%)>4tablets/ included:number ofwomenineachDBSdosingcategory 1/14(7%)<2 29 daysand86%ofallwomenreported<1misseddose(IQR=1). The was2years.median lengthofcurrentrelationship MeanPrEPusewas 32 years, 63%were AA, 68%hadsomecollegeor above education, and onemonth. and14hadDBSresultsat the UnitedStates was Medianage Results: betweenDBSandSRmeasuredascontinuous variables.the association based ona17-dayhalf-life. wasusedtoassess Spearmancorrelation tenofovir disoproxilfumarate. dosingadjustmentwasmade state Steady spot (DBS)fortenofovirlevelsonemonthafterstartingemtricitabine/ Methods: for conceptionwithHIV-positive men. ORALself-report andbloodlevelsamongHIV-negative womenwhousedPrEP needed. measuredby We toassessadherencerates conductedastudy is womentoadherePrEPintheUnitedStates motivates tion ofwhat Background: 7 6 5 ABSTRACTS4 3 2 1 Ashley Leech Jenell Coleman Emily StinnettMiller in theUnitedStates Conception withHIV-Positive MalePartners Drexel UniversityCollegeofMedicine, Philadelphia, PA, USA University ofColoradoDenver, CO, USA Philadelphia FIGHT, Philadelphia, PA, USA Johns HopkinsMedicalSchool, Baltimore, MD, USA Boston UniversitySchoolofPublicHealth, Boston, MA, USA Boston MedicalCenter, Boston, MA, USA Northwestern University, Chicago, IL, USA 16 HIV-negative women were enrolled at 4medicalcentersin 16HIV-negative womenwereenrolledat Self-reported(SR)measureswerecomparedtodriedblood Negative Women Attempting Adherence toPrEPamongHIV- itcomparesobjectiveand isuniqueinthat This study 3 The efficacy ofPrEPisdependentonadherence. Examina , Erika Aaron(presenting) 4 , HelenKoenig 1 , MargaretSullivan 5 , Cabral Howard 2 , Mari-Lynn Drainoni 7 3 , Peter, Anderson 3 ,

6 , 11th International Conference on 11th International

- - 92 Methods: (POC CD4+ TA) inurbanandruralsettingsSouth Africa. (POCCD4+CF),care facilitation andPOCCD4withtransportassistance point-of-care CD4counttesting(POCCD4), POCCD4withlongitudinal inthe strategies tiveness ofthreelinkage-to-care Thol’impilo study: Background: 3 2 1 Griffiths Kubeka Chris Hoffmann African Settings Implemented inUrbanandRuralSouth timely initiation of timely initiation ART. care, toimprove whilePOCCD4alonewasthemostefficient strategy to toimprovingtimelylinkage CF wasthemostcost-effectiveapproach here, strategies. evaluated alternative Oftheinterventions POCCD4+ needtobeconsideredinthecontextof implement suchinterventions of care andinitiation ART inthisstudy, buttheincrementalcoststo intoHIV ortransportreimbursement)improvedtimelyentry facilitation Conclusion: CD4 arm($793), versusover$1,500intheothertwoarms. TA). Incrementalcostspercaseinitiating ART inthePOC were lowest linked tocarerangedfrom$905(POCCD4+CF)$1,967 sites.the urbanandruralstudy Incrementalcostperadditionalcase arm to$77.30inthePOCCD4+CFarm. Costsweresimilarbetween Results: ART with180days, initiation post-initialHIVdiagnosis. clinical intoHIVcareby90days,costs against outcomesofentry and perspective usinganingredientsbasedapproach. (in2014USdollars)fromahealthsystems mental costsofeachstrategy 40%. tothestandardofcare(SoC), Relative wemeasuredtheincre and180-day CF increased90-dayentry-into-care ART by intitiation HIV counselingandtesting(HCT)inSouth Africa, inwhichPOCCD4+ withHIVduringmobile trialamong2,398adultsdiagnosed pragmatic Aurum Institute, Johannesburg, South Africa Baltimore, MD, USA Johns HopkinsBloombergSchoolofPublicHealth, Johns HopkinsUniversitySchoolofMedicine, Baltimore, MD, USA Average per-clientAverage costsranged from$20.67inthePOCCD4 We conductedanunmaskedindividuallyrandomized HIV Linkage-to-CareStrategies Costs andConsequencesof POC CD4 testing (either alone or in combination withcare POC CD4testing(eitheraloneorincombination We theincrementalcostsandclinical evaluated effec 1 3 , Dowdy David , TonderaiMobuto HIV Treatment andPreventionAdherence 2 , SalomeCharalambous 3 , Kristen Little(presenting) We comparedthose

3 ,

2 - - 95 11th International Conference on 11th International widespread use, technicalissuesrequire resolution. sideeffectsanddisclosurecation needfurtherexploration, andbefore real-time, web-linkedmonitoringof adherence. Concernsaboutmedi andtechnicalfactorsrepresentedsubstantialchallengesto behavioral Conclusion: (41/58lapses,explanation 70.7%). disclosure (13/72, 18.1%). side effects(21/72, 29.2%), inconvenience(14/72, 19.4%), andfearof reasons. (27.4%) tounknown 72 (40.2%)wereduetobehavioral, 58(32.4%)totechnical, and49 over~4837monitoringdays),period (mean1.1lapse/subject of which subjects, overthepre-intervention weidentified179totalsignallapses adherence was81.6%(SD18.4%)measuredby WPC. Among enrolled 2.5previouspregnancies(range1-12).women hadonaverage Mean married. This wasthefirstpregnancy for28.6%ofwomen;multiparous school, andsecondary completed primary respectively;and74.2%were period.tervention was25.1years(SD5.6);40.7%and51.5% Meanage Results: 48 hoursormore. (usual care). Duringthismonth, of alladherencelapses weinvestigated (remindersandcounseling)orcontrol randomized themtointervention monitored subjects’adherenceusing WPC foronemonthandthen in Ugandausedawirelesspillcontainer(WPC)tostoretheir ART. We Methods: monitoring devices. WiseMama assessedthetechnicalfeasibilityofPPPW’s useofreal-time successfully, abouttheirusebyPPPW. littleisknown Onecomponentof usedsuchdevices settingshave HIV-positive inlow-resource patients counselingtoPPPWinitiating dose-taking anddata-informed ART. While monitorstoprovideSMSreminderstriggered by late medication Uganda thepotentialutilityofreal-time isevaluating ‘WiseMama’ Study (ART).face particularchallengesadheringtoantiretroviraltherapy The Background: 4 3 2 1 Lisa J. Messersmith Barbara Mukasa HHamer Davidson Harriet Chemusto BachmanDeSilva (presenting) Mary WiseMama Study Challenges EncounteredintheUganda Positive PregnantandPostpartum Women: Makerere University, Kampala, Uganda Veterans Health Administration, Washington, DC, USA Mildmay Uganda, Kampala, Uganda Boston UniversitySchoolofPublicHealth, Boston, MA, USA 165womenwereenrolled;132(80%)completedthepre-in ART-naive clinics twoantenatal pregnantwomenattending Monitoring DevicesamongHIV- Utilizing Real-Time Adherence twoUgandanclinics,Among pregnantwomenattending HIV-positive pregnantandpostpartumwomen (PPPW) 2 , Justin Tepe, 2 , JuliaGasuza 1 , RachaelBonawitz 1 Signal strength was the primary technical Signal strengthwastheprimary

1 Top reasonsincluded behavioral fearof , KimberlyBarrett 2 , JosephKyebuzibwa HIV Treatment andPreventionAdherence 1 1 , SegganeMusisi , LoraSabin 1 , JennaMenefee 1

, NafisaHalim 2 , Allen L. Gifford 4 ,

1 1 , ,

- - 3 , 99 ART release. following HIVcarevisits,attend reducebarrierstocare, andmaintainadherenceto andself-efficacy designedtoenhancemotivation to an intervention prisoners re-enteringthecommunity. Inresponse, wedevelopedimPACT, Background: 2 1 Kevin Knight Jennifer Groves Patrick Flynn imPACT Trial through LinkagetoCommunityCare:The of HIVViremia followingPrisonRelease policy toHIVprevention. approaches andotherstrategic prison release. oftheseforces isessentialtoinform The characterization challengeviralsuppressionafter directly addressedbytheintervention ofviralsuppression.but notrates forcesnot These resultssuggest that care, andsupportadherencesignificantlyincreased careengagement HIV-positive prisonreleaseestoaccessHIV care, to linkage facilitate Conclusion: gency medicalclinic visit(P=0.02). outpatient (86%) inimPACT leastonenon-emer at vs122(75%)inSOCattended werecomparable. ofmissingweek24data imputation Byweek6, 138 respectively (OR=0.94, 95%CI, 0.56to1.56). multiple Resultsfollowing Of these, 62%and63%inimPACT andSOChadHIVRNA<50copies/ml, use problemhistory. At week 24, for253(65%). HIVRNAwasavailable highpsychologicaldistress,reported high/very and67%asubstance was44years;78%weremen,Median age 65% African American, 31% Results: weeks2,at 6, 14, and24, post-release. staff contact.planning andacellphoneforstudy HIVRNAwasassessed weeks oftext ART reminders. The SOCarmreceivedroutinedischarge for communitycarewithin5daysofrelease, andacellphonefor12 lease phonesessions, pre-releaseneedsassessmentandappointment byupto6post-re sessionspre-releasefollowed interviewing tivational imPACT versusstandardofcare(SOC). The imPACT armreceived2mo released fromprisonin Texas andNorthCarolinawererandomizedto Methods: University of North Carolina at Chapel Hill, Chapel University ofNorthCarolinaat NC, USA Texas ChristianUniversity, Fort Worth, TX, USA 381participantswererandomized: 195toimPACT, 186toSOC. HIV-positive individualswithaviralload <400 c/mlbeing Intervention toMaintainSuppression Intervention A RandomizedControlledTrial ofan designedtomotivate A comprehensiveintervention 1 1 LossofviralsuppressioniscommonamongHIV-positive , CarolGolin , Fogel Cathie 2 , Becky White ,

2 , 2 David Wohl (presenting) , StephenCole 2 , MichelleGould 2 , SoniaNapravnik 1 , JessicaCarda-Auten 2 2 ,

2 - , - - ORAL ABSTRACTS 31 32 100

while balancingtimeandresourceconstraintsoftheintervention. health services, etc.)toensurewomen’s psychosocialneedsaremet existingclinicrequire leveraging resources(e.g., socialwork, mental promising forHIV-positive women. RefinementofSisters-GPSwill group clinical visitmodeltoimprove ARV adherenceisfeasibleand Conclusion: (p=0.009). baseline to91%post-intervention as “not justHIVinfection.” Meanadherenceincreasedfrom74%at and providedhealthcareadvocacy them treated andholisticcarethat senseofsocialisolation addressedtheirpervasive felt theintervention but desiredmoretimetodiscusspsychosocialconcerns. Participants 100%). Overall, participantsfoundSisters-GPStobehighlyacceptable, disorder. forweeklyvisitswas78%(range: Meanattendance 43%- conditions and50%asubstanceuse co-morbid medicalandpsychiatric pants was52.4±8.4years. BlackorLatina.All werenon-Latina All had Seven oftheeight(87.5%)womenenrolled. forpartici Meanage Results: post-intervention. baselineand immediately over thepast4weeksat focus groupdiscussionpost-intervention. We comparedmeanadherence anda andacceptabilityviabriefpost-groupvisitsurveys retention rates viremia intheprioryear. We assessed feasibilityviarecruitmentand self-reported ARV adherenceinthepast4weeks<100%anddetectable ORALMethods: participants meetsregularlywithahealthcareprovider. comprised of sevenweeklygroupclinical visitswherethesamegroupof tested Sisters-GPS, forHIV-positive anadherenceintervention women, port. To determinefeasibilityandacceptability, wedevelopedandpilot thepeer-grouptarget womenorleverage toprovidesocialsup dynamic of theCDC’s evidence-based exclusivelyARV adherenceinterventions ABSTRACTS(ARV) adherenceincluding lackofpositivesocialsupport. However, none Background: Montefiore MedicalCenter, Bronx, NY, USA Oni Blackstock(presenting) Rosy Chhabra, ChristineLee, LorletteHaughton, Chinazo Cunningham, RobertGrossberg, Alain Litwin, Julia Arnsten, Clinical Visit Intervention among HIV-Positive Women throughaGroup We screened51women andfound8(15.7%)tobeeligible. HIVclinic,At anambulatory werecruitedwomenwith These findings indicate that an intervention adapting the adapting anintervention that These findingsindicate HIV-positive womenfacemultiplebarrierstoantiretroviral Promoting Antiretroviral Adherence Promoting Antiretroviral “We’re NotJustHIVInfection”:

11th International Conference on 11th International -

- 101 engagement outside of demonstration projectsisrequired. outsideofdemonstration engagement men intheUnitedStates, sufficientaccesstoPrEPcareandcontinued sexwith in significantreductionsHIVincidenceformenwhohave projects. well asindemonstration efficacyinfection hasdemonstrated inrandomizedcontrolledtrialsas Background: 4 3 2 1 Susanne Doblecki-Lewis(presenting) Stephanie Cohen Erin Andrew Miami FollowingtheUSPrEPDemoProject of thisevidence-basedpreventionintervention. projectsisneededtorealizethepotentialimpact side ofdemonstration Conclusion: survey.follow-up completionandthe HIV seroconversionintheperiodbetweenstudy to successfullyobtainPrEPmedication. theendofDemoProjectmorelikely careproviderat with aprimary from theSanFrancisco site, thosewithmedicalinsurance, andthose cost. orno low careprovidersandfrequentlyat largely throughtheirprimary projectcompletion, ofPrEPfollowing 39.9% reportedcontinuation they were interested”“very incontinuingPrEP. behavior. after completionoftheDemoProject, ongoingsexualrisk indicating medical careandhadahighincidenceofsexuallytransmittedinfections Results: across groups. forcomparison calculated estimate Mantel-Haenszel commonoddsratio comparisonsweremadeusingFisher’sBivariate Exact Test andwith characteristics. Results werecomparedbysiteanddemographic utilization, completionoftheDemoProject. andHIV/STItestingfollowing addressinginterestincontinuingPrEP,survey PrEPaccess, healthcare wereaskedtocompletea15minute telephone Those participating completion. forstudy theirscheduled date Project 4-6monthsfollowing ticipants fromtheMiamiandSanFrancisco sitesoftheU.S. PrEPDemo Methods: San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA University ofCaliforniaSanFrancisco, CA, USA University ofMiami, FL, USA Bridge HIV, SanFrancisco, CA, USA Variability wasseen, inaccess andengagement withparticipants Survey respondents(n=173)continuedtofrequentlyaccess Survey InterestincontinuingPrEPwashigh, with70.8%indicating Telephone withthe457formerpar contactwasattempted 1 Additional efforttoincreaseequitableaccess to PrEPout , MichaelKolber Pre-exposureprophylaxis(PrEP)forpreventionofHIV tinuation inSanFranciscoand Healthcare AccessandPrEPCon 4

, DanielFeaster HIV Treatment andPreventionAdherence 2 , GabrielCardenas 2 For toresult PrEPimplementation , Albert Liu , Albert Two respondentsreported 2 1 , Among respondents,

2 , OliverBacon

3 ,

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103 11th International Conference on 11th International for blacksremain. for thisimprovement. Notwithstanding theseimprovements, disparities with ART andadherencesupportprogramsmay, inpart, beresponsible and regimencharacteristics. Awareness oftheimportanceadherence improved markedlyfrom2001to2010evenafteradjustmentforpatient Conclusion: (allp<0.0001). withhigheroddsofcompleteimplementation associated living inCalifornia(OR=2.30)andNew York (OR=2.25)vs Texas were 1.20 for2004-2006vs2001-2003). Non-blackvs. black(OR=1.23)and the adjustedmodel(OR=1.43for2007-2010vs2001-2003andOR trend in ART overthethreeperiodswassignificant in implementation increased from62.0%, 68.4%to73.9%acrossthesameperiod. The 88.0% in2007-2010. also The proportionofcompleteimplementation increased from81.5%in2001-2003, to85.4%in2004-2006and whoinitiated patients ART. rate The mean monthlyimplementation Results: equations. ( and calendaryear. The oddsofachievingcompleteimplementation included age, gender, race, state, regimentype, numberofpillsperday, acrossallpersistentpatients.averaging The adjustedregressionmodel by rate monthlyimplementation we determinedthepopulation-level ofuse).corresponding periodofpersistence(duration For crudeanalysis, suppliedbythenumberofdaysineachmonth duringthe medication bydividingthenumberofdays each calendarmonthwascalculated United States. For individuals initiating ART, for episodeimplementation ically dispersedstates, whichaccountfor75%ofHIVprevalenceinthe Medicaid fee-for-service claims from2001to2010in13geograph data Methods: improved overtime. (ART)therapy implementtheprescribedregimen, andwhetherthishas ontheeffectivenesswithwhichindividualsantiretroviral States Background: University,Brown Providence, RI, USA Bora Youn (presenting) Ira Wilson, Aadia Rana, OmarGalarraga, Theresa Shireman, Yoojin Lee, States withtheGreatestHIVPrevalence from theMedicaidBeneficiariesin13 and 2010intheUS:Population-Level Data ≥ 90%) for each month were estimated using generalized estimating usinggeneralizedestimating 90%) foreachmonthwereestimated 1,477,407 months of observation wereobtainedfrom79,826 1,477,407monthsofobservation usingthe study We performedaretrospective observational Monthly implementation of Monthly implementation ART intheUnitedStates Limited population-based data are available intheUnited areavailable data Limitedpopulation-based Therapy Improved between2001 Therapy Improved Implementation ofAntiretroviral

HIV Treatment andPreventionAdherence - 104 to 2/2/16, theCenter. 66cisgenderwomenreceivedcareat Duringthis theCenter.infections at From oftheOvalCenter) 12/1/14(openingdate aswellindividualstestedforsexuallytransmitted organizations and testingprogramemergency department, localcommunity-based the Centerinclude thehealthcaresystem’s HIVclinic, itsHIVcounseling biomedical HIVpreventionandsexualhealthcare. Referralsourcesfor healthcaresystemintheBronx,a largeintegrated provides NYthat Methods: PrEP uptakeamongcisgenderwomenintheUnitedStates. Background: Montefiore MedicalCenter, Bronx, NY, USA Oni Blackstock(presenting) Sachin Jain, CedricBien, UriFelsen, Viraj Patel, Community-Based STIClinic after PrEPinitiation. drop-offinclinical isneededtounderstandtheobserved visits study isneeded.may notbeinstableserodiscordantrelationships Further Conclusion: more than6months. partners. Additionally, lessthanhalfofwomencontinuedonPrEPfor serodiscordant relationships, mostofwhomreportedhaving ARV-using sources yieldeduptakeprimarilyamongcisgenderwomeninstable Results: time, least6months. only44.4%continuedincareforat their partner. Oftheninewomen with6monthsormoreofobservation toconceivewith (ARVs)and23%reportedtrying tiretroviral medications women, allbutone(92%)reportedtheirpartnerwascurrentlytakingan with amalepartner(81%).stable serodiscordantrelationship Ofthese Black.non-Latina forPrEPwasbeingina The mostcommonindication was36yearsold(range:age or 20-56)andallwereeitherLatina these women, 16women(80%)received time period, forPrEP. 20cisgenderwomen(30%)wereevaluated Of PrEPofferedinaclinical settingwithmultiplediversereferral The OvalCenterisacommunity-basedspecialtyclinic within Outreach to women who are at high riskforHIV, Outreachtowomenwhoareat butwho Little is known aboutthereal-worldclinical Littleisknown experienceof Women atanUrban, PrEP UptakeamongCisgender ≥ 1 PrEPprescription. Median

- ORAL ABSTRACTS 33 34 105

disparities persistforBlacksandwomen. experienced ART withintwoyearsofinitiation, discontinuation and caresites.adherence at Nevertheless, asignificant proportionofpatients sample,population-based to becauseofincreasedattention perhaps tics, ART persistencehasimprovedmarkedlyovertimeinthisnational, Conclusion: (allp<0.001). discontinuation treatment withhigherhazardsof vs Californiawerealsosignificantlyassociated ART regimen, andlivingin Texas (HR=1.90)and Virginia (HR=1.67) (HR =1.36), ( youngage = 1.21), femalevsmale(HR=1.16), multiplepillusevssingle in 2001-2003(HR=0.78, 95%CI: 0.76-0.81). Blackvsnon-black(HR thanthosewhoinitiated discontinuation hazardoftreatment 22% lower In theadjustedmodel, whoinitiated patients ART in2007-2010hada The medianpersistenceof ART in2007-2010wasnotreached. initiated creased from17.3monthsin2001-2003to25.02004-2006. Results: single pilluse, year. initiation andtreatment model wasadjustedforage, gender, race, state, initialregimentype, wereusedtodescribecrudepersistence.curves Coxproportionalhazard period,the study death, ordisenrollmentfromMedicaid. Kaplan–Meier discontinuation). (treatment gap theendof Patients werecensoredat datebeforea90-day date tothelastfill fromthefirstfill of treatment 6-month wash-outperiod. Persistence wasmeasuredbytheduration identified 79,844HIV-positive whoinitiated patients ARTat leasta with ORAL whichaccountfor75%ofHIVprevalence.ically-dispersed states We Medicaid fee-for-service claims from2001to2010in13geograph data Methods: has improvedovertime. (ART) (non-persistence), discontinuetherapy andwhetherpersistence startedanti-retroviraltherapy whichindividualswhohave at the rates Background: ABSTRACTS University,Brown Providence, RI, USA Bora Youn (presenting) Ira Wilson, Aadia Rana, OmarGalarraga, Theresa Shireman, Yoojin Lee, Prevalence ciaries inthe13StateswithGreatestHIV tion-Level DatafromtheMedicaidBenefi and 2010intheUnitedStates:Popula The mediantimefrom ART tonon-persistencein initiation using study We performedaretrospective observational Evenafteradjustmentforpersonandregimencharacteris Limited population-based data are available intheUSon areavailable data Limitedpopulation-based Therapy Improved between2001 Therapy Improved Persistence withAntiretroviral ≤ 40 yearsvs>40years, HR=1.24), older - 11th International Conference on 11th International - - - - 117 Twitter, LinkedIn, Craigslist, and Tumblr) completedanonlinesurvey recruitedthroughsocialmediasites(e.g.,the UnitedStates Facebook, Methods: andcare. HIV iscriticalfortheirtreatment forpersonslivingwith impacthealthcareempowerment ing factorsthat tolerant ofuncertaintyreferstohealthcareempowerment. Understand ofbeingengaged,and state informed, collaborative, committed, and Background: 3 2 1 van denBerg(presenting) Saberi Parya with HIVforMedicationAdherence among personslivingwithHIV. address theeffectsofexaminedpsychosocialfactorsonadherence model,the healthcareempowerment to andformulti-levelinterventions Conclusion: (p <.05)wasalsosignificant. onadherencethroughhealthcareempowerment knowledge treatment ment. andHIV The indirecteffectofhealthcareproviderrelationship <.05), (p<.001), knowledge HIVtreatment andhealthcareempower (p<.001),between healthcareproviderrelationship socialsupport(p herence. Inaddition, significantdirectpathways therewerestatistically (p< .001),health careproviderrelationship trauma(p<.05), andad betweendepression(p<.001), significantdirectpathways statistically working full-time. fromMplusindicated Analyses ofmodelfitstatistics (51.5%) butwerenotcurrentlyenrolledinschool(87.6%);45.9% and gay/lesbian(86.8%). Mosthadsomeexperiencewithcollege majority ofparticipantsself-identifiedasmale(93.1%), White(71.1%), Results: factors onadherence. ofthesepsychosocial modeling wasusedtoassesstheinterrelations framework,Guided bythehealthcareempowerment structuralequation ma, depression, healthcareempowerment, adherence. andmedication provider relationship, knowledge, HIVtreatment perceivedstigma, trau characteristics,about theirdemographic socialsupport, healthcare Brown University,Brown Providence, RI, USA The UniversityofRhodeIsland, Kingston, RI, USA University ofCalifornia, SanFrancisco, CA, USA ofthesamplewas45.6years(SD=11.4).The meanage The A cross-sectionalsampleof1,494personslivingwithHIVin The study’s resultshighlight aneedformoreresearchon 1 , BingChen Patient-controlled health care that includesPatient-controlled healthcarethat theprocess ment ModelamongPersons Living Testing theHealthCareEmpower HIV Treatment andPreventionAdherence 2 , Johnson Mallory 3 1 , TorstenNeilands 1 , Jacob - - - - -

118 11th International Conference on 11th International inaccessingthem. programs toassistpatients PrEP paymentassistanceoptionsandbetternavigation common reasonfordiscontinueduse, highlightingtheneedformore increases (e.g., beingsingle). wasthesecondmost Insurancecoverage particularly duringso-called “seasons ofrisk” whentheirriskbehavior ior Thus, forsome, riskreductionstrategy, PrEPmaybeatemporary most commonreasonbeingaself-reportedreductioninHIVriskbehav Conclusion: were onPrEP. comparedtowhenthey CAS(M=4.07)now tohave in theirtemptation HIV-positivecondomless analsexwithaknown partner, andnodifferent HIV status, in slightlyless(M=3.27)intheirlikelinesstoengage they wereonPrEPslightlymorelikely(M=4.73)todiscuss average, comparedtobeingoffPrEPnow, while participantssaidthat issues,insurance coverage sideeffects. andtworeportednegative On (i.e.,monogamous relationship riskreduction), behavioral fourreported in CASandtwohadentereda use becausetheystoppedengaging 15 (16.6%)haddiscontinueduse. Four saidtheyhaddiscontinued Results: compared towhiletakingPrEP. forcondomlessanalsex(CAS)postPrEP sex partnersandtemptation change, discussionwith 7=morelikely)toquestionsaboutHIVstatus PrEP. Participants alsorespondedonLikertscales(1=lesslikely, 4=no an open-endedquestionaboutwhytheychosetodiscontinuetaking Participants whohadexperiencetakingPrEPanddiscontinuedanswered of1,071HIV-negative GBMfromacrosstheUnitedStates.nal study Method: forPrEPtreatment. provide valuableinformation stay onthemedication, will anddeterminingreasonsfordiscontinuation Background: New York, NY, USA Studies& Center forHIVEducational Training, HunterCollege, CUNY, Thomas Whitfield(presenting) Christian Grov, H. Rendina, Jonathon JeffreyParsons, Regimen and Bisexual MenGiveforStoppingaPrEP Data werecollectedfromOne Data Thousand Strong, alongitudi In total, 14.7%(n=90)hadexperiencetakingPrEP. Ofthese, OneinsixmenwhostartedPrEPdiscontinueduse. The Not all gay and bisexual men (GBM) who initiate PrEP Notallgayandbisexualmen(GBM)whoinitiate Examination oftheReasonsGay Why IQuit:AMixedMethods

HIV Treatment andPreventionAdherence

- 125 VL for criteria toenrollintheclinic: 1)viralload(VL)>1,000copies/mLorno the countyhospitalHIVClinic. eligibility Patients mustmeetthefollowing Methods: intraditionalHIVcare.engaged model forpersonsinSeattle, Washington notsuccessfully whohave Background: 2 1 Meena Ramchandani Shireesha Dhanireddy Spellman Dawn Persons LivingwithHIV/AIDS Designed toEngagetheHardest-to-Reach assess theintervention’s impact. complex barrierstocare. incentives, with patients andintensiveoutreachsupportcanengage Conclusion: ART (N=39), and58%hadachievedviralsuppression(N=29). had completed in thepastyear. ment, (88%;N=44)hadusedillicitstimulantsoropiates mostpatients male (74%)andnon-Hispanic White (56%)orBlack(24%). through outreachprograms;and4(8%)referredbypeers. 23(46%)identified referred bytheirmedicalproviderorcasemanager; Results: enrolledduringthefirstyear.outcomes ofpatients VL results. We thecharacteristicsandHIVcarecontinuum evaluated copies/mL); andaone-time$100bonusfor3sequentialsuppressed 2months),visit withphlebotomy(every $100 forasuppressed VL (<200 once weekly, snacksanda$10mealvoucher. Patients receive$25fora and buspassesreneweduponclinic attendance, eachvisitupto andat outreach supportandcarecoordination. Incentivesinclude cellphones HIV care5afternoons/week. Two specialistsprovide diseaseintervention clinical ofviolencetoward staff.history walk-inaccessto Patients have health andclinical withcare, patient outreachtore-engage and3)no University of Washington, Seattle, WA, USA andKingCounty,Public Health–Seattle Seattle, WA, USA ≥ 12 months and off antiretroviral therapy ,12 monthsandoffantiretroviraltherapy 2)failureofpublic 2015;23(46%) We January-December enrolled50patients The Clinicisjointlyadministeredbythehealthdepartmentand

An alternative HIV care model that includes HIVcaremodelthat An alternative walk-inaccess, The MAXClinicisamulti-component, care alternative ≥ 1 As of12/31/15(medianenrollment=5months), 82% Healthcare Systems Intervention Healthcare SystemsIntervention The MAXClinic:AStructural , Golden Matthew 2 visitstotheMAXClinic(N=41), 78%hadinitiated 2 , 2 , RachelPatrick Julia Dombrowski(presenting)

A controlled study isneededtodefinitively A controlledstudy 1 , RobertHarrington 1 , Allison Moore , Allison 1 2 , ,

2 Mostwere Upon enroll - ORAL ABSTRACTS 35 36 127

success. surveillance, preventionandcareprograms, whichisessentialtoD2C sharing. todata stepsfromcommunityengagement to Carefromoperational Conclusion: tion andcareprograms. first time, thecomingtogetherofstaffacrossHIVsurveillance, preven program. sharing,confidentiality anddata morbidity, ofthesurveillance andhistory factors,considered organizational around data jurisdictionlaws/policies plementation. Programs. Results: in care” lists, tocareevaluation. anddata quality, data surveillance sharing, data staffingresources, creating “not limited to, security, confidentialityanddata communityengagement, HIV required. Jurisdictionsreceived TA onD2Cactivitiesincluding, butnot was tohealthdepartments’HIVsurveillance load testsbylaboratories confidential name-basedreportingofallCD4 T-lymphocyte andHIVviral of intensivetechnicalassistance(TA) onD2Cactivities. Mandatory with thetoolkitlaunch, sevenhealthdepartmentsreceivedsixmonths toSupporttheHIVCareContinuum. Data HIV Surveillance ORAL toCare(D2C): launched atoolkit–Data Method: continuum ofcare. ineachstepofthe proportion ofpeoplelivingwithHIVwhoareengaged care isapromisingtoolhealthdepartmentscanusetoincreasethe toidentifypersonslivingwithHIVwhoarenotin data HIV surveillance oftheirinfection.to transmitHIVcomparedpersonsunaware Using ABSTRACTSwho areretainedincareandvirallysuppressed94%lesslikely Background: 2 1 Kathleen Ruth(presenting) Michele Clark theHIVCareContinuum to Improve Data Departments onUsingHIVSurveillance US CentersforDiseaseControlandPrevention, Atlanta, GA, USA John Snow, Inc., Boston, MA, USA

Additionally, itisessentialthat TA among collaboration facilitates Weapproach toD2C learnedthereis noonesizefits Participation inthisprojectfacilitated, inmostcasesforthe In 2014,April theCentersforDiseaseControlandPrevention Jurisdictions were at different stages indevelopmentandim differentstages Jurisdictions wereat It is important that Itisimportantthat TA isflexibleandaddressesallData

TA amonghealthdepartments. variedgreatly approach According toarecentUSstudy, personslivingwithHIV , Vasavi Thomas of Technical AssistancetoHealth Lessons LearnedintheProvision

2 2 , RhondetteJones

A Public Health Strategy Using A PublicHealthStrategy

2 ,

In conjunction 11th International Conference on 11th International

We - - 128 immediate immediate ART initiation, bolsteringretentionincare, HIV andeliminating pact.” ofGTZSanFrancisco, PrEPexpansionisakeyinitiative alongwith under theprinciplesof independent consortiumoperating “collective im “Getting toZero.” In2013, SanFrancisco establishedanewmultisector, Background: 6 5 4 3 2 1 Stephanie Goss Jen Hecht Hyman Scott Zero (GTZ)ConsortiuminSanFrancisco of PrEP. arefeasibleandcanmaximizethepotentialimpact and implementation across PrEP subcommittees. PrEP delivery City-wide efforts to coordinate andimplementation coordination facilitated share bestpracticeshave Conclusion: and peoplewhoinjectdrugs. nities ofcolor, youth, transgenderindividuals, populations, incarcerated been identified,and barriers to PrEP access have particularly for commu and PrEPuserosefrom15%in2014to23%2015. Importantgaps increasedfrom20%in2012to>85%2015 amongMSM,knowledge funded acrossclinics andCBOs. Basedoncommunitysurveys, PrEP been have 10PrEPnavigators andreferrals/navigation; on PrEPdelivery clinics, >80clinical providersand>50HIVtestcounselorsweretrained Results: stigma (PrEPmetrics). sourcestomeasurePrEPuse, multipledata integrating knowledge, and broad rangeofcommunityproviders(PrEPproviders);andassessing line workersanddevelopinganacademicdetailingprogramtoreacha PrEP access(PrEPusers);conductingtrainingsforcounselors/front tofacilitate and establishinganetworkofcommunity-basednavigators launching aPrEPambassadorprogramto “get thewordout” aboutPrEP providers, andmeasuringPrEPimpact. Keyaccomplishmentsinclude forPrEPusers,expanding accessandawareness for buildingcapacity committees wereestablishedtoadvanceworkinthreepriorityareas: researchers, governmentandprivate-sector, andPrEPusers. Sub (CBOs), fromcommunitybasedorganizations representation providers, Method: stigma. Bridge HIV, SanFrancisco, CA, USA Asian andPacific Islander Wellness Center, San Francisco, CA, USA San Francisco AIDS Foundation, SanFrancisco, CA, USA Kaiser Permanente SanFrancisco, CA, USA University ofCalifornia, SanFrancisco, CA, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA Overthelastyear, increasedto>30 siteshave PrEPdelivery The GTZPrEPcommitteeformedin2014andhasdiverse 4 , SusanScheer Establishinggoalsandmetricsregularmeetingsto 1 , Shannon Weber, Cities aremobilizingtoachievetheUNAIDSvisionof 5 as aKeyInitiativeoftheGettingto Expanding PrEPImplementation , PierreCedric-Crouch HIV Treatment andPreventionAdherence 1 , TraceyPacker 2 , BradHare 4 , Albert Liu(presenting) 1 3 , StephanieCohen , SusanBuchbinder 1 ,

1 , 6

- - - - 130 11th International Conference on 11th International toHIVpreventioninacommunityhealthcentersetting. approach plinary careaspartofamultidisci toprovidecomprehensivepatient shown needs outsidethescopeofmedicalcare. The PrEPspecialisthasbeen Conclusion: withhousing,patients transportation, and mentalhealthservices. referred forinsuranceassistance. Various referralsweremadetoassist receivedfundingthroughassistanceprogramswhile 25%were patients assistancewiththePrEPspecialist.for patient Seventy-fivepercentof toGroup was available A forPrEPcarewhile28%ofGroupBapplied enrollment betweenthegroups. Limitedaccesstofinancialassistance (13%). rate same discontinuation There wasa27%increaseinpatient and92%startedinGroupB.A startedtreatment Bothgroupshadthe Results: were providedasneeded. were addressedbythePrEPSpecialist. Referralstosupportiveservices counseling, andassessmentoffinancialbarriers. Thebarriersidentified visitorasneededforPrEPeducation, every Specialist at HIVtestingand vices (GroupB). Inaddition, allindividualsinGroupBmetwiththePrEP 2015toMarch2016,April 155individualswereassessedfortheseser from PrEP services August 2012throughMarch2015(Group A). From Method: delivering comprehensivecaretopatients. PrEPprogramisakeycomponentinincreasingenrollmentand ciplinary supportive services. The roleofthePrEPspecialistaspartamultidis comesanincreaseinfinancialobstacles growth patient andaneedfor ofPrEP,public knowledge therehasbeenanincreaseindemand. With in highriskindividuals. With anincreaseinmarketing, outreach, and for HIVpre-exposureprophylaxis(PrEP)toreducetheriskofHIV-1 Background: Trillium Health, Rochester, NY, USA Sally Holt Health Center Team ApproachtoPrEPataCommunity Ninety-four percent of patients assessed forPrEPinGroup Ninety-fourpercentofpatients PriortohiringaPrEPspecialist, 126peoplewereassessedfor Patients seeking PrEP services are likely to have other arelikely tohave Patients seekingPrEPservices Emtricitabine/tenofovir was FDA approved inJuly2012 Emtricitabine/tenofovirwasFDAapproved Specialist in a Multidisciplinary Specialist inaMultidisciplinary The ImportantRoleofthePrEP HIV Treatment andPreventionAdherence - - - 136 Methods: accessing care. to Healing(G2H)programwasaclinic-based toassist initiative WOC withpoorclinicalassociated outcomes, including mortality. The Guide and oneffectivetreatment. MissedHIVclinic been have appointments HIV, including anddifficultiesremainingincare increasedinfectionrates Background: 3 2 1 ParnellHeather Kristen Sullivan Anna FinestoneLeViere (presenting) HIV CareVisits retention incare. womentorespondtheseeventswillfacilitate ment flexibilitytoallow providingappoint widespread reportsofmajorlifeeventssuggestthat chaos interferewith WOC’s retentioninHIVcareNorthCarolina. The Conclusion: interviews. women reportedmorethanonereasonfortheirmissedvisitin28 = 8/57), familyissue(n=8/57)andforgot8/57). Also importantly, 27/57), orclose ofrelative death friend(n=13/57), loss(n relationship missing appointments, withthemostcommonbeing: (n= transportation their appointments. analysisrevealed18uniquethemesfor Qualitative port, autonomy, self-determination thetimeof orHIVRNAat relatedness vs 45.05, p=0.003). The groupsdidnotdifferindepression, socialsup (6/51 vs5/136, p=0.03), andhigherself-advocacy (meanscore 48.21 Results: the clinic andthosewhoattended WOC whono-showed appointments. tion, psychosocialscales, andHIVRNAloadswerecomparedbetween were selectedforacomparisongroup(n=136). using NVivo©. Temporally matched WOC withnomissedappointments andindependentlycodedforemergentthemesbytwo researchers batim garding theirmissedappointments. The responsesweretranscribedver than once), andwereaskedtwoadditionalopen-endedquestionsre more (somewomenwereinterviewed interviews in 57uniqueevaluation who “no-showed” duringthistime, foranappointment 51participated period(2011-2014). duringthestudy 2-week intervals Ofthewomen measures wereconductedwith clinic WOC attending at appointments Portland University, State Portland, OR, USA Duke University, Durham, NC, USA Hill, Chapel University ofNorthCarolinaat NC, USA The no-show WOC weremorelikelytoreportunstablehousing Evaluation interviews comprised of validated psychosocial comprisedofvalidated interviews Evaluation Unstablehousing, transportation, death, andgenerallife USwomenofcolor(WOC)experiencehigherburdens 2 2

Color ReportReasonsforMissed Cars, Chaos, andGrief:Women of , MiriamBerger , Roytburd Katya 2 , Lynne Messer 1 , Tyffany EvansColeman 1 , EvelynByrdQuinlivan 3 Demographic informa Demographic 1 ,

1 ,

- - - - - ORAL ABSTRACTS 37 38 137

poor healthoutcomes. exhibitingdetectableviralloadsandpotentially ence priortopatients difficultieswiththere arecontinuedopportunitiestocapture ART adher self-report. As technologiesfordailymonitoringofadherenceevolve, withobjectiveadherencecomparedtoretrospective strongly associated taking (measuredbyMEMS), responsesaremore dailytextmessage withdailymedication significantassociations response methodsshow Conclusion: OR=1.02, CI=1, 1.05, p=0.053). MEMS (Text reportOR=1.97, 95% CI=1.47, 2.64, p<0.001vs VAS score of MEMSadherence, only Text reportwasasignificantpredictorof 0.333). usedboth Inamodelthat Text reportand VAS scoreaspredictors not significantlydifferentfromoneanother(t=0.98, df=40, p= VAS: Spearman’s Rho=0.45, p=0.003). were These twocorrelations withMEMS(Textassociated report: Spearman’s Rho=0.56, p<0.001; Results: MEMS adherence. and examinedamodelusing Text reportand VAS scoresaspredictorsof 0-100%) andMEMS. Statistically, wecomparedthesetwocorrelations retrospective self-reportedadherenceusinga Visual Analog Scale(VAS, EventMonitoringSystem(MEMS),as measuredbyMedication and2) text responses(Text report)andtheproportionof100%adherentdays between 1)theproportionof100%adherentdaysasmeasuredbydaily ORALfected methamphetamineusers(n=43), weexaminedtheassociation weresentasadherencepromptsamongHIV-indaily textmessages Methods: limitations. ing. Retrospectiveself-reportofadherencehassimilarmeasurement ustorecognizeadherencedifficulties astheyareevolv does notallow an typically indicates ART adherenceproblem;however, thismeasure ABSTRACTS (ART).to antiretroviraltherapy Inclinical settings, adetectableviralload assesswhetherpersonsliving withHIVareadherent ability toaccurately Background: University ofCalifornia, SanDiego, CA, USA Jessica Montoya, Alexandra Rooney, Umlauf,Anya BenGouaux, Anne Heaton, HIV-Infected MethamphetamineUsers Adherenceamong Report ofAntiretroviral Both Text reportandretrospectiveself-reportweresignificantly In the context of an intervention study wherepersonalized study Inthecontextofanintervention Although bothretrospectiveself-reportanddailytext Adherence measurementissuescontinuetohamperour Compared toRetrospectiveSelf Daily Text MessageResponsesas David Moore(presenting)

11th International Conference on 11th International - - - 140 Grace Marx(presenting) Presenting toanUrbanSTDClinic least one of the following criteria:least oneofthefollowing 1)manreportingsexwithothermen at at timeofvisitwith PrEP-eligibility wasdefinedasHIV-negative seen inthecalendaryear2015.to identifyPrEP-eligiblepatients Methods: anurbansexuallytransmitteddiseases (STD)clinic.seeking careat andcarebyeligibleindividuals describe thecontinuumofPrEPinitiation vention, pre-exposureprophylaxis(PrEP)isunderutilized. We soughtto Background: 3 2 1 Edward Gardner continuum ofcare. PrEP services, starterpacksmayimprovethePrEP orPrEPmedication infections. Enhancedandstandardizedreferralsystems, centralized barriers anddelaystoPrEPinitiation, HIV increasingriskforavoidable was suboptimal. resultin CurrentreferralsystemsforPrEPservices STD clinic, PrEP; amonginitiators, fewinitiated 3months adherenceat Conclusions: required 3-monthclinic visit. follow-up (IQR 23-125days). OfthosewhostartedPrEP, 67(81%)presentedtothe Median timefromSTDclinic visittoIDclinic PrEPintakewas35days were consideredeligibleforPrEPwhileonly83hadanintakePrEP. (18%) wereMSM. Ofallpatients, 1,301(14%)and1,095(64%)ofMSM Results: clinic andfollow-up queried forPrEPinitiation visits. 3 months. infectiousdiseases(ID)clinicThe EMRoftheco-located was last 3months, or5)exchangeofsexformoneydrugswithinthelast within thelast3months, 4)useofHIVpost-exposureprophylaxisinthe anal intercoursewithinthelast3months, 3)HIV-positive sexualpartner the last12months, 2)MSMwith>1malesexpartnerandcondomless ofearlysyphilis,(MSM) withdiagnosis gonorrheaorchlamydiawithin Denver Prevention Training Center, Denver, CO, USA Denver PublicHealth, Denver, CO, USA University ofColorado, Boulder, CO, USA In2015, theSTDclinic 1701 9,497uniquepatients; saw The STDclinic electronicmedicalrecord(EMR)wasqueried Despite a large number of PrEP-eligible patients inthe DespitealargenumberofPrEP-eligiblepatients DespitebeingoneofthemosteffectiveformsHIVpre Continuum ofCareinPatients HIV Pre-ExposureProphylaxis 2 , Karen Wendel, HIV Treatment andPreventionAdherence 1 , DeanMcEwen 2 , JudithShlay 2 , CorneliusRietmeijer 2 , SarahRowan 2 3 , - 141 11th International Conference on 11th International targetsarediscussed. intervention adherence behaviors. ofHIV-affect implications management Behavioral needed torigorouslyassessthisscale’s abilitytopredictHIVtreatment HIV-affect asmeasuredbytheH-AMS. management Futureworkis Conclusion: validity]. their HIV-positive toothers(r=-.021, status p=.842)[discriminant general copingskills(r=.171, p=105)orparticipants’disclosure of directions [convergentvalidity]. with H-AMSscoreswerenotassociated HIV-affect withperceivedabilitytomanage inthepredicted associated (r= -.386, p<.001), andsocialsupport(r=.214, p=.045)wereall .022). Numberofdepressivesymptoms(r=-.359, p=.001), HIVstigma whenHIV-affect (r=-.238,was observed wasmoreeasytomanage p= salient (r=-.265, p=.001)partofone’s identity. Better ART adherence harder tomanage, HIVwasamorecentral(r=-.212, p=.045)and easy(M=3.60,moderately SD=0.917). When HIV-related affectwas Results: theHIV-Affect Scale‘sconstructvalidity.to evaluate Management HIV-status disclosure, andsocialsupport[mMOS-SS]). Resultsareused (Depression[CESD-10], BriefCOPE, HIV-Stigma MechanismsScale, ART adherence, toinfluence andconstructsknown ART adherence H-AMS andmeasuresofHIVidentity(centrality, salience), self-reported betweenthe assessedpotentialrelationships associations Bivariate aparticipant’sscores arecomputedbyaveraging responses( hard,sadness’) ona5-pointLikert-typescale(1=very easy); 5=very ‘Thinking aboutbeingHIV-positive withoutfeelinganger, shame, or HIV-related affect(e.g., easy/harditistomanage H-AMS assesseshow completedaninterviewer-administeredty-based services survey. The Methods: novel construct. administered inthecurrentstudy, toestablishthecontributionsofthis We developedthe5-itemHIV-Affect Scale(H-AMS), Management adherence.to livingwithHIVmayplayacriticalroleintreatment one’ssuggest that affectrelated negative perceivedabilitytomanage Skills(sIMB)model the situated-Information-Motivation-Behavioral Background: 3 2 1 Valerie Earnshaw Treatment AdherenceContexts ConstructSituatedtoHIV Theory-Based University ofCaliforniaSanDiego, CA, USA University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA MedicalSchool,Harvard Boston, MA, USA On average participants found managing HIV-related affect participantsfoundmanaging Onaverage UrbanHIV-positive clients (N=93) accessingcommuni These patterns of associations supportthevalidityof ofassociations These patterns Initial findings from mixed-methods research evaluating Initial findingsfrommixed-methodsresearchevaluating Scale (H-AMS):Evaluating aNovel A 5-ItemHIV-Affect Management 1 , K. Rivet Amico 2 , Laramie Smith(presenting) HIV Treatment andPreventionAdherence α =.835). 3 - 146 Lee LemusHufstedler(presenting) tive Study Francisco BayArea:ALongitudinalQualita Nutrition FoodSupportProgramintheSan HIV andParticipating inaComprehensive care amongpeoplelivingwithHIV(PLHIV), explored yetfewstudieshave Background: 4 3 2 1 Kimberly Madsen Loulou Chayama prioritizing food support initiatives couldpositivelyimpactHIVhealth. prioritizing foodsupportinitiatives and reducingcompetingdemandsbetweenfoodhealthcare. Policies easing sideeffects, providingstructured mealtimes, reducingstress, Conclusion: unstable housingorpoormentalhealthwhichinhibitedadherence. baselineorintractableissueswith described eitherhighadherenceat needs andhealthcare. Those whoreportednochangesinadherence andareductionincompetingdemandsbetweenbasic appointments toprocuringfoodwhichhadpreviouslyinterferedwithhealthcare related incarewerediminishedstress Mechanisms forimprovedengagement to take ART threestructuredmealsaday. onschedulewheneating ability ona fullstomachandgreater effects whentakingmedications mechanisms forimproved ART adherencewerefewerperceivedside improvements in ART incare. adherenceandengagement Salient exit(totalparticipants=43).or study Programparticipantsdescribed Results: tive approach. double-coded. Salientthemeswereidentifiedusinganinductive-deduc and aftertheprogram. wereaudio-recorded, Interviews transcribed, and of adherenceto ART andretentioninHIVcarebefore andengagement exit). baselineand6months(orstudy at Topics included perceptions ed semi-structured, withFood=Medicine in-depthinterviews participants nutritional education, for6months. andcasemanagement We conduct requirements,provided healthymealsandsnacksmeetingdailyenergy fered the “Food=Medicine” pilotprogramtoPLHIVin2014. The program Methods: andcare. adherence toHIVtreatment through whichacomprehensivefoodsupportprogrammayimprove We undertookalongitudinal, mechanisms toelucidate study qualitative foodsupportmayimproveadherenceinresource-rich settings.how of SouthCarolina, Columbia, SC, USA Department ofHealthPromotion, Education, andBehavior, University University,Emory Atlanta, GA, USA Project OpenHand, SanFrancisco, CA, USA University ofCalifornia, SanFrancisco, CA, USA We interviewed 38 individuals at baseline and 34 at follow-up follow-up baseline and34at We 38individualsat interviewed Project OpenHand, aSanFrancisco Bay Area non-profit, of Comprehensive foodsupportmayimproveadherenceby Food and insecuritycompromisesadherencetotreatment Treatment forPeople Livingwith AdherencetoCareand Improved 2 2 , NikhilRanadive , SimonPitchford 3 , Fredrick Hecht 2 , KartikaPalar 1 , SheriD. Weiser 1 1 , Edward A. Frongillo 1 , TessaNapoles - - 1 - , - 4 , ORAL ABSTRACTS 39 40 151

e development to andintervention and bisexualswarrantfurtherstudy referral. Additionally, amongsexworkers, oflinkage rates lower youth duringpatient andpresentsanopportunityforintervention population) times morecommoninMSMand TW thaninthegeneralmalePeruvian youth, andbisexualswerelesslikelytolinkcare. AUD iscommon(5 Conclusion: significantinpredictinglinkage. tion werenotstatistically wasseenfor linkage lower TW (OR=0.62, p=0.12). Incomeandeduca years oldweremorelikelytolinkcare(OR=1.9, p=0.003). A trendto p =0.002)andbisexualidentity(OR=0.57, p=0.022). Participants = 0.025). Additional riskfactorsincluded ofsexwork(OR=0.48, history predictor oflinkingtocare(OR=0.63,pendence) wasastrongnegative p alcohol usedisorder(AUD: participants (45%)linkedtocarewithin90days. Inlogisticregression, Results: within 90days. logisticregressiontomodelcarelinkage andmultivariate univariate collected priortodiagnosis.from enrollmentquestionnairedata We used program data. Potential tocareweregathered predictorsoflinkage for care. fromtheseparticipantswerelinkedto data Study TARGA ORAL5/2015. Participants whowereHIV-infected baselinewerereferred at between5/2013and asprevention study enrollment intoatreatment Methods: the Peruvian healthcaresystem. tocarein theHIVcarecascadeandbarrierstolinkage evaluated have gram providesfree, mosthospitals. accessibleHIVcareat ABSTRACTS(TW). The Peruvian ofHealth Ministry Antiretroviral (TARGA)Therapy pro sexwithmen(MSM)and transgenderwomen among menwhohave Background: 3 2 1 Angela Primbas(presenting) Ann Duerr HIV CareinLima, Peru nsure their linkage tocare. nsure theirlinkage University of Washington SchoolofMedicine, Seattle, WA, USA Asociación CivilImpactaSaludyEducación, Lima, Peru Fred HutchinsonCancerResearchCenter, Seattle, WA, USA Of 3 MSM and TW inLima, Peru werescreenedforHIVat 1 , Lama Javier

Within theMSMpopulation, sexworkers, highriskdrinkers, ,394 participants, withHIV. 487werenewlydiagnosed 218 HIV is a growing publichealthconcerninPeru,HIV isagrowing especially

Women WhohavePoor Linkageto Identifying MSMandTransgender 2 , Manuel Villaran , hazardous orharmfuldrinking, oralcoholde

3 2 ,

Few studies 11th International Conference on 11th International ≥ 25 - - - 155 graphic data frompeoplelivingwithHIV(PLWH) data graphic wascollectedthrough (LISA)cohort, Services lary psychosocial, behavioural, andsocio-demo Methods: subscales) onoptimal ART adherencebygender. socio-structural andpsychosocialfactors(including HIV-related stigma (ART) tomen. adherencerelative We between examinedassociations optimal( of womenlivingwithHIVattain Background: 2 1 Robert Hogg Columbia, Canada viral TherapyAdherencebyGenderinBritish food securitymaysupportwomeninachievingoptimaladherence. supportpovertyreductionand adherence programssuchasonesthat safety netforwomenlivingwithHIV. ofmoreholistic The implementation amongwomensuggesttheneedtoprovideabettersocial observed Conclusion: withadherence. No psychosocialvariablesexaminedwereassociated (AORperyearincrease:age 0.95;95%CI: 0.93to0.98)wasprotective. with sub-optimal ART adherence(AOR: 2.27;95%CI: 1.45to3.57), while 1.37 to5.56). Among men, ofinjectiondrugusewasassociated history [AOR]:adherence (adjusted oddsratio [CI]: 2.77;95%confidence interval Among women, withsub-optimal foodinsecuritywasassociated ART year priortocompletingthequestionnaire(39.2%vs63.2%;p<0.001). optimaladherencethanmeninthe proportionofwomenattained lower HIV-related stigma(31vs27;p<0.001), tomen. relative A significantly ly toreportdepression(71.4%vs52.0%;p<0.001)andhighermedian en werefoodinsecureandlivinginpoverty. Women werealsomorelike Results: between menandwomen. wereusedtoassessdifferencesinoptimal statistics ART adherence using theshortenedBergerstigmascale. andmultivariable Bivariate from theyearpriortointerview. Stigmacomponentsweremeasured 2010, whichwerethenlinkedwith ART pharmacy refillcompliancedata interviewer-administered questionnairesbetweenJuly2007and January Simon Fraser University, Burnaby, BC, Canada Vancouver, BC, Canada British ColumbiaCentreforExcellenceinHIV/AIDS, Ofthe753PLWH (26.3%women), proportionofwom agreater Using the Longitudinal Investigation into Supportiveand UsingtheLongitudinalInvestigation Ancil 1 Disproportionate povertyandotherformsofvulnerability Disproportionate , CariMiller Inhighhumandevelopmentcountries, proportion alower Factors AssociatedwithAntiretro Socio-Structural andPsychosocial HIV Treatment andPreventionAdherence 2 , Angela Kaida , Angela 2 , ≥ Cathy Puskas(presenting) 95%) antiretroviral therapy 95%) antiretroviraltherapy

2 - - - - - 156 11th International Conference on 11th International PLWHAefforts toengage incare. maystrengthen that programsbyCBOsisoneapproach drug treatment incare.still beabarriertoinitialengagement to linkage Integrating Conclusion: >12months. with notbeingincareforthosediagnosed p =.043)andharmfuldruguse( = 32.472;p<.001respectively). When stratified, druguse( comes, was( thoughtimesincediagnosis (19%). withcascadeout Substanceusevariableswerenotassociated reporting past30daybingealcoholuse(16%)andharmfuldrug year useofalcohol(59%)andillicitdrugs(54%), proportions withlower among these, viralsuppression. 28%reportedknown Mostreportedpast ment inthepast6-months. Ofthoseincare, 49%wereon ART, and Results: <12-months 15%). ( bytimesincediagnosis cascade outcomes;stratified ofsubstanceusewith testedassociations for siteanddemographics ties) past30days. ChiSquareandLogisticRegressionmodelsadjusted marijuana) usepast12months, andharmfuluse(i.e., difficul creating suppression], alcohol(via Audit) andillicitdrug(via TCU-DS2, excluding byreceiptofCD4), (indicated HIV careappointment ART use, viral known ondemographics,were surveyed cascadeoutcomes: [timesincelast to/retention incarestudy.community-based HIVlinkage Participants wereobtainedaspartofalongitudinalmulti-site in theUnitedStates Methods: (CBO)-recruitedPLWHA.ty-based organization ofsubstanceuseandcascadeoutcomesamongcommuni sociations progress throughtheHIVcarecascade. We soughttounderstandas group moreconnectedtocare, substanceusecanimpede suggestthat Background: 3 2 1 Laramie Smith(presenting) Daniel Triplett Anita Raj Community-Based Test andTreat Initiative Kaiser Permanente, SanFrancisco, CA, USA Boston UniversitySchoolofMedicine, Boston, MA, USA University ofCaliforniaSanDiego, CA, USA Cascadeoutcomes: Most(63%)receivedanHIVcareappoint 1 , JeffreySamet Baseline data from495PLWHA Baselinedata recruitedacross7CBOs CBOsarereachingvulnerablePLWHA, butdrugusemay 1 Clinical cohortsofpeoplelivingwithHIV/AIDS(PLWHA), a , Jennifer Yore, Cascade: FindingsfromanHIV Substance UseandtheHIVCare 2 , JohnEdmiston 1 , LianneUrada 1 , Alexandra Caraballo , Alexandra χ 2 =4.108, p<.043)wereassociated HIV Treatment andPreventionAdherence 3 χ , Sankari Ayyaluru , 2 =14.754, 1 , Pamela Schwartz 3 ≥ 12-months 85%; χ 2 =15.493, χ 1 , 2 =4.090,

3 ,

- - - - χ - 2 158 tion inNairobiandCoastalMombasa[SEEK]. We HIVandHCV didrapid HIV-1 Cvirus(HCV)prevalenceandviralloaddetermina andhepatitis Method: difficulttoseek,an underground-subpopulation test, treat, andretain. drug-useandpossessionillegal, law-making with Kenya theyrepresent Cvirus(HCV)infection.hepatitis BecausePWIDarehighlystigmatized, riskforHIVand (KP)at amongst themostvulnerablekey-populations Background: 3 2 1 John Lizcano(presenting) Ann Kurth Kenya: ChallengesandSuccesses for ART andretention, initiation regardlessofthechallengesthisKP. previously diagnosed.effective tocarebyPCMshasbeenvery Linkage forfindingPWIDwithHIVandHCVinfection,strategy including thosenot Conclusion: they simplyforgottoattend. visits becausetheywerebusy “hustling” tosustaintheirdrugneedsor them arehomeless. Inaddition, toclinic sometimestheydidnotattend of andasignificantpercentage challenging astheyarehighlymigratory HIV-infec tested andreceivetheirresults. POCCD4andtheuseofPCMs, forthose individuals.for uncoveringundiagnosed Participants werewillingtobe of HIVvirusamongparticipants. Testing helpful forHIVandHCVwasvery network; Phylogeneticspecimenswerecollectedtoassessrelationship HIV-status-connected-PWID injectingtogetherwithintheirsocial saturated.within certainsocialnetworksgotrapidly We founddiscordant participants werewillingtorecruiteachother. However, somechains Results: conditional cashtransferforPWIDadherencetoHIVcarevisits[RETAIN]. link to ART withadherence[TREAT]. BothPCMsandPWIDreceivedsmall (PCMs) to thosewithCD4<500cells/μL ment ofpeercasemanagers guidelines [TEST], forHIV-positives, POCCD4determination andassign participants, testing onallstudy theGovernmentof Kenya following New York University, New York, NY, USA ofHealthKenya, Nairobi,Ministry Kenya Yale University, NewHaven, CT, USA RDS waseffectiveinrecruitingthishiddenKP, asthe We usedrespondent-driven-sampling (RDS)toreachPWIDfor ted, werehelpfulforearly ART initiation. RetentionofPWIDwas 1 , Peter Cherutich testingisaneffective ofRDSandrapid The combination People whoinjectsdrugs(PWID)insub-Saharan Africa are People WhoInjectDrugs(PWID)in Testing andLinkagetoCarefor 2 1 , HelgarMusyoki 2 , CharlesCleland 3 ,

- - ORAL ABSTRACTS 41 42 159

health outcomes. adherenceand ment withcaremayimprovelongitudinaltreatment duringpregnancy initiated tosupportengage interventions Innovative and mortality. isforthcoming. intocauseofdeath Furtherinvestigation ofretentionandviralsuppression, rates low andsignificantmorbidity Conclusion: 2010-2015. occurringbetween months-13.5 years)with64%(n=42)ofdeaths was5.3years(range6 todeath 2015; mediantimefromlastdelivery (14.4%)weredeceasedasofDecember31, vitalstatus with known and only13.3%(n=74)hadaPVL<200copies/mL;66of457women and/or HIVplasmaviralload(PVL)reportedineHARS(n=106, 75.2%), clinicas evidencedbyeitheranoutpatient visit(n=35, 24.8%)oraCD4 an have AIDS diagnosis. 141women(25.4%)werestillincare2015 count was386cells/µL(IQR165-610L), and47.8%(n=266) with amedianannualincomeof$10,000. CD4+ Medianlastavailable 83%(n=463)wereblack firstdelivery; and26at HIVdiagnosis 22 at (22.5%) with Results: byHIV-infectedcare utilization patients. health comprehensivedescriptionofstate-wide these methodsallows (MSDH) EnhancedHIV/AIDSReportingSystem (eHARS). Usingbothof CARE Act clinics inMississippiandtheDepartmentofHealth Dec 31, 2014, usingclinical fromall9federallyfundedRyan data White 1,fected womenwhodeliveredinMississippifromJanuary 2002, to ORAL andmedicaloutcomesamongHIV-inHIV-related healthcareutilization Methods: postpartum womeninMississippi. describe longitudinaloutcomesandtheHIVcarecontinuumamong challengeswithcareengagement.experience greater We seekto Background: ABSTRACTS4 3 2 1 Aadia Rana(presenting) Leandro Mena Ira Wilson en inMississippi amongHIV-InfectedFollowing Delivery Wom Mississippi State DepartmentofHealth,Mississippi State Jackson, MS, USA Columbia University, New York, NY, USA University ofMississippiMedicalCenter, Jackson, MS, USA University,Brown Providence, RI, USA 556 women delivered during the study period,556 womendeliveredduringthestudy with125women 1 We and conductedaretrospective analysisofdemographics , DebbieKonkle Parker Postpartum HIVinfectedwomeninMississippiexperience ≥ 2 Postpartum HIVinfectedwomeninthedeepSouth may 2 deliveriesforatotalof681deliveries. was Medianage , BinfordNash Long-Term EngagementinCare High MortalityandLowRatesof

1 2 , ChisaLanier 2 , CaronZlotnick 2 , KendraJohnson 1 , Gina Wingood , 4 ,

3 11th International Conference on 11th International , - - - 160 could improveHIV-related outcomes. unmet needs, including housing, substanceabuse, andmentalhealth focused onaddressing that a trauma-informed-care-basedintervention project betweenSeptember2013andOctober2015, westudiedwhether Significancedemonstration a HRSA-fundedSpecialProjectsofNational orders, andunmetneedsforfood, shelter, andotherservices. As partof tion inHIVcarebecauseofsubstanceuse, mentalhealthdis untreated Background: 2 1 Jessica Davila(presenting) Yasmeen Quadri formed-Care-Based Intervention Patients UsinganIntensiveTrauma-In addressing ongoingunmetneedsinconjunctionwithHIVclinical care. in HIVcare. Continuedeffortsareneeded tosupporthomelessclients in withimprovedviralsuppressionandretention with HIVwas associated housing andunmetneeds amongpoorlyretainedhomelesspatients Conclusion: andmentalhealth. substance abusetreatment score didnotchangeorworsened. for Similarresultswereobserved whosehousingscoreimprovedandthose housing for patients 12months.from 35%to49%at Viral suppressionimprovedcomparably to 71%inthe6-monthsafterenrollment. improved Viral suppressionrate percent hadavisitinthe6monthsbeforeenrollment, whichincreased intervention. The meanhousingscorealso improvedby32%. Thirty-nine enrollmentinthe following and 94%substanceabusetreatment 93%wereabletoaccessmentalhealthservices baseline wasobserved; Results: ed retentionincareandviralsuppression. usingourin-houseresources.and providingservices Outcomesinclud providing referrals, totheproviding agencies, thepatients accompanying and otherunmetneeds. included Othercomponentsoftheintervention to clinical partnersfocusingonaddressinghousing andsocialservice withdirecthand-offs approach consistedofacoordinated intervention signed duringsubsequentencounters. The trauma-informed-carebased scorewasas baselineandanupdated at was assignedtoeachpatient baseline,collected at 3-, 6-, and12-monthfollow-up. A housingscore mental healthtreatment, data survey wereascertainedthroughpatient use, andmentalhealth. Unmetneeds, including substanceabuseand Methods: Harris HealthSystem, Houston, TX, USA Baylor CollegeofMedicine, Houston, TX, USA 156 patients wereenrolled.156 patients Improvementsinunmetneedsat At enrollment, wereassessedforhousing, patients substance Using an intensive trauma-based approached toaddress Usinganintensivetrauma-basedapproached Many homelessHIV-positive strugglewithreten Many patients Outcomes amongHomelessHIV inHIV-RelatedImprovements 1 , Nancy Miertschin HIV Treatment andPreventionAdherence 1 , Thomas Giordano , Thomas 2 , Pasalar Siavash 1 2 , CharleneFlash - 1 - - , - - 161 11th International Conference on 11th International BLMSM maybekeytoincreasingPrEPinterestandadoption. trust,patient-provider andincreasingbeliefsinPrEPefficacy among levels.patient Focusing on diversifyingPrEPprograms, improving at thesystems,significant barrierstoaccessremain provider, and Conclusion: HIV-positive partner(aOR=.61, p<0.01)islessriskyonPrEP. withcondomlesssex(aOR=.51,associated p<0.01), sexwithan orthat (aOR =2.0, p<.01), werelesslikelytobelievePrEPreducestherisk HIVriskbytakingPrEP to believetheywouldbeputtingthemselvesat PrEPefficacyreported greater concerns, including beingmorelikely decision-making (aOR=.58, p<0.001). At theindividuallevel, BLMSM (aOR=3.7, p<0.001), perceivedagency andreportedlower inmedical talking totheirdoctoraboutsexlifeabarrierPrEPuptake settings. At theproviderlevel, BLMSMweremorelikelytoconsider p <0.001), potentiallyreducingPrEPaccessibilitythroughLGBT-focused (aOR=2.4, p<0.01). BLMSMwerelesslikelytoidentifyasgay(aOR=.45, insurance (aOR=.45, p<0.001)andmorelikelytousepublicclinics Results: toPrEPuseforBLMSMversusothers. facilitators (SES),controlling forsocioeconomicstatus wecomparedbarriersand completed aself-administeredsurvey. Usinglogisticregressionmodels 66; 32%Black, and study enrolledinaPrEPmessaging 24%Latino) Methods: enhance access. to and otherMSM(n=214)tobetterunderstandpointsofintervention vider-, barrierstoPrEPusebetweenBLMSM(n=277) andpatient-level disparities. examineddifferencesinpotentialsystems-,This study pro white MSM, existingHIV andthereareconcernsaboutrecapitulating PrEPcomparedto toinitiate beenslower sex withmen(BLMSM)have Background: Hunter CollegeoftheCityUniversityNew York, NY, USA Corina Lelutiu-Weinberger (presenting) Sex withMen At thesystemslevel, private BLMSMwerelesslikelytohave MSM meeting CDC criteria for PrEP use (N=491; ages 18- MSMmeetingCDCcriteriaforPrEPuse(N=491;ages DespitereportsofhighPrEPacceptabilityamongBLMSM, Reports suggest that Black and Latino men who have menwhohave BlackandLatino Reportssuggestthat Black andLatinoMenwhohave Enhancing PrEPAccessfor HIV Treatment andPreventionAdherence , SaritGolub

- 163 access tocareisinadequate, arelacking. needs ofHIV-positive women, particularlyintheruralDeepSouth, where to HIV-positive men. However, addressingthepsychosocial interventions women aredisproportionallyaffectedbycomorbiddepressionrelative withincreasedmorbidityandmortality.and associated HIV-positive (ART),consistent predictorsofnon-adherencetoantiretroviraltherapy Background: 3 2 1 Karen Cropsey Christina Jagielski Mirjam-Colette Kempf(presenting) Women intheDeepSouth and Depression(CBT-AD) inHIV-Infected ered efficacy trialisneeded. reductions indepressionsymptomswithhighsatisfaction. A well-pow come, ruralethnicminorityHIV-positive womenresultinginsignificant Conclusion: (CBT-ADbetween interventions =29.6vsISP31.8). 30.7 (SD=3.8, maximumpossiblescore =32)withsmalldifferences was post-treatment score(CSQ-8)acrossallparticipantsat satisfaction daily adherenceadjustedfortechnicalfailuresandpocketdosing). Mean 6months(Wisepill high, baselineand91.4%at 90.2%at averaging found. butremained criteriaforthestudy Adherence wasnotanentry (Cohen’s d=1.26)). Nobetween-groupdifferenceinCES-Dchangewas sion forbothgroups(CES-D=22.6(SD2.7);(t(41)9.44, p<.0001); scores (M 6months.at of52min. Sessionslastedforanaverage BaselineCES-D 11.4 sessionsover14.8weeks;oneparticipantwaslosttofollow-up Results: questionnaires. andvalidated ceptability wereassessedusinginterviews (i.e., Interview). Neuropsychiatric Feasibility MiniInternational andac self-report, anddepressionassessedbyblindedstructuredinterview was assessedby Wisepill (real-timeadherencemonitoringdevice)and 3and6months. at evaluation post-intervention Adherence to ART Participants sessionswith werescheduledto10-12weeklytherapy 11) wasconducted, enrollingwomenacrossfourclinic sitesin Alabama. reduce depression(CBT-AD) (n adherenceand toenhancemedication therapy cognitive-behavioral Methods: University ofMiami, FL, USA Massachusetts GeneralHospital, Boston, MA, USA University of Birmingham,Alabama at AL, USA

All study participants completed the study with an average of withanaverage participantscompletedthestudy All study = 36.4 (SD = 8.9) were significantly reduced at study concluat study =36.4(SD8.9)weresignificantlyreduced

A twoarm, randomizedcontrolledpilot-trialcomparinga Telemedicine-delivered CBT-AD canbedeliveredtolow-in Depression, highlyprevalenttoHIV, isoneofthemost 1 , CorilynOtt Behavioral TherapyforAdherence A Telemedicine-Delivered Cognitive 1 , AndresAzuero 1 , ChristinaPsaros = 11) to supportive therapy (ISP)(n= =11)tosupportivetherapy 1 , KristiStringer 1 , JessicaHaberer 2 , StevenSafren 1 , RobertSavage 2 ,

3 1 - , - - - ORAL ABSTRACTS 43 44 168

relationship between stigma and appointment attendance. betweenstigmaandappointment relationship and; 2)whetherdepression, the socialsupportorCD4countmediate betweenstigmaandlonger-term1) theassociation retentionincare, exploration, qualitative shouldassess: andfutureinvestigations deserves carevisit,primary adjustingforpotentialconfounders. This finding intakewere lesslikelytomisstheirfirst internalized HIVstigmaat Conclusion: 0.15-0.91, p<0.05). CI 0.40-0.85, p<0.01)andbeing ART-experienced (aOR0.37, 95% CI (aORper10-yearincrement0.59, wereolderage of no-showing 95% 0.83, 95%CI0.70-0.98, p<0.05). decreasedodds Otherfactorsthat carevisitby17%(aOR forthefirst primary the likelihoodofno-showing stigma. Intheadjustedanalysis, eachunitincreaseinstigmadecreased points, themedianstigmascorewas1.0(IQR0-3);42%endorsedno socialsupportscoresweremid-range.on average Outofatotal6 cells/mm was8years;medianCD4cellcount495 time fromHIVdiagnosis ART-experienced, inthepast year. and18%werediagnosed Median Latino. Eighty-fivepercenthadbeeninHIVcarepreviously, 80%were 42 (range20-73);92%weremale, 79%MSM, 23%blackand carevist.subsequently missedthefirstprimary age was Themedian Results: carevisit. thefirstprimary at between stigmaandattendance ORALHIV carehistory, andprior ART wasusedtoassesstheassociation age, gender, race, ethnicity, sexualorientation, timesinceHIVdiagnosis, clinicat intake. adjustedfor logisticregressionmodel that A multivariate nalized StigmaScaleaspartofasocialworkassessment AIDS-Related asafety-netHIVclinic at new patients inSanFrancisco usingtheInter Methods: longitudinal outcomedata. ABSTRACTSlimited byself-reportedcareoutcomes, smallsamplesizes, andalackof incare,HIV-related stigmapredictspoorerengagement butthisworkis Background: University ofCalifornia, SanFrancisco, CA, USA Dilworth, MonicaGandhi, Torsten Neilands, ElvinGeng Katerina Christopoulos(presenting) Care Primary ically PredictMoreSuccessfulLinkageto We 341newlyenrollingpatients, evaluated 22%ofwhom 3 . toseveredepressionand Thirty-three percenthadmoderate Between February 2013andDecember2014, weassessed Inasafety-netHIVclinic, withhigherlevelsof patients Existing research in the United States suggests that suggeststhat ExistingresearchintheUnitedStates Stigma atClinicIntakeParadox Higher LevelsofInternalizedHIV , Johnson, Mallory Samantha 11th International Conference on 11th International - - 169 Resources for Urban Sexual Health (CRUSH) Projectwasconceivedasa Resources forUrbanSexualHealth(CRUSH) ofEmergencywhere aHIVState hasexistedsince1998. The Connecting infections, particularlyinurbansettingssuchasOakland, California, iscriticalforstemmingthetideofnew relevant sexualhealthservices youth intheUnitedStates. Improvingaccesstoculturallyandclinically men (Y/MSM)accountfornearly75%ofallnewinfectionsamong Background: 3 2 1 Remi Frazier Ifeoma Udoh Erguera Xavier Michael D’Arata with Men PrEP. targeting messaging into Y/MSM ofcolorareneededforengagement Y/MSM inroutinesexualhealth. Intensifiedin-reachandoutreach youthisessentialtoengage forbothHIVpositiveandnegative treatment Ensuring flexible clinic accessincluding dropinvisitsforSTI testing and caresetting. PrEPintoanexistingHIVprimary a criticalforintegrating of colorwashigherthananticipated. is ProvidingroutineSTItreatment Conclusion: period. 36 weeksofa48-weekstudy participants is24.7. amountoftimeparticipantsstayonPrEPis Average Just over26%(n=96of373)are Y/MSM ofcolor. ofall age Average some pointinthecourseofstudy.were assessedasneedingPEPat receivedPrEP.have About 17%(n=43of259)thosereceivingPrEP tive and93HIVpositiveparticipantstoreceivesexualhealthcare;259 Results: retention efforts, youthtoaccessbarrierfreeservices. allowing MSM, embodiesa CRUSH “clinic withoutwalls” structure, supporting PrEP andPEP, andadherencesupportforPrEP ART. To engage Y/ receive regularHIVtesting, forSTIs, beassessedandtreated access community partners, canarriveforscheduledordrop-invisits; patients PEP access, for Y/MSM ofcolor. Utilizingabroadrangeofscientificand routine sexualhealthservices: STIscreeningandtreatment, PrEPand ofHIVcare,tiveness ofapackage andprevention, treatment including Method: serostatus, sexualhealth services. canaccessaffirmingandinnovative toHIVpreventionwhere comprehensive approach Y/MSM, regardlessof Pangea Global AIDS Foundation, Oakland, CA, USA University ofCaliforniaSanFrancisco, CA, USA East Bay AIDS Center, Oakland, CA, USA Since February 2014, enrolledatotalof280HIVnega CRUSH The aim of CRUSH is to implement and evaluate theeffec istoimplementandevaluate The aimofCRUSH 2 3 Uptake of sexual health services inthissettingfor Uptake ofsexualhealthservices Y/MSM , KimberlyKoester sexwith youngmenwhohave that The CDCestimates 2 , RobertGrant 1 for Young UrbanMenwhohaveSex PrEP andSexual HealthServices , JessicaHorwitz HIV Treatment andPreventionAdherence 2 , JeffBurack 2 , Janet Myers(presenting) 1 , RebeccaPackard 1 , Mi-SukKangDufour 2 , KristinKennedy 2 ,

2 , -

1 -

, 173 11th International Conference on 11th International young peopleliveandwork, notjusttheirpill-takingbehavior. to improveadherence ART mustconsidertheenvironmentinwhich adherence. affectHIVmedication survive Conclusion: needsOR0.25(95%CI0.07-0.93). about survival and insurancestatus, withconcerns adherenceremainedassociated low and uninsured. withbeingBlack,ence wasassociated Hispanic, ormixedrace/ethnicity being White or insurance;lessthan90%adher private Asian andhaving safe community. concerned mostorallofthetimeaboutbeingabletoliveandworkina (28%).Hispanic/Latino was25. Meanage Morethanhalfreportedbeing were male(95%)gayidentified(75%)andeitherBlack(59%)or 73 individuals. forasubsetof55.Viral loadresultswereavailable Most Results: self-reported adherenceandviralloadlabresults. the courseofoneyear. vices, infourcomputer-assisted andtoparticipate over self-interviews California. theEastBay at study AIDS CenterinOakland,Sexual Health(CRUSH) between 18and29wereenrolledintheConnectingResourcesforUrban Methods: inHIVcare. aimingtoimproveengagement inastudy men participating these factorsandtheirinfluenceonHIVoutcomesinasampleofyoung e.g., unmetaccesstohousingandjobs. for thesedifferencesmayinclude competingneedsfacingyoungpeople, viralsuppression. andlower in startingantiretroviraltherapy Reasons poorerretentionintreatment,(MSM) livingwithHIVhave increaseddelay Background: 3 2 1 Remi Frazier, Mi-SukKangDufour, Kristin Kennedy Color inOakland University ofCaliforniaSanFrancisco, CA, USA Pangea Global AIDS Foundation, Oakland, CA, USA East Bay AIDS Center, Oakland, CA, USA Interview and self-reported adherence data were available for wereavailable andself-reportedadherencedata Interview

Participants enrolledtoreceiveHIVand sexual healthser Between February, 2014and2016HIV-infected individuals ConditionsaffectingtheabilityofyoungurbanMSMto

Compared toadults, sexwithmen youngmenwhohave Inmultivariablelogisticregressioncontrollingforrace 1 among Young HIV-Infected MSMof NeedsandARTSurvival Adherence , JeffBurack with than90%wasassociated Adherence ofgreater We characteristics, reportbaseline demographic 1 , IfeomaUdoh Janet Myers(presenting) HIV Treatment andPreventionAdherence We examinetheprevalenceof Clinicalprogramsseeking 2 , KimberlyKoester,

- - 177 viral loadsuppression(VLS)oneyearafterhospitaldischarge. Houston, wesoughttodeterminepredictorsofretentionincare(RIC)and in ofapeermentoringintervention study recently completednegative for out-of-carehospitalizedpatients. froma Usingparticipantdata Background: 4 3 2 1 Christine Hartman Melinda Stanley of HIVCare One Year AfterbeingHospitalizedwhileout HIV care. with outpatient toimproveengagement most inneedofinterventions andnorecentHIVcareappear talized withchallengingsocialsituations recent ART hospitalization, useat andwithemployment. Persons hospi arebetterforpersonsnewlydiagnosed,care ornewlydiagnosed with Conclusion: p =.03). <.001), enrollment(OR=1.92,VLS at P=.03), (OR=1.82, andemployed p =.05). Multivariablepredictorsof (OR=5.72,VLS werenewdiagnosis p .02), (OR=1.89, employed p=.03), andon ART enrollment(OR=1.57, at Spanish speaker(OR=6.48, p<.01), CD4 appointments.to schedulefollow-up MultivariablepredictorsofRICwere depression, lengthofhospitalization, visitbeforedischarge andalinkage speaker. Non-significantfactorsincludedage, race, sex, maritalstatus, employed, newdiagnosis, and, forretentiononly, MSMandSpanish predictors ofbothoutcomesincluded norecentuseofillegaldrugs, 12 months, 65%wereretainedand33%had VLS. analysis, Inunivariate 78% CD4<200cells/mm withHIVinfection; non-Hispanic black;40%MSM;11%newlydiagnosed analysis.to-treat At baseline, was42years;73%male;67% medianage Results: analyses examinedpredictorsoftheoutcomes. were consideredfailures. andmultivariablelogisticregression Bivariate and days apart) 12months.VLS (<400copies/mL)at Missingdata were RIC( withHIVoroutofcare.ly diagnosed Outcomesforthispost-hocanalyses Methods: Houston,USA TX, VA inQuality, CenterforInnovations EffectivenessandSafety, University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA Northwestern University, Chicago, IL, USA Baylor CollegeofMedicine, Houston, TX, USA We enrolled460participants;417wereinthemodifiedintent- Participants wererecruitedwhenhospitalizedandeithernew ≥ 2 completed HIV primary carevisitsover12months,2 completedHIVprimary RICand VLS oneyearafterbeinghospitalized while outof Re-engagement inHIVcarecanbeuniquelychallenging Re-engagement 1 and HIVViral LoadSuppression Predictors ofRetentioninHIVCare , MichaelKallen 4 , Thomas Giordano(presenting) 3 ; 20% VLS; 47%recentprescriptionfor ART. At 2 , K. Rivet Amico ≥ 350 cells/mm 3 , JessicaDavila 1 3 (OR=1.92, p=

≥ 1 , 90 - - ORAL ABSTRACTS 45 46 180

efforts. Policy arediscussed. andprogramimplications mayidentifymoreout-of-caremembersthanData-to-Care populations Conclusion: PWID. Mortality washigh(8%)amongeligiblepersons, bothcaseswerefemale were referrals, ofwhom25%wereeligibleandenrolledintheprogram. identified. butconsistent; 19%ofpersonsscreened Referralswereslow accepted bythetargetcommunities, butonly1out-of-carePWIDwas violence concernsaccountedfor75%ofnon-enrollments. Outreachis sons enrolled). Feeling ‘too sick,’ symptoms, withdrawal anddomestic (67%of personsscreened,persons fromkeypopulations 83%ofper wereidentified.populations In-reachyieldedthemajorityofout-of-care 30% hadphonecontacts[nonewerePWIDorFSW]. Noout-of-carekey Results: eligible), enrolling18(69%;6PWID, 2FSW, 10MSM)intheintervention. persons, (40% identifying26out-of-carepersonsfromkeypopulations andcommunitymembers.from localagencies Promotoresscreened64 outreach (healthfairs)withinthetargetcommunities, andreferrals programs (needleexchange, HIVtesting, free-community-basedclinic), More traditionalmethodsincluded thehostorganization’s in-reachat policynational home-basedcontactofHIV-positive discourages persons. program;contactswererestrictedtophonecallsas versal HIVtreatment asout-of-carevis-à-visMexico’s wereflagged where localpatients uni with MexicanFederal (ISESALUD)healthofficials, (CENSIDA)andState recruitment methods. methodwasusedincollaboration A Data-to-Care ORAL activities weretracked(08/15/2015-02/29/2016)tomonitorapproved in HIVtreatment inavailable key populations Tijuana. Promotors’daily tion, Method: sexwithmen[MSM])inthiscontext. have inject drugs[PWID], insexwork[FSW], femalesengaged andmenwho (personswho tional methodsforidentifyingout-of-carekeypopulations ABSTRACTS andmoretradi comparestheutilityofData-to-Care The currentstudy substantial challengeinresourcelimitedsettings, like Tijuana, Mexico. Background: 2 1 Eileen Pitpitan Traditional Methods A ComparisonofData-to-CareandMore Universidad Autónoma deBajaCalifornia, Mexicali, Mexico University ofCaliforniaSanDiego, CA, USA Conexiones Saludables A newcommunity-basedpromotor(peer-navigator) interven National HIV data flagged 311 out-of-care patients in 311out-of-carepatients flagged HIVdata National Tijuana, withcommunity-basedprogramstargetingkey Affiliation Engaging key populations intheHIVcarecontinuumisa keypopulations Engaging 1 , RebecaCazares Populations inTijuana, Mexico: Identifying Out-of-CareKey , out-of-care workstoidentifyandengage 2 , Laramie Smith(presenting) 1 11th International Conference on 11th International - - - - 190 presumed OOC/NIC(noCD4or VL Method: DtC initiatives. who areCTCorOOJcanincreasetheoverallandcost-effectivenessof jurisdiction (OOJ). ReducingthenumberofPLWH presumedOOC/NIC in New York City(NYC)mayactuallybecurrenttocare(CTC), oroutof to care, haslimitations. For example, PLWH presumed tobeOOC/NIC never-in-care (NIC)personslivingwithHIV(PLWH) inordertolinkthem toidentifyout-of-care(OOC)or registry reports intheHIVsurveillance Background: New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, Shakara Brown(presenting) Lessons forotherJurisdictions should beimplementedandencouraged. agencies withHIVsocialservices Protocols forreciprocaldata-sharing healthdepartmentsoptimizesDtCinvestigations. localandstate tries at Conclusion: presumed OOC/NICPLWH forLTC initiated whowereCTCorOOJ. to ascertaincurrentresidency reducedthenumberof andcarestatus NIC, animprovementfrompreviousyears. sources Useofmultipledata thus far, 13%wereCTC, 3%wereOOJ, and82%wereconfirmedOOC/ ofthe178OOC/NICPLWH that results show tracedandinvestigated Results: to identifyOOC/NICPLWH likelyresidinginNYCforoutreach. outside NYC. agency We database toaNYCsocialservices alsomatched in2015toidentifyandexcluderegistry PLWH receivingcareinNYSbut theNew against matching systematically York HIVsurveillance State residing inNYC. were CTC, 13%wereOOJ, and62%wereconfirmedasOOC/NIC PLWH presumedOOC/NICbetween2013and2015. Among these, 22% tocare. areregularlyselectedforlinkage diagnosis) DtCidentified2,563 With theimplementedchangesinourmethodology, 2016 The NYChealthdepartmentimplementedDtCin2008. Persons Routine cross-jurisdictional data-matching betweenregis Routine cross-jurisdictionaldata-matching Data toCare(DtC),Data ofCD4or theutilization VL RNA To classification, improveoutofcarestatus webegan Data toCareMoreEfficient: New York City’s Effortstomake HIV Treatment andPreventionAdherence , Chi-ChiUdeagu ≥ 9 months/orwithin6monthsofHIV

- 200 11th International Conference on 11th International surroundingPrEP. withinmedicaleducation grated populations, culturalcompetence trainingbeinte that itisimperative heterosexism. ofMSMandotherpriority Giventhemarginalized status to affectPrEPclinical decision-makingorbuffertheadverseimpactof diminishingPrEPprescription.ultimately failed PriorPrEPeducation Conclusion: indirecteffects(p>.05). any toclinicaldid notrelate judgmentsorprescriptionwillingnessbuffer CI(-.13,characteristics [95%bootstrapped -.01)]. PriorPrEPeducation less sexremainedsignificantafteradjustingforrelevantbackground and adherepoorly. indirecteffectviapredicted condom The negative more likelytoincreasecondomlesssex, sex, inextra-relational engage pathways,willingness viaall3mediational judgedas withthepatient adjusted analyses, prescription tolower heterosexismindirectlyrelated sex.extra-relational Suboptimaladherencewaspredictedby53%. Inun relationship, PrEPwouldlead to 30%endorsedsomelikelihoodthat sex ifprescribedPrEP. Though informedofthepatient’s monogamous inmorecondomless wouldengage thepatient some likelihoodthat inmedicalschool.prior PrEPeducation The majority(90%)perceived Results: wasexamined. effectofPrEPeducation moderating betweenheterosexismandprescriptionwillingness.the relationship The gaymen.toward of Clinicaljudgmentsweretestedasparallelmediators Heterosexism wasassessedviaaself-reportmeasureofattitudes and adherence), PrEPprescriptionwillingness, andpriorPrEPeducation. increasedcondomlesssex,judgments (anticipated sex, extra-relational about aPrEP-seekingMSMpatient. Participants reportedclinical andaclinicalpresented withPrEPbackgroundinformation vignette Methods: buffering effectofPrEPeducation. ship betweenheterosexismandPrEPclinical decision-makingandthe isessential. delivery on PrEPservice examinedtherelation This study pre-exposure prophylaxis(PrEP), minimizingtheimpactofproviderbias Background: 7 6 5 4 3 2 1 Trace Kershaw Magnus Manya Sarah Calabrese(presenting) Education Regarding Provider Decision-Making andConsiderations Massachusetts GeneralHospital, Boston, MA, USA University ofGeorgia, Athens, GA, USA Boston Children’s Hospital, Boston, MA, USA George Washington University, Washington, DC, USA Beth IsraelDeaconessMedicalCenter, Boston, MA, USA University,Harvard Cambridge, MA, USA Yale University, NewHaven, CT, USA Mostparticipants(85%)hadheardofPrEPand50%reported USmedicalstudents(n=115), online(2015), surveyed were Heterosexismmaycompromiseclinical judgment, forHIV indicated With 1in4MSMtheUnitedStates 1 4 , JosephBetancourt , KristenUnderhill Heterosexism forPrEPClinical Adverse Implicationsof 1 , KennethMayer 1 ,Earnshaw Valerie 7 , JohnDovidio HIV Treatment andPreventionAdherence 2 , DouglasKrakower 1 5 , Hansen Nathan - 3 - , - 6 , - 201 visits would facilitate proactive,visits wouldfacilitate targetedinterventions. outcomes andhighermortality.at riskofmissed ofpatients Identification Background: 7 6 5 4 3 2 1 Jeanne Keruly Christopoulos Katerina Brian Pence (presenting) HIV CareintheUnitedStates grated Systems(CNICS)CohortofPatients in interventions to those at greatest risk. greatest tothoseat interventions visits, ofresourcesandtailoring forproactiveallocation allowing riskformissed thepoint ofcarecanidentifythoseat at readily available Conclusion: predictive value. positive predictivevaluebutmoremoderate Cutoffs hadhighnegative AUC =0.64, andthebestriskscorehad69%sensitivity/50% specificity. demographic, clinical andpsychosocialvariables(butnoMVP)yielded specificity(50%).but lower For thoseincare<1year, amodelwith chosocial variablesimproved AUC andyieldedhighersensitivity(79%) had 67%sensitivity/61%specificity. Demographic, clinical, andpsy 0.68; ariskscorecontrastingthosewithpast-yearMVP visit waspast-yearMVP. A modelwithonlythispredictorhad AUC = Among thoseincare 25.8). For 16%ofvisits, wasmissed. thenextscheduledappointment (mean =5.3, SD=4.4)and334,892HIVvisits(mean28.9, SD= Results: from predictedprobabilities. (AUC)andthesensitivityspecificityofcurve “riskscores” derived tions perperson, theareaunderreceiveroperating andcalculated We fitlogisticregressionmodelswith clustering formultipleobserva in care alcohol use, druguse, andantiretroviraluseadherence. For patients gender, race/ethnicity, timeincare, CD4, viralload, depression, anxiety, psychosocialvariables.patient-reported Predictorsincluded site, age, usingdemographic,the nextscheduledappointment clinical, and ≥ tween 2002-2014, inCNICScare <1vs consideringpatients separately Methods: 1 year. At eachHIVappointment, wepredictedthelikelihoodofmissing University ofCaliforniaSanDiego, CA, USA Johns HopkinsUniversitySchoolofMedicine, Baltimore, MD, USA University of Washington, Seattle, WA, USA University ofCaliforniaSanFrancisco, CA, USA Fenway Health, Boston, MA, USA University of Birmingham,Alabama at AL, USA Hill, Chapel University ofNorthCarolinaat NC, USA ≥ 1 year, weincluded thepast-yearmissed visitproportion(MVP). Overall, 11,581participantscontributed61,461person-years 6largeUSHIVclinics at We onpatients be analyzeddata Past andclinical attendance andpsychosocialfactors MissedHIVmedicalcarevisitspredictpoorclinical 6 , ChrisMathews Visits intheCFAR NetworkofInte Who WillShow?PredictingMissed ≥ 4 1 year, thestrongestpredictorofafuturemissed , StephenCole 1 , MichaelMugavero 7 1

, HeidiCrane 2 , StephenBoswell 5 , ElvinGeng ≥ 50% vs<50% 4 , 3

, - - - - ORAL ABSTRACTS 47 48 204

efforts mayneedtoaddressmentalhealthissuesformaximumimpact. missed visitsareindependentlypredictiveofpooroutcomes, retention imum definitionofretentionbutmorelikelytomissscheduledvisits. withdepressionwereequallylikelytomeetamin patients that indicate Conclusion: andMVP.depression onmissedappointments criterion. points. the MVPovernext12monthsby3(95%CI=1-4)percentage =1.18,pointment by18%(riskratio 95%CI=1.08-1.29)andincreased particular visitincreasedthelikelihoodofmissingnextscheduledap wereeverdepressed(PHQ-9score patients (mean =2.7, =1.8). standarddeviation Duringfollow-up, 37%of Results: proportion, MVP). weremissedoverthenext12months(missedvisit scheduled visitsthat months (HIV/AIDSBureau[HAB]in-carecriterion), and(3)proportionof attending thenextscheduledHIVmedicalappointment,attending (2)probabilityof the causaleffectofdepressionon(1)probabilitymissingvs. marginalstructuralmodeltoestimate weights andarepeated-measures soring (2014). We andcensoring usedinverseprobabilityoftreatment HIVappointment),months withoutanattended cen oradministrative fromtheirfirstPHQ-9untildeath,We patients followed losstocare(>12 least oncebetween2005and2013.Health Questionnaire-9(PHQ-9)at CNICS siteswhocompletedadepressionassessmentwiththePatient Methods: defined. and clinical outcomes. withmissedHIVvisitsislesswell Itsrelationship ORAL with poorantiretroviraladherence Depression isstronglyassociated Background: 8 7 6 5 4 ABSTRACTS3 2 1 Michael Mugavero Richard Moore Heidi Crane Brian Pence (presenting) (CNICS) CohortintheUnitedStates in theCFAR NetworkofIntegratedSystems University of Birmingham,Alabama at AL, USA University ofMiami, FL, USA MedicalSchool,Harvard Boston, MA, USA Johns HopkinsUniversitySchoolofMedicine, Baltimore, MD, USA University ofCaliforniaSanDiego, CA, USA Duke University, Durham, NC, USA University of Washington, Seattle, WA, USA Hill, Chapel University ofNorthCarolinaat NC, USA

There wasnoeffectonthelikelihoodofmeetingHABin-care Patients contributed a total of 26,155 person-years of follow-up Patients contributedatotalof26,155person-yearsfollow-up

The longer a patient wasdepressed,The longerapatient theeffectof thegreater 6largeUS inHIVcareat We on9,752patients analyzeddata ≥ 2 2 HIV medical appointments 2 HIVmedicalappointments , BradleyGaynes These resultsusingrobustcausalinferencemethods Depression is highly prevalent among patients inHIVcare. Depressionishighlyprevalentamongpatients 5 , SoniaNapravnik HIV MedicalVisits amongPatients The EffectofDepressiononMissed

8 1 , Angela Bengtson Angela 3 , Amy Heine , Amy 1 , ConallO’Cleirigh ≥ 1 90 days apart overthenext12 90 daysapart , ChrisMathews ≥ 1 10). , StephenCole Depression at a Depression at 6 , StevenSafren 4 ,

1 ,

11th International Conference on 11th International 7 , -

As - - 207 not on ART andcurrentsubstanceusers(N=203;74women/129men; Methods: fortheseeffects. pathways toms, socialsupport, andphysiciantrust, aswellpotentialmediating healthcare setting(HCS)onnon-suppressedviralload, depressivesymp In response, examined theeffectsofexperiencingstigmaina thisstudy is vitaltoachievingbetterhealthoutcomesforpeoplelivingwithHIV.” prevention, testing, andcarecanbedeliveredinastigma-freemanner House MeetingonHIVStigma(March, 2016), HIV “working toensurethat andretentioninHIVcare.major roleinlinkage a As notedat White Background: University of Birmingham,Alabama at AL, USA Bulent Turan, RobinLanzi, Janet Turan, among People LivingwithHIV for peoplelivingwithHIV. andretentionincare,ical toimprovelinkage aswellhealthoutcomes Conclusion: physiciantrust. stigma inaHCStolow fromexperiencing workers wasparticularlyimportantinthepathway and physiciantrust. stigmawassignificantinpredictingsocialsupport through anticipated effectofHCSstigmathroughinternalized andthen mediation to internalizedstigma, whichleadstodepressivesymptoms. The serial ized stigmawassignificant, experiencingHCSmaylead suggestingthat indirect effectofHCSstigmaondepressivesymptomsthroughinternal other predictorswereadded(aOR=4.60, 95%CI[1.03, 20.56]). The withnon-suppressedviralload,ciated whichremainedsignificantwhen Results: (using bias-corrected95%CIforindirecteffects)wereconducted. self-reportmeasures.dated analyses Logisticregressionandmediation workers), socialsupport, trustinphysicianswereassessedusingvali stigma, stigma(fromcommunity;friends/family;healthcare anticipated viral loadwereextractedfromclinic records. HCSstigma, internalized 73 white/130black). ondepressivesymptoms, Data of duration ART, and Notably, experiencingstigmainaHCSwassignificantlyasso Participants fromanHIVclinic; werepatients excluding those Reducingexperiencedstigmainhealthcaresettingsiscrit

Experienced stigmainhealthcaresettingscanplaya Settings andHealthOutcomes HIV-Related StigmainHealthcare stigmaspecificallyfromhealthcare Anticipated HIV Treatment andPreventionAdherence

Whitney Smith(presenting) -

- - - - 208 11th International Conference on 11th International strategies. considering preventionandintervention stage. factorsisessentialwhen andstage-specific Recognitionofage- PHIV increasedwithage, factorsvariedbydevelopmental andassociated Conclusion: adolescence); perceived ARV sideeffects(emergingadulthood). income,(early adolescence);lower perceived ARV sideeffects(late withUVLincluded:associations oftheirHIVstatus youthunawareness disclosure, adolescence). CD4%late Inadjustedmodels, significant ly adolescence);indirectexposuretoviolence, stigma/fearofinadvertent (pre-adolescence); beingBlack, system, buddy once dailyregimens(ear nonadherence included: systemtopromoteadherence usingabuddy adolescence. bylate pre-adolescence followed Factors with associated withnonadherence,were associated in magnitude withthegreatest tively. allages, Inadjustedanalysesat perceived ARV sideeffects from 31%to50%(p<0.001)and16%40%<0.001), respec emerging adulthood, prevalenceofnonadherenceandUVLincreased, [17%]), 52%weregirls, and75%wereBlack. From pre-adolescenceto adolescence [32%], adolescence[36%], late andemergingadulthood Results: effects models. (“emerging adulthood”), fittingmultivariablegeneralizedlinearmixed 12-14 (“earlyadolescence”), adolescence”), 15-17(“late and18-21 age (years):and UVLwereidentifiedby 8-11(“pre-adolescence”), Individual, caregiver, withnonadherence andsocialfactorsassociated past week)andUVL(HIVRNA>400copies/mL)wereassessedannually. chosocial evaluations. misseddose, Self-reportednonadherence(any enrolled youthandcaregiversviarecordabstractionphysical/psy Methods: HIV/AIDSCohortStudy atric Adolescent MasterProtocol(AMP). ofadolescenceamongparticipantswithPHIV inthePediacross stages been observed. withtheseoutcomes We factorsassociated investigated HIV(PHIV)have adolescence amongyouthwithperinatally-acquired herence andunsuppressedviralload(UVL)inyoungadulthoodvs. early Background: 7 6 5 4 3 2 1 the Pediatric HIV/AIDSCohortStudy Sonia Lee Claude Mellins Deborah Kacanek(presenting) AIDS CohortStudy:ALongitudinalAnalysis Perinatally AcquiredHIVinthePediatric HIV/ Adolescent DevelopmentinUSYouth with Baylor CollegeofMedicine, Houston, TX, USA InstitutesofHealth,National Bethesda, MD, USA Children’s and Diagnostic Treatment Center, Fort Lauderdal, FL, USA Chicago,University ofIllinoisat IL, USA Columbia University, New York, NY, USA Chicago, IL, USA Northwestern UniversityFeinberg SchoolofMedicine, Harvard T.H. ChanSchoolofPublicHealth, Boston, MA, USA Of379youth(1,190visits: pre-adolescence[14%], early 6 At 15clinical sitesacrosstheUS, wereobtainedfrom data , ClaireBerman The prevalenceofnonadherenceandUVLinyouth with Elevated rates of antiretroviral (ARV) medication nonad ofantiretroviral(ARV)medication rates Elevated 3 , ReneeSmith Viral LoadacrossStagesof Nonadherence andUnsuppressed 1 , Paul Mary 4 , Patricia Garvie 1 , YanlingHuo HIV Treatment andPreventionAdherence 7 , Ana Puga , Ana 5 1 , Katherine TassiopoulosKatherine , , Malee Kathleen 5 , Susannah Allison, for

2 ,

- - - 1 - , - 211 analysis wastodescribeself-reporteduptakeofPrEPamong YMSM (YMSM): increasedriskofHIVinfection. agroupat The purposeofthis described PrEPuptakeamongyoungMSM States, fewstudieshave very sexwithmen(MSM)intheUnited phylaxis (PrEP)amongmenwhohave Background: 4 3 2 1 Robert Garofalo Anna Hotton Size Race, Sexual RiskBehavior, and Network Who HaveSex withMenisAssociated of actionandpointsintervention. work size. Furtherresearchisneededtoidentifypotentialmechanisms among is low YMSM andvariesbyrace, andnet sexualrisk behavior Conclusion: withPrEPuptake. significantly associated werenot tions ofBlackracewithsocioeconomicandinsurancestatus use ofPrEP. A testoftimetrendovertheenrollmentperiodandinterac (vsHouston)weresignificantlymorelikelytoreport those fromChicago sex inthepast6months, thosewithlarger YMSM networksize, and uptake, whilethosewithanHIVpositivesexpartnerorreportinggroup model, Blacks(vs Whites) weresignificantlylesslikelytoreportPrEP (4.7%) and Whites thehighest(29.5%). Inthemultivariableregression reported evertakingPrEP;Black ofuptake rates YMSM hadthelowest 18orolder.who wereHIV-negative (tested)andaged A totalof12.2% Results: and RDSweight. multivariable logisticregressionmodels, controllingforrecruitmentchain engagement. Potential ofPrEPuptakewereassessedin correlates characteristics, sexualriskbehavior, care networktiesandPrEP-related thebaselinevisitregardingtheirsociodemographic questionnaires at ticipants completedHIVtestingandself-interviewer-administered andHouston)from2014-2016. threesitesintwocities(Chicago at Par of YMSM, 16-29, ages recruitedviarespondent-drivensampling(RDS) Methods: outside ofaformalPrEPtrial, ofuptake. aswellpotentialcorrelates University of Texas Houston, at TX, USA University ofChicago, IL, USA Lurie Children’s HospitalofChicago, IL, USA Hektoen Institute, Chicago, IL, USA The analyticalsampleincluded N=394(of553)participants Data for this analysis come from an on-going network study forthisanalysiscomefromanon-goingnetworkstudy Data 1

, Evidence outside of a formal PrEP trial indicates that uptake that Evidence outsideofaformalPrEPtrialindicates Lisa Kuhns While evidence suggests slow uptakeofpre-exposurepro While evidencesuggestsslow Prophylaxis (PrEP)inYoung Men Uptake ofPre-Exposure 2 , KayoFujimoto

(presenting) 4 2 , JohnSchneider

3 ,

- - - - ORAL ABSTRACTS 49 50

POSTER ABSTRACTS 9 for any HIVintervention. for any whileplanning shouldbetakenintoconsideration by thiskeypopulation ofSTI healthfacilitiesandthebarrierstoaccessingtreatment available Conclusion: than 7months. thanMSMwholivesinanarealess likely toaccessqualitySTItreatment between7to 12monthsare0.253timesmore livedinalocation have ofHealthFacility theservices wasfriendly.and believedthat MSMwho accessed while32.1%MSM withtheservices/treatment being satisfied (34.4%). reported Only40.4%oftheMSMwhoreceivedSTItreatment centers/publichospitals(16.9%MSM)andothers visits totreatment (27.5% MSM), sideStores(20.6%ofMSM), patent/road withonlyafew fromunqualifiedsourcesincludingobtained treatment self-medication six months. Mostoftherespondentswithself-reportedSTIsymptoms respectively, forSTIinthelast while49.2%ofMSMreceivedtreatment The proportionofMSMwhoreportedSymptomsSTIwas25.4% Results: services. treatment withuptakeofSTI analysis wasalsodonetoidentifyfactorsassociated betweenvariables.to testforassociation logisticregression A binary gorical variablestoidentifyprevalencewhilechisquaretestswereused semi-structured questionnaire. Descriptionanalysiswasdoneforcate wascollectedusinga STI symptomsandaccesstohealthcareservices (LGAs). characteristics, onsocio-demographic Information self-reported to recruit195MSMrespondentsin5selectedLocalGovernment Areas Methodology: State,Lagos Nigeria. uptakeamongMSMin services withSTItreatment factors associated istodescribetheburdenofSTIsandidentifykey aim ofthisstudy riskpopulation.prevalence ofbothSTIandamongthisHIVmostat The developing countries, including Nigeria. This hasledtoanincreasing ened bysocialdiscrimination, recentlyenactedinmany anti-gaylaws asoftenwouldbedesirable. services treatment iswors This situation toaccesssexuallytransmitted onfection(STI) men (MSM)donotappear Background: 3 2 1 Grace Hygie-Enwerem Tosin Oderinde Samuel Nwafor(presenting) have Sex withMen(MSM)inLagos, Nigeria Ngohygie-Enwerem Foundation, Lagos, Nigeria Society forFamily Health, Abuja, Nigeria Centre fortheRighttoHealth, Lagos, Nigeria Treatment UtilizationbyMenwho Service Sexually Transmitted Infection(STI) The mean age oftheMSMwas24.94+4.7yearsold. The meanage MSM access STI treatment carefromawiderangeof MSMaccessSTItreatment HIV high risk population including HIVhighriskpopulation sexwith menwhohave Respondentdrivensampling(RDS)techniquewasused 2 , Chinedu Onyekatu 3 1 , Stella Iwuagwu 1 , OloruntobaBabawarun 1 , ChristyEkerete-Udofia 1 ,

11th International Conference on 11th International - 1 - , 10 sitivity analysis. tothequalityofprimary Heterogeneityattributable size and95%CI. wasdeterminedbysen Robustnessoftheestimate Methods: cember 2015). in thePubMed, Embase, 2000-De (January andCochranedatabases studies basedonacomprehensivesearchofobservational relationship Objective: among HIV-positive individualsinantiretroviraltherapy. adherence betweenhousingstabilityand medication of anassociation Background: Albert EinsteinCollegeofMedicine, Bronx, New York, USA Rebecca Harris(presenting) Persons LivingwithHIV? tion ofhousingstability, buttheeffectissmallandnotrobust. Conclusions: biaswasnotdetected. Publication of thesubgroupandmeta-regressionanalyseswerenonsignificant. mean difference=0.15;95%CI=0.02-0.29), butnotrobust. Results adherencewaspositiveandsignificant(standardized ity andmedication Results: plot andtheEggerBeggtests. meta-regression analyses. withafunnel biaswasevaluated Publication wasassessedbysubgroupand studies ortoaseculartrendinthedata betweenhousingstabil effectfortheassociation The summary overalleffect A randomeffectsmodelwasusedtoestimate We conductedameta-analysisofthehousing–adherence Adherence to Antiretroviral Therapyin Adherence toAntiretroviral Does HousingStabilityAffect adherenceisanincreasingfunc Antiretroviral medication Previousresearchhasproducedinconsistentevidence HIV Treatment andPreventionAdherence , Peter Selwyn, XiaonanXue - - - - 12 11th International Conference on 11th International anexcellentrangeofadolescentsandyouth. have because itwasthe usingsocialnetworks strategies WG consensusthat called oftheapplication ation “Viva Bem” hasemergedasdemand WG, toaccession.linked touniversitiesandresearchcentersrelated The cre of thedepartmentSTD, (DDAHV) andpeople AIDS andviralhepatitis ofthesocialmovementtocombat of representatives AIDS, members work adherencetoantiretroviraltreatment. The WG ismixed, composed to strategies aims toreflectanddiscussmechanismsinnovative of HealthBrazil, throughthe Working Group(WG)of Accession, which Bem” bythedepartmentofSTD, AIDS, and oftheMinistry Viral Hepatitis Conclusion: youngrequiresandneeds. that inhealth andcommunication these spacesasawayofusinglanguage toworkadhesionin it isimportantforthesemechanismsandstrategies roviral treatment. The youtharehighlyconnectedtosocialnetworks, so adherencetoantiret young peoplelivingwithHIV/AIDSandencourage Results: co-infections andopportunisticinfections. sufferingfromotherdiseases,- thusbenefitingalsopatients aswell to remember, also, medications canbeusedtoregisterany theapp that theprogress oftheirtreatment.viral loadandthusfollow Itisimportant Bem” and canrecordCD4testsdata wherepatients workslikeadiary orgetyourmedicineinhealthservices.to medicate Inaddition, the “Viva HIV/AIDS withantiretroviral(ARV)toremindtheuserwhenitisnecessary for totreatment contributes tobetteradherenceofpatients that strategy isa ofHealthlaunchedthetoolon12May2015.Theapp the Ministry Method: to antiretroviraltreatment. leastadhere cents andyoungadultsarethesegmentofpopulation HIV-positive, regardlessofviralload. But, allevidence, against adoles as toallpeoplediagnosed universal accesstoantiretroviraltreatment Brazil, guidelinesforHIVandtopromote changedthe treatment have Introduction: 3 2 1 Diego Calixto(presenting) Brazil –Reviewof “Viva Bem” App TreatmentAntiretroviral inYoung People in UNESCO, Brasilia, Brazil Pontifícia UniversidadedeSãoPaulo, Brazil University ofCalifornia, Berkeley, CA, USA itwaspossibletoaccessadolescentsand Through theapp The departmentofSTD, AIDS and (DDAHV)of Viral Hepatitis Media ApplicationsinAdherenceto The Relevance ofTools andSocial It was assertive and innovative the creation of the app oftheapp thecreation Itwasassertiveandinnovative “Viva Many scientific studies show that countries, that scientificstudiesshow Many including 1 , HelenaLima HIV Treatment andPreventionAdherence 2 , DanielaBatista 3 - - - 14 of Englishpeer-reviewed reviewsandmeta-analysispapers systematic macro level. A searchwascarriedoutbytwoindependentresearchers includingmultiple levelsofintervention theindividual, interpersonaland the socialecologicalmodelwhichexaminesprotectiveandriskfactorsat Methods: overstretchedhealthsystems. to already substantialincreasedcosts pooradherencecreates despite thefactthat tomiddle-incomecountries(LMICs) tions andfactorsspecificallyinlow- Background: 2 1 Gill Green(presenting) Middle-Income Countries(LMICs), 2004-2015 Adherence toHIVTreatment inLow-and LMICs. of evidencebased ART andpolicy adherenceenhancinginterventions in areeffectivewhichwillsupportthedesign that risk andinterventions ability fornon-adherenceinLMICs.at highest Ithasidentifiedgroups Conclusions: individualfactor. thanany impact onadherenceprobablygreater itisclear amajor tural factorsdespitethefactthat thesecanhave that andstruc reviews oninterpersonalandcommunitylevelinterventions are,texts that short, lessfrequentandinteractive. There isapaucityof to beparticularlyefficaciousinresourcepoorsettings, particularly (e.g., singledose)improveadherence. appears Electronicmessaging key impactandregimes, burden whicharesimpleandreducetreatment those exposedthroughnon-forciblesex. hasa oftreatment The delivery adherencethan ence tothegeneralpopulation. lower victimshave Rape similarlevelsofadher drugusershave Sex workersandintravenous isgenerally linkedtohigheradherence.higher socialeconomicstatus Results: host andISS Web ofScience(WoS) databases. published injournalsbetween2004and2015thePubMed, EBSCO University ofSouthampton, England University ofEssex, England Adherence ishigherinLMICsalthoughwithinthesesettings A rapid reviewwasundertakenandorganisedaccording to A rapid Social-Ecological Factors thatAffect A SystematicRapidReviewofthe This review has identified factors that increasevulner This reviewhasidentifiedfactorsthat Few reviewsof ART focusedoninterven adherencehave 1 , Doreen Tembo, 2 - - - - POSTER ABSTRACTS 51 52

POSTER ABSTRACTS 17 promote thehealthofhigh-riskwomen. addressgenderdisparitiesand that effective systemschangeinitiatives of inasystemicprocesscanresulttheimplementation social services byaligningthecriminaljustice,approach healthcare, andcommunity Conclusions: of involvementinthe WISH program. = 26.27, [M=27.83, SD=9.52];follow-up SD=7.76])aftersixmonths [M=5.61,12.98]; follow-up SD=10.50]), andcigaretteuse(intake: [M = 1.05, SD=4.10). , illegalsubstanceuse(intake: [M=11.19, SD= intake(M=1.71,use at (M SD=5.27)comparedto6monthfollow-up = 8.60, p (4, n=88)12.02, p abuse, X2(4, n=243)22.58, p test statistics, therewasasignificantdifferenceinreportsofemotional Results: behaviors, mentalhealth, andsubstanceabusewereassessed. inwhichcriminaljusticeinvolvement, interviews month follow-up sexual Delaware. 18yearsandolder,age wererecruitedinthelocalareaof Wilmington, insexwork. females whoengage ment training, HIVtestingandcounseling, andtraumacounselingon munity-based outreach, carecoordination, courtadvocacy, empower casemanagement, andtherapeutic trauma-informed probation com of the WISH Program’s (Women InSupportofHealth)gender-specific, care services. workers whichalsoincreasesthewomen’s health accesstoadequate andagender-specificprobation explicitly designedforsex services oftrauma-informed with thejusticesystemaswellimplementation asanintervention commissioners, serves that aprogramwascreated Method: andgenderinequity,status lackofaccesstohealthcare. es, suchascriminaljusticeinvolvement, poverty, illiteracy, social low Background: CounselingandCommunityServices,Brandywine Wilmington, DE, USA Domenica Personti in After engaging WISH, accordingtothePearson Chi-Square with criminaljusticeprograms andlocal Through collaborations < Eachparticipantcompletedface-to-facebaselineandsix Women inSupportofHealth(WISH) .1. Women involvedinsexworkexperiencemyriadchalleng istoexaminetheeffects The purposeofthispresentation Independentsamplest-testfoundadecreaseinalcohol This work suggests that takingaholistic,This worksuggeststhat intensive < .05; and, reportsofsexualabuseX sampleof257females,A matched < .001; reportsofphysicalabuse, X

2 (4, n=35)

11th International Conference on 11th International - - 2 -

- 21 (MMP) participantsin Virginia from2009-2013, whohaddurable VS Methods: with SVSinasampleofPLWH in Virginia. variablesareassociated is todetermineifspecificsociodemographic level (i.e., leasttwoyears). viralsuppressionforat The aimofthisstudy predictors forsustainedviralsuppression(SVS)PLWH thestate at level. theindividualandpopulation sion at Few explored studieshave probability oftransmission. Thus, itisimportanttomonitorviralsuppres outcomes amongpersonslivingwithHIV(PLWH) andcanreduceoverall Background: Virginia DepartmentofHealth, Richmond, VA, USA Jennifer Kienzle(presenting) (MMP), 2009-2013 in Virginia: TheMedicalMonitoringProject such as treatment adherenceprograms,such astreatment ofSVS. mayimproverates groups differedonSVS. Addressing thesedifferencesincaresettings, SVS forin-care, PLWH. Furtherresearchisneededtoexplainwhythese Conclusions: CI 2.8-14.3). SVSthanBlackparticipants(AOR6.0,were sixtimesmorelikelytohave –2.9]. Inaddition, Hispanicparticipantsandofotherraces (AOR) 1.8,participants [adjustedoddsratio (CI), ConfidenceInterval 1.1 SVSthanBlack twotimesmorelikelytohave were approximately regressionmodel.variate For model, themultivariate White participants metthecriterionforinclusiondaily smokingstatus inthefinalmulti Results: model arereportedwherep<.05. regression model(wherep<.10). regression Resultsforthemultivariate independent variabletodetermineinclusion logistic inthemultivariate (N =515). logisticregressionmodelswereperformedfor each Binary leastoneyearafterthe MMPinterview systemat HIVsurveillance state andaviralloadtestpresentinthe priortotheMMPinterview) diately (defined asbeingvirallysuppressedduringthe12-monthperiodimme Fifty-one percent(n=263)ofparticipantshadSVS. Raceand Cohort ofIn-CareHIV-Positive Patients Sustained Viral Suppressionina Data forthisanalysisincludedData MedicalMonitoring Project Findings suggesttheremaybedifferencesbyracefor Viral suppressionofHIVcancontributetobetterhealth HIV Treatment andPreventionAdherence , Lauren Yerkes, CelestineBuyu - - - 23 11th International Conference on 11th International enrollees shouldbeinvestigated. onHIVoutcomesamongthese ence ofplacementandhousingpatterns non-institutional residence, particularlyfortheplacedsubset. III, including increasedgovernment-subsidizedhousing anddecreased Conclusions: (14%vs18%). stitutionalized (17%vs53%)orincarcerated stably housedafterahalf-year(50%vs. 8%)andlesslikelytobenon-in (p<0.01),patterns withplacedpersonsmorelikelythanunplacedtobe buthaddifferentpost-enrollmenthousing rollment housingpatterns and clinicalunplaced onmostdemographic characteristicsandpre-en (16%).and incarceration The 495placedpersons(56%)weresimilarto stability afterahalf-year(31%), housingstabilityafteroneyear(20%), Post-enrollment werenon-institutional(33%), housingpatterns housing was45years.in non-institutionalhousingpre-enrollment;meanage Black orHispanic, 85%substanceusers, 98%mentallyill, and79% Results: identified differencesbetweenplacedandunplacedpersons. enroll inNY/NYIIIthancanbeplaced. among NYCPLWH enrolledinNY/NYIIIduring2007-2010. year pre-andtwopost-enrollment, overallandbyNY/NYIIIplacement, as non-institutional. housing; notlimitedtoNY/NYIII), Time outsideofthesewasclassified shelters, andgovernment-subsidizedhousing(alsoreferredtoasstable included datasets ofresidence injails,istrative dates hospitals, homeless Methods: post-enrollment inNY/NYIIIamongPLWH. including PLWH. pre-and We housingstabilitypatterns investigated riskofhomelessness, at supportive housingprogramforpopulations suppression. likely thanhomelessPLWH andachieveviral toadhereHIVtreatment Background: New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, Yaoyu Zhong, SarahBraunstein, JohnRojas Sarah Walters, GerodHall, ChristopherBeattie, JoanneHsu, Ellen Wiewel(presenting) from NewYork City, 2006-2012 Supportive HousingProgram:DataforAction Of 880PLWH enrolledinNY/NYIII, 72%weremale, 91% Pre- and post-enrollment data obtained fromNYC/NYSadmin Pre- andpost-enrollmentdata HIV-Positive Persons Enrolling ina Housing StabilityPatterns among NY/NYIIIisajointNew York (NYS) City(NYC)andState PLWH housingstabilityafterenrollinginNY/NY hadgreater Stably housedpersonslivingwithHIV(PLWH) aremore Sequence analysis identified housing patterns one Sequenceanalysisidentifiedhousingpatterns , Tejinder Singh, SungwooLim, A Chi-squaretestofassociation HIV Treatment andPreventionAdherence

Morepersons

The influ - - - - 27 wholesale prices(AWP) intheUSA($18,500/year)offiverecommended usingSTART’sgroup wasestimated and50%ofaverage publisheddata Methods: areprevented. diseasesthat associated HIV costsoftreating transmissionandwilllower ment willresultinlower onlongtermadherenceto of earlytreatment ART, whetherearlytreat costsofearlytreatment,makers shouldconsiderthemedication impact without regardtoCD4+count. in guidelinestoemphasizethat ART HIVdiagnosis shouldbestartedat ofsignificant eventsduetoearlyinitiation ART. Background: University of Texas Houston, HealthScienceCenterat TX, USA Richard Grimes(presenting) Initiation ofART transmission preventedandcostofclinical eventsprevented. research isneededonlongtermadherencetomedication, thelevelof Conclusions: in theSTART aretoosmalltovalidlypredictthepreventedcosts. study highCD4+counts. transmission at ence. time butthestudiesareshorttermandmaynotpredictlifelongadher respectively. adherenceto suggeststhat The literature ART declines over $4,218,376, $2,280,203, $1,140,102, $570,051, $228,020, $31,695 $5000, $2500, $1000and$139(DoctorswithoutBorderscost)were $18,500, medication at oftreating $10,000,3 yearcost/100patients using50%of of thestudy AWP been$99,511,500. wouldhave The Results: potential reductioninHIVtransmissions. long termadherenceto ART, costpreventedbyearlytreatment, and volumesand patient ART prices. ART regimens. other thecostsat werethenusedto estimate These data on ontheimpactofearlytreatment There arenopublisheddata theSTART’sThe costoftreating delayedgroupforthe3years theSTARTThe costoftreating study’s delayedtreatment Prevention ofTransmission fromEarly Cost, Long-Term Adherence, and The START areductioninclinically demonstrated study Medication costsofearly Medication ART aresignificant. More , DeannaGrimes Before initiating thenewguidelinespolicy Before initiating

The literature was examined to estimate wasexaminedtoestimate The literature The numbersofpreventedconditions

This hasledtochanges

- - POSTER ABSTRACTS 53 54

POSTER ABSTRACTS 28 portation barriersandincreasingsocialsupport. portation in ruralcommunitiesincluding telehealthinterventions, minimizingtrans opportunities toincreaseaccesscareforHIV-infected olderadults especially forthoseinruralenvironments. Findings suggestthereare andHIV,tions areneededtoaddressthecomplexintersectionofaging ofHIV-infected population individuals,coupled withanaging interven Conclusions: andtheirsideeffects. medications and non-HIVrelated medications, longdistancestopharmacies, multipleHIV andmanaging to maintainingadherenceincluding thecostburdenoftakingnumerous werehigh, adherencerates medication participantscitedseveral barriers anxiety, andloneliness. alongwithsignificantisolation Althoughreported by significantmentalhealthconcernsincluding stress, depression, and closest HIVspecialistswerenearly2hoursaway. Carewascomplicated Participants barriersandformany, facedsignificanttransportation the medical carefortheirHIVbutnotedaccesstowasachallenge. sideeffects,cation oraging. All participantswerecurrentlyreceiving withHIV,symptoms wereassociated othermedicalconditions, medi medical needsinadditiontoHIVandnoteddifficultydiscerningwhether by challengestomaintaininggoodhealth. Participants hadcomplex resource-constrained settings, weredominated participants’narratives White (n=21), male(n=23), andheterosexual(n=16). Livingin Results: andanalyzedusingMAXQDA. transcribed verbatim were conductedbyphone.states. interviews Qualitative Audio fileswere were recruitedthroughpartnershipswith in4 Organizations AIDS Service Methods: ence, andqualityoflifeamongthisunderstudiedpopulation. incare, affectengagement examined thefactorsthat adher medication mortalitythannon-ruralHIV-infectedgreater individuals. This study challenges toaccessingHIVcareandmedications, andsufferfrom Background: 2 1 Katherine Quinn(presenting) Lakehead University, Thunder Bay, ON, Canada Medical Collegeof Wisconsin, Milwaukee, WI, USA We 29participants, interviewed themajorityofwhomwere HIV-positive of50livinginruralareas adultsovertheage Rural Communities Barriers toHIVCareforOlderAdultsin GiventheincreaseinruralindividualslivingwithHIV, OlderadultswithHIV/AIDSlivinginruralareasfaceunique 1 , ChrisSanders 2 , Andrew Petroll, Andrew

1 11th International Conference on 11th International - - - - 30 months tosexuallyactivepersonswhodidnotexchangesex. sex formoney, drugs, food, inthepast12 shelteror transportation al andclinical characteristicsofsexuallyactivepersonswhoexchanged We from2009-2013tocomparethebehavior usedweightedMMPdata lance systemofHIV-infected adultsinmedicalcaretheUnitedStates. Methods: fected personswhoexchangesex. withHIVacquisition;however,associated aboutHIV-in littleisknown Background: US CentersforDiseaseControlandPrevention, Atlanta, GA, USA Linda Beer Oluwatosin Olaiya (presenting) 2009-2013 Adults whoExchangeSex –UnitedStates, ART useandadherenceamongthispopulation. sex, accordingly, providerisk-reductionstrategies andexplorebarriersto providers shouldconsideraskingHIV-infected aboutexchange patients be virallysuppressed. To reducepotentialforonwardHIVtransmission, andwerelesslikelyto prevalence ofHIVtransmissionriskbehaviors Conclusions: (56.4% vs68.0%);allp<0.05. adherent to ART (74.2%vs87.0%), sustainedviralsuppression andhave (ART)likely tobeonantiretroviraltherapy (85.6%vs92.0%), be100% Compared tothosewhodidnotexchangesex, thosewhodidwereless load testabove200inthelast12months)(16.5%vs10.9%)(p<0.001). leastoneHIVviral partner whilenotsustainablyvirallysuppressed(at status vs 38.2%)andcondomlesssexwithanHIV-negative/unknown range, 1.0-1.9)]andweremorelikelytoreportcondomlesssex(53.6% those whodidnot[3.0(interquartilerange, 1.4-9.8)vs1.00(interquartile exchanged sexhadahighermediannumberofsexualpartnersthan and 14.7%(CI9.7-21.5)amongtransgenderpersons. Persons who heterosexual men, 2.7%(CI2.2-3.4)amongheterosexualwomen, sexwith men,2.9-3.7) amongmenwhohave 4.8%(CI4.0-5.6)among [CI]3.3-4.0)overall;3.3%(CI was 3.6%(95%confidenceinterval Results: Among sexuallyactiveHIVpatients, exchangesexprevalence The Medical Monitoring Project (MMP) is a national surveil The MedicalMonitoringProject(MMP)isanational Characteristics ofHIV-Infected Behavioral andClinical HIV-infected whoexchangedsexhadhigher patients Persons who exchange sex may engage in risk behaviors Persons inriskbehaviors whoexchangesexmayengage HIV Treatment andPreventionAdherence , ChristineMattson, LinaNerlander,

- - - 31 11th International Conference on 11th International arenoted. intervention navigator of apatient are discussed.care services forcontentandstructure Recommendations toandretentionindual linkage provider-level facilitate that interventions processes, andproviders’rolesoutsidetheirdiscipline. Systemand standing ofdifferentdiscipline’s modalities, treatment communication across thecarecontinuum. BothHIVandSUproviderslackanunder Conclusions: inservices. andre-engagement improve carecoordination “sponsor” asabridgeacrossHIV/SUcaremay whoserves forthepatient both disciplines. an Bothprovidertypesreportedhaving “advocate” ora however, emergedasathemedeemedrelevantwithin navigators patient adherenceamongHPWUD; andtreatment improving carecoordination resources.and organizational multiplemethods for Providersindicated andmedicalcomorbiditiesamongPWUDistaxing onprovider psychiatric andretainhigh-riskpatients.treat theconfluenceof Providersnotedthat structures toadequately need foradditionalsupportwithinorganizational forHPWUD. andcarecoordination age the Bothprovidertypesindicated Results: findings. confirm preliminary sis isoccurringiteratively. Formal analysiswillbeconducted to thematic were 45-90minutes, asemi-structuredguide. andfollowed analy Data position title, andhadaminimumofoneyearrelevantexperience. IDIs withinalocalHIVorSUfacility,if theywereemployed hadarelevant 29 providers(n=16HIV; n=13SU)in2015. Participants wereincluded Methods: substance use(SU)providers. intrainingamongHIVand and(d)perceivedgaps to carecoordination; provider experienceswithHPWUD;(b)referralprocesses;(c)challenges healthcare system. wastoassess: study The aimofthisqualitative (a) the people whousedrugs(HPWUD)whichimpedeabilitytonavigate a consequenceofmultiplesyndemicsexperiencedbyHIV-infected Background: 2 1 Kasey Claborn(presenting) Michael Saccoccio Infected People whoUseDrugs Brown University,Brown Providence, RI, USA Rhode IslandHospital, Providence, RI, USA Analyses highlightchallengesamongHIV/SUprovidersinlink Individual in-depth interviews (IDIs)wereconductedwithN= Individualin-depthinterviews Care ContinuumOutcomesamongHIV- Utility ofPatient NavigatorstoImprove HPWUDcontinuetoexperiencesignificantdisparities Challenges in linkage andretentiontocareare often Challengesinlinkage 1 , SusanRamsey 1 2 , Guthrie Kate HIV Treatment andPreventionAdherence

2 ,

- - - 33 Methodology: variable HIVexpertise. care throughawiderrangeofhealthnetworkswhereprovidershad medical center, Affordable Care providedoptionsfor Act implementation ously, nearlyallHIVpregnancy carewasdeliveredthroughanacademic networks, transmissions. withthegoalofzeroperinatal Whereas previ with HumanImmunodeficiency inmultiplehealth Virus(HIV)followed Background: 3 2 1 Pamposh Kaul Corrine Lehmann Perinatal Transmission woman and her newborn during the labor and delivery processes. woman andhernewbornduringthelabordelivery prepared toassurepropercareisgiventheHIV-infected pregnant unitsandwherestaffmaybeless hospitals newlyopeningmaternity with andcommunication willfocusonfurtheringcollaboration strategies transmission ofHIVinfection. system andtopreventperinatal fromgettinglostinthehealthcaredelivery to retainpregnantpatients Conclusion: up. the areabeforedeliveringandmother/babylosttofollow care. prenatal 2015, withHIVinfectionwhentheyinitiated 37(26%)werediagnosed review. transmission. with 212livebirths, outcomesandonly2casesofperinatal 23unknown Results: care providersthroughfacetotrainingsandtelephoneconsultation. health transmissionandeducating riskforperinatal at identify patients casesand include monthlymeetingstoreviewknown multidisciplinary HIV-positive pregnantwoman. tomeetthisgoal employed Strategies hospitals, forthe toimproveaccessexpertcareandconsultation settings, including communityclinics, physicians’offices, andrural acrossmultiple includes ofservices andcoordination communication to preventHIVtransmissionfromthemotherinfant. This process University of Cincinnati MedicalCenter,University ofCincinnati Cincinnati, OH, USA Caracole, Inc., Cincinnati, OH, USA Children’sCincinnati HospitalMedicalCenter, Cincinnati, OH, USA Ofnote, between2010and of140pregnantwomenfollowed Overthepast16years, beenmonitored, 257pregnancieshave Positive PregnantPatient toPrevent Coordination ofCarefortheHIV- With systematic collaboration andplanning, collaboration With systematic itispossible ofthepastsixyearsisincludedA detailedsummary for Coordination ofcareforpregnantwomenwhoareinfected Coordination Unknown outcomesresultedfrommothermovingoutof Unknown 3 wasdesigned A formalizedprocessofcarecoordination , JanStockton 1 , Carolyn Yorio, 3 , Jennifer Sparks(presenting) 2 , LoisBull 3 , Krista Andrews , 3 , Future

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POSTER ABSTRACTS 55 56

POSTER ABSTRACTS 34 are discussed. clinical careteams, andlocalhealthdepartments organizations service ofcareforHIV-infectedfor coordination pregnantwomenbetween usedandpresentsclinicalinterventions outcomes. Conclusion: beginning herthirdtrimester. sion. Results: status. Disease andPerinatal Clinicsstaffregardingpatient betweenInfectious andregularcommunication by HIVcasemanagers; inforcement ofteachingdoneinclinic; morefrequentcontactsandvisits cluded forDOTandre referraltohealthdepartmenthomecareservices in HIVviralloadmeasurements. since becomingpregnant, eachoneexperiencedintermittentelevations sodes ofnon-adherencewith ART andclinic visitspriortopregnancy and developmentally-disabled, theotherwithbipolardisorder. transmission: riskforperinatal revealedtwocasesat nant patients Methodology: 30% to HIVtransmissionfromapproximately ofperinatal has reducedtherate DepartmentofHealth andHumanServices developed byUnitedStates a significantpublichealthsuccess. HIVtestingandprompt through routineprenatal ART represents initiation Background: 2 1 Jan Stockton Carolyn Yorio Women withHIVInfection Therapy (DOT) forNon-AdherentPregnant University of Cincinnati MedicalCenterCincinnati,University ofCincinnati OH, USA Caracole, Inc., Cincinnati, OH, USA One mother gave birthtoanHIV-negative infantandtheotheris One mothergave BothmothersachievedandmaintainedHIVvirologicsuppres Administered as Directly Observed Administered asDirectlyObserved TreatmentAntiretroviral (ART) This posterdescribeseachclinical case, detailstargeted 1 2 , Pamposh Kaul Prevention ofmother-to childHIVtransmission(PMTCT) Clinic attendance monitoringamongHIV-infected Clinic attendance preg

2 , Jennifer Sparks(presenting) Interventions toincreaseadherence in Interventions Implementation ofguidelines Implementation Recommendations Recommendations Bothhadepi

2 ,

11th International Conference on 11th International one - - - - - 35 Methods: relationships. among MSMoccurswithinprimary remains under-studied evenasagoodproportionofHIVtransmissions isaunitofsocialnetworksthat romanticrelationship The primary among youngHIV-positive sexwithmen(MSM). Blackmenwhohave maintenance, abouttheirroleinHIVcareengagement butlittleisknown Background: 3 2 1 Greg Rebchook Huebner David Positive BlackMenwhohaveSex withMen Engagement OutcomesamongYoung HIV- factors foryoungHIV-positive BlackMSM. differbyrelational that mechanisms involvedinHIVcareandtreatment disease management, underlying moreresearchisneededtoexplicate inHIVcare.Black menmayengage GiventhesocialcontextofHIV ment, andwhyyoungHIV-positive highlightingthecomplexityinhow ofHIVcareandtreat outcomes wasnotconsistentacrossthestages Conclusions: men withaconcordantornopartner. men withadiscordantpartnerreportedbetteradherencecomparedto they werelesslikelytoreportcurrentantiretroviraltherapy. Moreover, receive recenttreatment, takenantiretroviralmedication, andtohave aregularprovider,more likelythantheirsinglecounterpartstohave to social, andstructuralfactors. While partneredmenwereconsistently withHIVcareengagement,associated evenafteradjustingfor individual, tus. HIVsta theirpartnerwasHIV-negative orofunknown (73) reportedthat relationship,(179) reportedbeinginaprimary andofthesemen, 40.8% Results: young BlackMSMinDallasandHouston, TX, between2009and2014. trialof as partofalargercommunity-levelHIVpreventionintervention sample ofyoungHIV-positive BlackMSM. werecollected data Survey (concordant-positive vs.and partnerHIVserostatus discordant)ina (singlevs. status byrelationship tion adherence)vary inarelationship) er, receivingHIVtreatment, takingantiretroviralmedication, andmedica outcomes(i.e., HIVcareengagement careprovid how aprimary having University ofCalifornia, SanFrancisco, CA, USA University,Georgia State Atlanta, GA, USA University ofUtah, SaltLakeCity, UT, USA Results showed mixedfindings. Results showed wassignificantly status Relationship Of the 350 men who reported their relationship status, Ofthe350menwhoreportedtheirrelationship 51.1% Usingsimpleandmultiplelogisticregressions, Romantic RelationshipsinHIVCare It’s Complicated:TheRoleofPrimary apartnerandimproved betweenhaving The association Relational factorsplayafundamentalroleinhealth Relational 1 3 , JohnPeterson , Judy Tan (presenting) HIV Treatment andPreventionAdherence 2 , SusanKegeles 3 3 , LancePollack

we examined 3 ,

- - - 36 11th International Conference on 11th International ofcolor.care outcomesamongtranswomen opportunities, areastartforimprovingHIV andlegalservices education addressinstrumental needsforeconomic care sitesareneededthat impacttheirHIVcareengagement. tohealththat and related Services competingneedsfarbeyondthose livingwithHIVhave transwomen Conclusion: suppressed. most reportedanundetectableviralload, 28%reportednotbeingvirally of thosewhohadeverreceivedcaredidsointhelastsixmonths. While Almost allparticipantshadeverreceivedHIVcare(89%), butonly55% and69%ranoutofmoneytomeetbasicnecessities.were incarcerated healthinsurance(96%).Most reportedhaving Inthepast6months, 11% and 73%ofthesamplelivedonlessthan$1,000permonthincome. 76% identifiedas African American. highschool Only60%graduated 40orolder.of participantswereaged and 31%identifiedasLatina all participantsidentifiedasfemale/women(91%). The majority(42%) Results: wereadministered. surveys wereenrolledandpatient transwomen programming andalegalclinic. At baseline, African American andLatina ofcolorpreviouslyoutHIVcareviaworkshop and retaintranswomen Methodology: project intheEastSanFrancisco Bay Area. women ofcolorfromanHIVcare, andretentiondemonstration linkage findings onthelifecircumstancesandHIVhealthoutcomesoftrans is currently.their levelofHIVcareengagement We willdiscussnovel livingwithHIVexistandwhat circumstances withinwhichtranswomen livingwithHIV.to otherpopulations However, aboutthe littleisknown HIV, compared rates survival andlow HIVcareengagement low have Background: 2 1 Sean Arayasirikul Tiffany Woods Martell Project HIV Care:BaselineFindingsfromtheBrandy San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA Tri CityHealthCenter, Fremont, CA, USA At baseline, therewere45participantsintheprogram. Almost Retention ofTranswomen ofColorin Challenges toEngagementand Despite having accesstohealthinsuranceandcare, Despitehaving Transwomen impactedby ofcoloraredisproportionately 1 toengage Martellprojectisanintervention The Brandy , JanetHalfin 2 , ErinC. Wilson 1 , Terry Washington (presenting) 2 , HIV Treatment andPreventionAdherence 1 ,

- 37 intersecting forms of stigma and discrimination (i.e.,intersecting formsofstigmaanddiscrimination racism, poverty), women livingwithHIV. byother HIV-related stigmamaybeexacerbated (ART),roviral therapy invulnerablepopulations, isinadequate including Background: 5 4 3 2 1 Carmen Logie Mirjam-Colette Kempf Tessa Napoles Whitney Smith(presenting) with HIV Treatment AdherenceamongWomen Living disparities amongwomenlivingwithHIV. ART incare, adherenceandengagement HIV-related health andmitigate toreducestigma,can guidethedevelopmentofinterventions improve adherencefordiversewomenlivingwithHIV.treatment These findings Conclusions: inHIVcare. to remainengaged with thesestigmas, including prayerand optimism;whichhelpedthem for somewomen. for coping Respondentsalso reported usingstrategies adherence self-care; whichcontributedtosub-optimalHIVtreatment their interpersonalrelationships, mood, self-esteem, for andmotivation women. affected Participants thesestigmasnegatively reportedthat the samesetting, as whereparticipantsdescribedbeingundervalued stigma intheworkplace, whichconvergedwithsexismexperiencedin some participantsdiscussedfearsandexperiencesofHIV-related poverty, butalsoincarceration, age, image. andbody For example, totheirgender,with otheridentities;mostcommonlyrelated race, and inconjunction based ontheirHIVstatus es ofstigmaanddiscrimination Results: coded usingatheme-basedapproach. status, race). wereaudio-recorded, Interviews transcribedverbatim, and identities(e.g., involvingmultipleinterrelated discrimination gender, HIV adherence,tors toHIVtreatment including experiencesofstigmaand discussions aroundbarriersandfacilita guides wereusedtofacilitate inBirmingham,HIV Study Jackson, Atlanta, andSanFrancisco. Interview economic backgroundswhowereenrolledinthe Women’s Interagency withHIV-infectedinterviews womenofdiverseracial/ethnicandsocio Methods: adherence. treatment examinedtheroleofintersectionalstigma inHIV few studieshave and thesemaycontributetoreducedadherenceHIVcare. However, University of Toronto, ON, Canada University ofMississippiMedicalCenter, Jackson, MI, USA University,Emory Atlanta, GA, USA University ofCalifornia, SanFrancisco, CA, USA University of Birmingham,Alabama at AL, USA Participants acrosssettingssharedperceptionsandexperienc From JunetoDecember2015, weconducted75qualitative Intersectional StigmaforHIV Examining theImplicationsof ExperiencesofintersectionalstigmacompromiseHIV Engagement inHIVcare, Engagement including adherencetoantiret 5 2 , Johnson Mallory , Melonie Walcott, 1 , Gina Wingood , 1 , Janet Turan, 1 2 , Abigail Batchelder , Abigail , Sheri Weiser, 3 , DebbieKonkle Parker 1 , Bulent Turan, 2 2 ,

1 ,

4 ,

- - - - POSTER ABSTRACTS 57 58

POSTER ABSTRACTS 38 cART adherence. Conclusion: stablearound90%duringfollow-up). stayedapproximately plementation oranon-HIV-related cognitivedeficit(im who hadanormaldiagnosis incomparisonwithpatients to 50%afteraround3yearsoffollow-up) with diagnosed among patients ANI, MND, dropped HAD(implementation asignificantdeclinetion over3.5yearsshowed adherence inmedication non-HIV-related neurocognitivedisorders(e.g. depression). Implementa (16%) had ANI, 4(9%)hadMND, 3(7%)hadHAD and 18(42%)had µl werestudied. Outof43patients, (25%)werenormal, 11patients 7 (IQR), 25(58%)maleandmedian(IQR)CD4count646(309-1,328)cells/ Results: acrosstime. patterns implementation estimate wasusedto (GEE)modeladjustedforneurocognitivediagnosis equation time. that asprescribedat taking medication A generalizedestimating timet.any wascomputedastheproportionofpatients Implementation asprescribedat wastakingthemedication whether ornotapatient base. throughEMs stating adherencemeasureswereavailable Repeated (SHCS)data were collectedbyreviewingtheSwissHIVCohortStudy (EMs). characteristicsandclinical Patients’ socio-demographic data long periodoftime. Adherence wasmeasuredwithelectronicmonitors withadherencecollectedroutinelyincareovera of43patients tre study Methods: arewithoutadeficit. adherencethanthosethat medication lower a HIV-positive withHANDhave hypothesisisthat patients Our study adherence. theimpactofHANDon medication important toinvestigate required tomaintainviralsuppressionamongHIVpositivepatients, itis and HIV-associated dementia(HAD). tocARTAs ahighadherencerate is neurocognitive impairment(ANI), mildneurocognitivedisorder(MND) degreesas: defined accordingtotheirdiagnostic Background: University ofLausanne, Switzerland Marie Paule Schneider Olivier Bugnon, RenaudDuPasquier, Cavassini, Matthias Susan Kamal(presenting) 43 HIVpositivepatients, 50(29-80)yearsmedian withage This wasanobservational, exploratory, retrospectiveonecen Disorders (HAND)oncART Adherence The ImpactofHIV-Associated Our findings support the hypothesis that HANDdecreases Our findingssupportthehypothesisthat HIV associated neurocognitivedisorders(HAND)are HIV associated

, IsabellaLocatelli, Asemaneh Sehhat, asymptomatic asymptomatic

11th International Conference on 11th International

- - - - 39 George Gachara(presenting) Rural SouthAfricanSetting in patients at theHIV/AIDSPreventionGroup at in patients Wellness ClinicinBela-Bela, toachievementofvirologicsuppressionafter HIV diagnosis ART initiation Methods: HIV transmission. the effectivenessof ART toachieveoptimalhealthoutcomesandreduce individuals intheHIVcarecontinuum. inthiscontinuumthreaten Gaps ofinfected rely onsuccessfulHIVtestingprogrammesandengagement Background: 2 1 Pascal Bessong counts increasingtheirriskofmortality. andinitiate aremorelikelytoseekcarelater patients ART CD4 withlow toimproveretentioninpre-ARTinterventions care. This isbecausethese toconsiderplacingstrongeremphasis on developing is thusimperative Conclusions: than doubletheviralloadofthosewhodidnot(p<0.001). Patients whodiedhadlessthanhalfthenumberofCD4cellsandmore whodidn’t(p=0.022). mortalitythanpatients suppression hadlower theirlastviralloaddetermination.sion at Patients whoachievedvirologic step 5, on 81.4%(n=355)ofpatients ART achievedvirologicsuppres whoinitiated (n =160)ofpatients ART up. diedorwerelosttofollow In 705) initiated ART withinthreemonthswhileinstep4analysis, 21.5% six months. Ofthe ART forstep3analysis, eligiblepatients 89.4%(n= ineligiblefor 15) ofthe169patients ART hadaCD4cellcountinthelast = 998)hadaCD4cellcountwithinthreemonths. Instep2, 8.9%(n= Results: dent ttestwasusedtocomparemeanCD4cellcountsandviralloads. ofcarewasused,incidences ofmortalityforeachstage whileindepen South cumulative forcalculating Africa. estimates survival Kaplan-Meier Bela-Bela,South Africa HIV/AIDS PreventionGroup Wellness andHealthClinic, of Venda,South Africa University In step1, withHIV, diagnosed among1,209patients 82.5%(n retentionfrom aimedtodescribethecumulative This study Diagnosis, Care, andTreatment ina Assessing theCascadeofHIV Most attrition occurred among patients ineligiblefor occurredamongpatients Most attrition ART. It The maximum benefits of antiretroviral therapy (ART)The maximumbenefitsofantiretroviraltherapy 1 HIV Treatment andPreventionAdherence 1 , LufunoMavhandu 1 , CecileManhaeve

2 - - , 43 11th International Conference on 11th International a clinical for indication ART. CD4 countsorduetopregnancy canadhereto ART aswellthose with initiation.at peopleeligibleforThese findingssuggestthat ART withhigh suppressed afteroneyear, irrespectiveofCD4countorpregnancy status Conclusions: reasons (95.8%vs87.0%;RR1.09;95%CI: 1.01-1.18). forother 12-monthsthanwomeninitiating to bevirallysuppressedat 0.98-1.09). Women initiating ART duetopregnancy weremorelikely mm was comparableamongthoseinitiating ART CD4counts>350cells/ at after ART eligibility. 12-monthsafter Viral suppressionat ART initiation period and896(93%)initiated ART inamedianof24days(IQR1-84) HIV-infected participantsbecame ART-eligible duringthe2-yearstudy was4.6log RNA concentration median CD4countwas462cells/mm was28years(IQR23-35).women andthemedianage entry,At study Results: regression. >350 cells/mm ml) amongpeopleinitiating ART differentCD4countlevels( at Uganda. Differencesinviralsuppression(plasmaHIVRNA<400copies/ and prevention amonghigh-riskHIVserodiscordantcouplesinKenya an open-label, ofintegrated prospectivestudy ART andPrEPforHIV Methods: duringpregnancyinitiated orwithhigherCD4counts. in HIV-infected membersofheterosexual serodiscordantcoupleswho ART initiation, andviralsuppression612-monthslater, waslower cluding womenwhoinitiate ART duringpregnancy. We assessedwhether andhealthyat wane inpeoplewhoareasymptomatic ART initiation, in determinant ofviralsuppression. forhighadherencemay Motivation Background: 7 6 5 4 3 2 1 Jessica Haberer Elly Katabira Nelly Mugo Andrew Mujugira High CD4CountsandDuringPregnancy Serodiscordant CouplesInitiatingART with Fred HutchinsonCancerResearchCenter, Seattle, WA, USA Massachusetts GeneralHospital, Boston, MA, USA Kabwohe ClinicalResearchCenter, Kabwohe, Uganda Makerere University, Kampala, Uganda Universityof Jomo Kenyatta Agriculture and Technology, Juja, Kenya MedicalResearchInstitute,Kenya Nairobi, Kenya University of Washington, Seattle, WA, USA 3 andCD4 Of1,010 ART-naïve HIV-infected partners, 677(67%)were We fromthePartners Project, useddata Demonstration East AfricanHIV-Infected Membersof Sustained Viral Suppressionamong 2 , KennethNgure 4 , NuluBulya (ART) Adherence toantiretroviraltherapy isa primary Nearly allHIV-infected partnersinitiating ART werevirally ≤ 3 350 (93.2% vs 89.1%; relative risk[RR]1.03;95%CI:350 (93.2%vs89.1%;relative 6 ) andduringpregnancy usingPoisson wereestimated , DeborahDonnell

(presenting) 4 , Stephen Asiimwe ,

3 , Elizabeth A. Bukusi 10 1 copies/ml(IQR3.9-5.0). 1007(99%) , JaredM. Baeten 7 , ConnieCelum HIV Treatment andPreventionAdherence 3 (IQR272-638)andplasmaHIV 5 , Edna Tindimwebwa, 2 , JosephineOdoyo 1 1 , ReneeHeffron , LaraKidoguchi ≤ 350 vs 5 , 1 1 2 , , - 45 Uganda describetheiradherencetoPrEP. HIV-uninfected in examines how partnersinserodiscordantrelationships risk reductionmethodsinreal-worldsettings. analysis This qualitative individuals toadherePrEPandcombineiteffectivelywithother PrEP, researchisneededtoassesstheabilityofhealthy, uninfected reducing theriskofHIVacquisition. As countriesconsiderimplementing Background: 3 2 1 Timothy Muwonge Melanie Tam Serodiscordant Relationships Ugandan HIV-Uninfected Partners in users’ commitmenttoadherence. PrEP insub-Saharan Africa neednot beimpededbyconcernsabout acommitmenttotakingPrEP demonstrated “responsibly.” Roll-outof counseling, HIV-uninfected individualsinserodiscordantrelationships Conclusions: “dishonor” clinic instructions. PrEP asinstructedanddidnotwanttobreakthe “rules” forPrEPuseor multiple sexualpartners. PrEPusersfeltasenseofresponsibilitytotake adopt riskreductionstrategies, including condomuseandavoiding doses infrequently. SomePrEPusersalsomadeconcertedeffortsto regulardosingschedulesandmissing byfollowing to meetexpectations ing doses, andcombinePrEPwithcondomuse. As aresult, theystrived day, thesametimeevery they wereexpectedtotakePrEPat miss avoid totakePrEP.about how that They understoodfromcounselingmessages Results: analyzed toidentifythemespertainingPrEPadherencebehavior. about PrEPuse, andadherence. Transcribed wereinductively interviews anddiscontinuation,to exploreexperiencesofPrEPinitiation feelings were conductedwithasubsetofseventy-oneHIV-uninfected partners ofmultiplesexualpartners.avoidance Individualin-depthinterviews throughconcurrentuseofcondomsand regimen andriskmanagement six months. emphasizedadherencetoadailyPrEP Counselingmessages acquisition untiltheirHIV-infected partnershadbeentaking ART least at HIV-uninfected topreventHIV individualsinserodiscordant relationships Methods: Massachusetts GeneralHospital, Boston, MA, USA Makerere University, Kampala, Uganda MedicalSchool,Harvard Boston, MA, USA PrEP users report trying tocarefullyadhereclinicPrEP usersreporttrying instructions The Partners ProjectdeliveredPrEPto Demonstration Analysis ofPrEPAdherencein “Responsible” PrEPUse:AQualitative

(presenting) In a PrEP delivery strategy emphasizingadherence strategy In aPrEPdelivery Pre-exposure prophylaxis(PrEP)isaneffectivetoolfor 2 , JessicaHaberer 1 , Monique Wyatt , 3 , Norma Ware, 1 , EmilyPisarski 1 1 ,

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POSTER ABSTRACTS 49 possible approach. the qualityoflifeforPLWHA; computer-based programsmaybeone tions insettingswithfewMHresourcesisurgentlyneededtoimprove Conclusion: forsome. couldbecomplicated cal conceptsthat long, requiredsomenavigation, andincluded descriptionsofpsychologi with computers(i.e., notolder), because theprogramwas andpatient userswouldneedtobeeducated,was theimpressionthat comfortable benefit fromtheprogramasalearningtoolwell. Equallyconsistent distress (ourtargetgroup), familymembersandproviderscould butthat PLWHA forrecentlydiagnosed it wouldbeappropriate experiencing forthemand(2)itspotentialtobeeffective.services Participants agreed the programgivenpsychologicaldistressofPLWHA andthelackof program. Findings astrongconsensusonthe(1)clear indicated needfor of theirfamilymembers);and5CABmembersonanearlyversionthe from 6HIVproviders;5non-HIVnurses;PLWHA whowereMSM(and2 Results: com/turningsunshine). guided bySafren’s evidence-basedCBT-AD program(seehttp://tinyurl. therapy,behavioral activation, behavioral andproblem-solvingstrategies, ponents inthecascadeofcare. from modulesdraw The intervention careasimportantcom andHIVprimary both antiretroviraltherapy addresses(a)psychologicaldistressand(b) adherenceto program that Methodology: personnel whocoulddeliverthesetreatments. like China, withlimitedMHinfrastructureandnoaccesstoqualified ity oflifeandmedicaloutcomes. However, mostPLWHA liveinsettings, toaddresstheirdistress,available andthesecanleadtoimprovedqual aswellclinicalbehavior outcomes. are Evidence-basedtreatments riskformentalhealth(MH)problems,ate whichcanworseadherence Background: 7 6 5 4 3 2 1 Hongzhou Lu Wei-ti Chen Jane Simoni(presenting) Initial Acceptability among PLWHA inChina:Developmentand Adherence, andTreatment Engagement UNESCO, Yangon,Myanmar School ofPublicHealth, CentralSouthUniversityinChangsha, China Fudan University, Shanghai, China Central SouthernUniversity, Hunan, China Yale University, NewHaven, CT, USA University ofMinnesota, Minneapolis, MN, USA University of Washington, Seattle, WA, USA In China, we captured qualitative and quantitative usability data InChina, usabilitydata andquantitative qualitative wecaptured to PromoteMentalHealth, ART A Computer-Based Program 3 , Chengshi-Shiu Developing and evaluating scalable HIV treatment interven scalableHIVtreatment Developingandevaluating 5 Persons livingwithHIV/AIDS(PLWHA) disproportion areat , MiHu We versionofacomputer-based developedapreliminary

6 , Yu Yu Yu , 1 , Kutner Bryan 7 1 , Honghong Wang, , Frances, Aunon 1 , KeithHorvath 1 , XianhongLi 4 2 , Joyce YangJoyce , 4 ,

11th International Conference on 11th International - 1 - , - - - 51 virologically-suppressed (<20copies/ml), HIV-infected womenon (TFV-DP)diphosphate indriedbloodspots, whichwerecollectedfrom Methods: inHIVtherapy. withbiomarkersofinflammation adherence isassociated utes topersistentinflammation. ifsuboptimalWe aimedtoevaluate ART can leadtoHIVsuppression. However, whetheritcontrib itisunknown Background: 3 2 1 Jose Castillo-Mancilla(presenting) Patricia Caraway Amie Medtiz with Viral Suppression inflammation inthesettingofcompleteviralsuppressioniswarranted. inflammation and betweenadherencevariations ontherelationship investigation insomeindividuals. observed ute to theheightenedinflammation Further suboptimal ART adherence, despitevirologic suppression, could contrib high levelsofIFN-ginwomenwithHIVsuppression. This suggeststhat Conclusions: plasma cytokine levelsorCD4+andCD8+ T-cell (p>0.09). activation were observed. wasidentifiedbetween Nocorrelation TFV-DP and es amongtheremainingcytokines orinCD4+andCD8+ T-cell activation women whowere women whowere<85%adherentwas8.3±12.8vs. 1.5±0.6pg/mLin according to ART regimenwereidentified. TheplasmalevelofIFN-gin wereanalyzed.13 onraltegravir) Nodifferencesincytokine levels Results: considered significant. aremean±SD. Data coefficient.correlation ABonferroni-correctedp<0.0071(0.05/7)was and CD4+CD8+ T-cell wasassessedusingthePearson activation using unpairedttests. between The correlation TFV-DP, cytokine levels at percentile for85%adherenceestimated TFV-DP visit. wereanalyzedaccordingto Data tion (%HLA-DR/CD38co-expression), thesamestudy weremeasuredat interferon-gamma (IFN-g), inadditiontoCD4+andCD8+ T-cell activa levels ofinterleukins-1b, 6, 8, 10, 12p70, tumornecrosis-alphaand orraltegravir.itabine (TDF/FTC)andeitheratazanavir/ritonavir Plasma chronic ART ofdaily enrolledinastudy TFV disoproxilfumarate/emtric Denver PublicHealth, Denver, CO, USA University ofColoradoDenver, CO, USA Beacon CenterforInfectiousDiseases, Boulder, CO, USA Data from31women(10Black/African Data American; 10Hispanic; Cumulative Cumulative ART adherencewasmeasuredusingtenofovir Adherence inHIV-Infected Women Inflammation andLowerART 1 , Peter, Anderson Low cumulative cumulative Low ART with adherencewasassociated Less than 100% adherence to antiretroviral therapy (ART) Lessthan100%adherencetoantiretroviraltherapy 2 , EdwardGardner ≥ 85% adherent(p=0.0064). Nosignificantdifferenc HIV Treatment andPreventionAdherence 2 , LaneBushman 3 , Jia-HuaZheng 2 ≥ 85% vs<85%adherence(25th 2 , JuliePredhomme ≥ 2 , KristinaSearls 1,060 fmol/punch) 2 , 2 , - - - - - 52 11th International Conference on 11th International canhelpdevelop that provide information ART adherenceinterventions. forotherpopulations.ed andvalidated This measurewillalsobeableto SSA andotherresource-limitedcountriessothemeasurecanbeadapt inZimbabwe.to theirmedication oftheitemsarerelevantacross Many Conclusions: HIV andtreatment. al relationships, healthsystems, healthandwell-beingbeliefsabout SSA. Barriersinclude tofinancialconstraints, itemsrelating inter-person assess adistinctbarrierto ART adherencerelevanttoZimbabweand Results: inShona beforebeingfinalised. and someitemswereadapted intoEnglish.and back-translated werereviewed The twotranslations English. Shona intothelocallanguage The measurewasthentranslated upon theirsuggestionsitemswereremoved, andfinalisedin adapted the itemstoassesscontentvalidity, culturalrelevanceandclarity. Based tee allwereinitiallyincluded. SevenZimbabweanHIVexpertsreviewed item. At leastoneitemwasselectedforeachidentifiedbarriertoguaran anew byamendingexistingmeasuresorcreating pool wasgenerated herent Zimbabweanpatients. Fifty-one barrierswereidentified. Theitem SSA, ofnon-ad supplementedwithanalysisof42in-depthinterviews assessedbarriersto reviewwasconductedthat atic ART adherencein Methods: assess barriersto ART adherenceforZimbabwe. to infected; yetcurrentlynomeasurehasbeendevelopedandvalidated is oneofthemostaffectedSSAcountrieswithnearly 15%adults 25 millionpeoplelivewithHIVinSub-Saharan Africa (SSA). Zimbabwe byaddressingthebarriers.supporting thetakingofmedication Nearly disclosureencourages ofnon-adherenceandstartstheprocess of to antiretroviral(ART) medication. identifyingthese Systematically Background: King’s CollegeLondon, England Natasha Croome(presenting) Africa inSub-Saharan a Resource-LimitedCountry The measurecurrentlyhas40items. Eachoneisdesignedto The measureitemsweredevisedfromtwosources: asystem Barriers to Antiretroviral Adherencein Barriers toAntiretroviral Development ofaMeasureAssessing toadhere This measureisafirststeptoassistingpatients Many barriers exist which prevent patients fromadhering barriersexistwhichpreventpatients Many , Lyndsay Hughes, Melanie Abas HIV Treatment andPreventionAdherence - -

- - - 53 cluding 37HIV-infected (aged Latinos with51individuals, semi-structuredinterviews conducted qualitative in immigrants.in HIVcareforLatino Bi-lingualSpanish-speakingstaff Methods: immigrants. studiedinLatino notbeenadequately HIVcarehave dance) inprimary Background: 4 3 2 1 Iman Khan Steven Safren Perspectives onInterventions acceptability oftheseinterventions. care. Patient inputwillbeacriticalcomponenttoassurerelevanceand addressvariablebarrierstoHIV ualized assessmenttoappropriately immigrantsshouldemphasizeanindivid HIVcareinLatino primary Conclusions: trust). patient improve retentionincare(e.g. of family-orientedthemesandcultivation to couldbeintegrated barriers tocareandtheculturalelementsthat Patients, moresothanproviders, wereabletodetailthecomplexityof abuse providers, andSpanish-speakingcommunityhealthworkers. HIV physician/provider, casemanager, mentalhealthandsubstance healthcareteam,highlighted theneedforamulti-disciplinary including inHIVcare.and perceivedlessneedforattendance Providersuniformly ( patients (transportation,nity services housing, assistance). immigration Younger effects, andpreventionofHIVtransmission;3)referralstocommu emphasizesHIVdiseasetrajectory, that HIV education side medication and stigma;2)self-carethroughlinguisticallyculturallyacceptable in HIVcare: HIVdisclosure tomanage 1)interpersonalskillsforpatients Results: analysis. thematic Andersen ModelofHealthCareUtilization. wereanalyzed using Data fromthe acodingschemebasedonbarriersandfacilitators and applied wererecorded,Interviews transcribed, andtranslated. We developed to retentioninHIVcareandsuggestionsforimprovingclinic attendance. ers inametropolitanarea. We exploredparticipants’viewsonbarriers or aLatin and14HIVcareprovid American Spanish-speakingcountry) RAND Corporation, Santa Monica, CA, USA University ofSouthernCalifornia, Los Angeles, CA, USA Massachusetts GeneralHospital, Boston, MA, USA University ofMiami, FL, USA Patients suggestedthreemajorthemestoimproveretention ≤ Our objective was to identify strategies toimproveretention Ourobjectivewastoidentifystrategies 2 25 yearsold)werelessfamiliarwithcommunityprogramming Immigrants: Patient andProvider Inconsistent HIVCareamongLatino , LauraBogart Interventions to improve inconsistent attendance in toimproveinconsistent attendance Interventions Interventions toimproveretention(consistentatten Interventions 1 , Margarita Alegria , 4 , Julie Levison(presenting) 2 , Hortensia Amaro , ≥ 18 yearsandborninPuertoRico 3 , DiannaMejia 2 - 2 - , - - - POSTER ABSTRACTS 61 62

POSTER ABSTRACTS 55 with medication adherence. with medication providing toolstoaddressbarriers(e.g., may interfere HIVstigma)that adherenceforthisgroupaswell family) toimprovemedication (e.g.,of promotingnotedfacilitators ofsocialsupportfrom activation Conclusion: . . . . substance use. Examplesofthemesarebelow: (d) beingtiredoforsimplynotwantingtotakethemedications, and(e) daily tasks, toHIVstigma, (c)feelingsofangeranddistressoftenrelated en’s adherenceincluded (a)beingbusy, (b)feelingtiredfromcompleting organized pillstorage. asbarrierstowom served Commonfactorsthat (c) viewingtheirhealthandwell-beingasapriority, and(d)convenient/ (e.g.ing asetroutine/schedulefortakingtheirmedications meal-time), provided socialsupportandreminderstotaketheirmedications, (b)hav familymembers(e.g.the womenwere(a)having children, siblings)who Results: audiorecorded, transcribed, andcodedusinggroundedtheory. affectwomen’sbarriers that ART adherence. Women’s were interviews and onfacilitators Bostontoobtaininformation range 30-65)ingreater Method: copingamongBWLWH.adherence andenhanceadaptive to address trauma and an intervention methods to shape used qualitative of viralsuppressioncomparedtootherracial/ethnicgroups. rates (ART) lower adherencetoantiretroviraltherapy andhave port lower Background: 3 2 1 Conall O’Cleirigh Sannisha Dale(presenting) Living withHIVintheUnitedStates them.” Anger/Distress: “I getupsetsometimesandthenI’llforgettotake popper.” Not wantingtotakemedications: “I’m tiredofbeinglittleMisspill Set routine/schedule: supperItakeit.” whenIeat “I justknow vacations.” today? Yes Idid….Causesheknewaboutthebreaks. The med Family reminders: “My momandmysister. Didyoutakeyourmeds University ofMiami, FL, USA RAND Corporation, Santa Monica, CA, USA Massachusetts GeneralHospital, Boston, MA, USA In-depth interviews wereconductedwithBWLWH In-depthinterviews (N=30, age The most commonly reported facilitators foradherenceamong The mostcommonlyreportedfacilitators Adherence amongBlackWomen Facilitators andBarrierstoMedication Interviews withBWLWH Interviews highlightthepotentialbenefit Black womenlivingwithHIV(BWLWH) inthe USoftenre 1 , StevenSafren

1 ,

Catherine Pierre-Louis Catherine 3 1 , LauraBogart This study This study 11th International Conference on 11th International 2 , - - - 59 Methods: PLWH detainedinalargeurbanjail. adherence andtheuseofmarijuanaothersubstancesinasample effect onadherence. abeneficial hasfocusedonwhethercannabinoidusemayhave attention (ART), antiretroviraltherapy withlapsed has beenassociated butrecent risk forsubstanceuseuponreturningtothecommunity. Background: 2 1 Ouellet(presenting) Lawrence Jeremy Young Dorothy Murphy-Swallow Persons LivingwithHIVEnteringJail? severity on lapses in severity onlapses ART. theeffectofsubstanceusedisorder tomoderate Marijuana useappears conditions suchasunstablehousingandlackofhealthinsurance. ulants orheroin/opioids. adherencethandidtheuseorevenfrequentof illicitstim lapsed Conclusions: 95%CI=0.30-0.99, p adherence, tobeprotective(OR=0.55, whilemarijuanauseappeared withlapsed stimulant andheroin/opioidusewerenolongerassociated no effect. timeofarrest, adherenceat predicted lapsed whilemarijuanausehad analysis, heroin/opioiduse frequentcocaine/stimulantuseandany 37% cocaine/stimulants, and33%heroin/opioids. Inanunadjusted use ofillicitsubstanceswascommon, with42%reportingmarijuana, those, 32%reportedno ART inthe7daysbeforebeingarrested. Recent Results: and socioeconomiccharacteristicsontheserelationships. the 7daysbeforearrest. discontinued marijuana andothersubstanceusehaving ART during between ducted logisticregressionanalysestoexaminetherelationship screen) and ART adherenceduringthe3monthsbeforearrest. includedInterviews questionsaboutsubstanceuseanditsseverity(TCU inCookCountyJail,terviewed Chicago, Illinoisbetween2013and2015. Cermak HealthServices, Chicago, IL, USA Chicago,University ofIllinoisat IL, USA Of 410personsinterviewed, in 371(90%)hadengaged ART; of After adjustingforsubstanceusedisorderseverity, cocaine/ Persons whoself-identifiedortestedpositiveforHIVwerein Effect on Antiretroviral Adherencein Effect onAntiretroviral Does MarijuanaUseHaveaPositive Severity ofsubstanceusedisorderbetterpredicted ART Incarcerated personslivingwithHIV(PLWH) Incarcerated high areat 1 , ChadZawitz between examinesassociations This study ART < 05). HIV Treatment andPreventionAdherence We alsoexamined theeffectsofdemographic The effect may be exacerbated by associated byassociated The effectmaybeexacerbated 1 , JeannetteBailey-Webb 2 , EllenMackey-Amiti Mary 1 1 ,

1 , Substanceuse

We con - - -

63 11th International Conference on 11th International simultaneouslyand independentofoneanother. tooperate appear mechanisms,as wellintrapersonal sincebothtypesofmechanisms Conclusions: each other). predicted sub-optimal areindependentof ART that adherence(inpaths concerns aboutbeingseentakingHIVmedication, andbothmediators is, self-efficacy internalizedHIVstigmapredictedlower andincreased self-efficacy andconcernaboutbeingseentakingHIVmedication). That CI [-.48, -.01]andB=-.41, SE=.23, CI[-.88, -.02], respectivelyfor overall indirecteffectsofstigmaonadherence;B=-.16, SE=.13, betweeninternalizedstigmaand ciation ART adherence(withsignificant mechanismsintheasso wereparallelmediating taking HIVmedication Results: SES, andtimeon ART). internalized stigmaand ART adherence(controllingforgender, age, race, between inaparallelfashiontherelationship simultaneously mediate self-efficacythat andconcernaboutbeingseen taking HIVmedication totestthehypothesis vals (CIs)forindirecteffectsusingbootstrapping and ART adherence. We bias-corrected95% confidenceinter calculated self-efficacy, concernsaboutbeingseenwhiletakingHIVmedication, in Birmingham, AL, self-reportedinternalizedHIVstigma, HIVtreatment Methods: mechanism). (aninterpersonal concerns aboutbeingseenwhiletakingHIVmedication cy (confidencetoadhere ART—an mechanism) and intrapersonal HIV stigmaandsub-optimal ART adherence: self-effica HIVtreatment betweeninternalized rolesoftwofactorsintheassociation mediating affects ART adherenceremainelusive. We examinedtheindependent adherence. However, mechanismsthroughwhichinternalizedHIVstigma themselves becauseoftheirHIVinfection, andpredictssub-optimal ART Internalized HIVstigmaoccurswhenPLWH beliefsabout acceptnegative people livingwithHIV(PLWH) toachieveoptimalhealthoutcomes. Background: University of Birmingham,Alabama at AL, USA Victoria Seghatol(presenting) Bulent Turan, Janet Turan, Whitney Smith, Dark, Heather Stigma andMedicationAdherence in theAssociationbetweenInternalizedHIV Taking HIVMedicationasParallel Mediators Lack of treatment self-efficacyLack oftreatment andconcernaboutbeingseen Using validated measures, Usingvalidated 180PLWH (65women, 115men) and ConcernsaboutBeingSeen Lack ofHIVTreatment Self-Efficacy Adherence interventions mayneedtotargetinterpersonal Adherence interventions Adherence to antiretroviral therapy (ART)Adherence toantiretroviraltherapy iscrucialfor HIV Treatment andPreventionAdherence

- - - 64 high-risk Latino MSM and engage them in HIV testing and linkage toHIV theminHIVtestingandlinkage MSMandengage high-risk Latino MSM. foridentifyinghigh-riskLatino provideauniqueplatform (“apps”) ment withtheseservices. earlierengage tofacilitate interventions and areinneedofinnovative accessing HIVtesting, andmedicalcare(ifpositive) preventionservices Background: 2 1 Honghu Liu Ronald Brooks Treatment: Analyses Preliminary Testing andLinkagetoPrevention Recruiting High-RiskLatinoMSMforHIV increase thenumberofeligibleindividualswhoenrollinstudy. found throughthisapproach. ofhigh-risk HIV-positive MSMcanbe highrates Latino suggest that amongenrolledparticipants andourhighHIVpositivityrate behavior enrolled inthestudy. Nonetheless, ourfindingsofhigh-risksexual numberofeligibleindividualswhoactually low for HIVtestingisthevery Conclusion: forthe intervention. yielding a9.1%positivityrate intercourse inthepast12months, and 5individualstestedHIVpositive, spectively). (85%and15%,compared toolderindividuals36+yearsofage re enrolled in theproportionofyoungerindividuals18-35yearsage 0% banneradvertisements). inSpanish; inEnglish;13%pop-upmessages 36% pop-upmessages of individualsenrolledbymodeoutreach(51%directmessages; enrolled inthestudy. Results: to thestudy. ness ofthedifferentmodesoutreachforenrollingeligibleindividuals direct messaging. of modes, including banneradvertisements, pop-upmessages, and Methods: andmedicalcare(ifpositive). prevention services Bienestar HumanServices, Inc., Los Angeles, CA, USA University ofCalifornia, Los Angeles, CA, USA This study istestingtheefficacyThis study apps toidentify ofusingthese To date, 687individualswereeligibleforenrollment, and55 Latino MSM are being recruited through apps usingavariety MSMarebeingrecruitedthroughapps Latino Social NetworkingApplicationsin The EffectiveUseofGay-Oriented 1 , JesusDuran Among enrolledindividuals, 85%reportedunprotectedanal One challenge in using apps for recruitment of Latino MSM forrecruitmentofLatino One challengeinusingapps Many Latino men who have sexwithmen(MSM)delay menwhohave Latino Many 1 , Ying-TungChen Usingchi-squaretests, wecomparedtheeffective We foundsignificant differencesintheproportion Gay-oriented social networking applications Gay-orientedsocialnetworkingapplications 2 We alsofoundsignificant differences Ournextstepsaretoconsiderways 2 , Frank Galvan (presenting)

2 ,

- - - POSTER ABSTRACTS 63 64

POSTER ABSTRACTS 65 at risk. at persist amongsubgroupsandresourcesshouldfocusongroupsmost prove RICand the VS at been effective. VCCC have Conclusions: faredworse(p<0.05each). (RR=1.1 vsNRW) Females (RR=1.1vsmales);IDU(RR1.3Hetero); andthosewithRW and 25-34vs35-44-year-olds, respectively); AA (RR1.3vs Whites); p<0.05). For lackof VS, (RR=1.4andRR=1.2for18-24 youngerpatients faredworse(p<0.05each).NRW) MSMfaredbetter(RR=0.8vs. Hetero, vs. (RR=1.1vs Whites); IDU(RR=1.2vsHetero);andthosewithRW for 18-24and25-34-vs. 35-44-year-olds, respectively); AA (RR=1.3 2013 (p<0.01). For lackofRIC, (RR=1.3andRR=1.2 youngerpatients 76.8% wereRICand70.2% VS. RICand VS increasedfrom2004to were male;38.1% AA; 8.8%%reportedIDUand52.3%wereMSM; Results: [NRW]). [Hetero], Other), (Ryan andinsurancestatus White [RW], Non-Ryan White use [IDU], sexwithmen[MSM], menwhohave heterosexualcontact [AA], Hispanic, Other), sex, HIVtransmissionriskfactor(injectiondrug risks (RR)ofRICand VS, adjustingforage, race(White, African American in theyearofinterest. Modified relative Poisson regressionestimated and visitdates. VS wasa VL of using CD4+lymphocyte dates countorHIV-1 viralload(VL)laboratory included. RICwas Comprehensive CareClinic(VCCC)cohortfrom2004to2013were Methods: measures. oflaboratory designs ordescribedRICbasedonlyondates ofeffectiveHIVcare.cators utilized cross-sectional Prioranalyseshave Background: Vanderbilt University, Nashville, TN, USA Pettit,April Megan Turner, Peter Rebeiro, Anna Person, StephenRaffanti, SallyBebawy, William Rodgers, Vanderbilt ComprehensiveCareClinic HIV-1-Infected Patients inCareatthe

Among 4,641patients, was38;75.7%% medianbaselineage HIV-infected adultswith Care andViral Suppressionamong Longitudinal AnalysisofRetentionin RICand VS increasedovertime, suggestingeffortstoim Retention inCare(RIC)andviralsuppression(VS)areindi ≥ 2 encountersintheyearofinterest, ≤ 200 copies/mL at thelastmeasurement 200 copies/mLat ≥ 1 medicalvisitinthe Vanderbilt Michael Ghiam(presenting) However, disparities ≥ 90 daysapart,

11th International Conference on 11th International - - 68 in RiodeJaneiro, Brazil. withpoorSRHamongindividualsinHIVcare factorsassociated evaluate SRH,aimed toestimate determinetheprevalenceofsubstanceuseand addition totheirdeleteriousimpactonHIVdiseaseburden. This analysis ied inHIV. morbidity andmortalityinHIV-uninfected butisunderstud populations Background: 3 2 1 Iona Machado(presenting) Luciane Velasque Grinsztejn Beatriz de Janeiro, Brazil and mortalityinHIV-infected individuals. adherence, theconsequencesofpoorSRHontreatment date morbidity, inthispopulation.screening andtreatment Furtherresearchmayeluci viral load, emphasizingtheneedfor substance useandmentalhealth depression screening, andsubstance useinadditiontodetectableHIV-1 Conclusion: poor SRH. mL (aOR2.51, 95%CI: with 1.57-4.02)weresignificantlyassociated PHQ-2 screen(aOR3.43, 95%CI: 2.09-5.62), andHIV-1 RNA³40copies/ 90-day recallofcocaineuse(aOR3.82, 95%CI: 1.80-8.09), positive activity inthelast12months(aOR1.53, 95%CI: 1.01-2.30), positive (aOR)1.54,ratio (CI): 95%confidenceinterval 1.08-2.20), lackofsexual and 3.5%respectively. (adjustedodds Lessthanhigh-schooleducation tobacco, marijuanaandcrack/cocaineusewas30.1%, 19.5%, 3.9%, by 19.5%ofparticipants. The prevalenceof90-dayrecallalcohol, 35.8% werefemaleand54.4%non-white. Poor SRHwasreported included completeness. duetodata was42.9years,The medianage Results: withpoorSRH. significantly (p<0.05)associated (PHQ-2). Multivariablelogisticregressionanalysesidentifiedfactors ment Screening Test (ASSIST) andthePatient HealthQuestionnaire-2 World HealthOrganization’s Alcohol, SmokingandSubstanceInvolve Participants completedaninstrumentincluding oneitemofSRH, the between wasinterviewed August 2013and December2015.FIOCRUZ Methods: Federal UniversityofRiodeJaniero, Brazil University ofCalifornia, Los Angeles, CA, USA CruzFoundation,Oswaldo RiodeJaniero, Brazil Of1050HIV-infected participantsinterviewed, 1029were A conveniencesampleofHIV-infected INI adultsincareat Alcohol anddrugusemaybeimportantmodifiersofSRHin among IndividualsinHIVCareRio Self-Rated HealthandSubstanceUse Poor SRH was associated with lower education,Poor withlower SRHwasassociated positive Self-rated health (SRH) is a well-established indicator of health(SRH)isawell-establishedindicator Self-rated 3 1 , JordanLake , Valdilea Veloso HIV Treatment andPreventionAdherence 2 2 , RaqueldeBoni 1 , JesseClark 2 , RodolfoCastro 1 , Paula Luz 1 ,

1 , - - - 69 11th International Conference on 11th International barriers toaccessingsuchHIVcareservices. traditional systemstoeliminates developing arobustreferralandlinkage andinvestin implementing partnerstoprovideotherHIVcareservice shouldpartnerwithgovernmentandother around suchpopulations FSWs inanenvironmentofhighstigmaandambiguouslegislation Conclusion: success rates. increases referralsandlinkage providedbyaproject for MSMandFSWs enhancethescopeofservices HIVservices andNGOsprovidingcomplimentary umbrella organizations referral completionrates. Forging partnershipswithgovernmentdisease and oflinkage iscriticalinenhancingtherate facilitators as linkages tial pointofcontact. peers Useoftrainedandexperiencedkeypopulation builtwiththehealthcareproviderduringini harnessing therapport anewhealthcaresysteminadditionto cost andburdenofnavigating referredforbyeliminating,the leadtimetoaccessservices transport Results: intoHIVcare. effectivereferralsandlinkage trained tofacilitate HIV careservices. clinicsother partnerstoaccredittwentyoneprivate toprovideintegrated toHIVCareservices.ulations The projectworkedwithgovernmentand andlinkHIVpositivekeypop three yearprojecttoprovideHCTservices Description: HIVcare. priate andtimelyenrollmentintoappro tootherHIVcareservices populations andreferralsforthese impactsthesuccessoflinkages This negatively ofthesepopulations.workers coupledbytheambiguouslegalstatus andhealth perceptionsamongthegeneralpopulation by negative sexwithmen(MSM).workers (FSWs)andmenwhohave This isdriven Background: Uganda HealthMarketingGroup, Kampala, Uganda Denis Ahairwe Alege G. Stephen(presenting) Kampala City, Uganda Linkages forCombinationPreventionin Key Populations: HarnessingReferraland Integration of other HIV care services inanHCTprojectreduces ofotherHIVcareservices Integration HIV Care Service Enrolmentamong HIV CareService Exploiting Partnerships forIncreased HIV counselingandtestingprojectstargetingMSM Uganda HealthMarketingGroup(UHMG)implementeda In Uganda there is high incidence of stigma against sex In Ugandathereishighincidenceofstigmaagainst wererecruitedand facilitators A teamoflinkage , MosesSendija, Thomson Ngabirano, HIV Treatment andPreventionAdherence

- - - 70 of PrEP. toexaminealcoholinteractivetoxicitybeliefsin thecontext first study toimpede are known ART arena. adherenceinthetreatment This isthe alcohol withpharmaceuticalsisharmful(i.e., interactivetoxicitybeliefs) leadtounintentionalnon-adherence,pairments that mixing beliefsthat and drinkingisarobustbarriertoadherence. Along withcognitiveim of evenintermittentdosing. Alcohol useitselfcanundermine ART uptake medication, theeffectiveness ofPrEPdependsonuptakeandadherence HIVtransmission. than90%protectionagainst greater However, likeany HIV prevention;pre-exposureprophylaxis(PrEP)hasthepotentialtooffer Background: University ofConnecticut, Storrs, CT, USA Lisa Eaton, Poor UptakeandThreatstoAdherence with ART inthecontext ofPrEP. ventions areneededtocountererroneousbeliefsaboutmixingalcohol suggest thesebeliefsareimpedingPrEPuptakeandadherence. Inter are apotentpredictorofintentional ART-treatment non-adherenceand Conclusions: cantly morelikelytobingedrinkandholdinteractivetoxicitybeliefs. theywerenotinterestedinPrEPandthesemensignifi that stated should neverbemixed. Among menwhowerePrEPcandidates, 1in3 belief. Ofthe24mentakingPrEP, alcoholandPrEP that 1in3stated were common, leastoneinteractivetoxicity with75%endorsingat over 90%ofmen. mixingalcoholand Beliefsthat ART isatoxichazard anal sexintheprevious6-months. Currentalcoholusewasreportedby candidacy, hadtwoormoremalesexpartnersandcondomless having Results: toxicity beliefs. sexual behaviors, alcoholuse, alcoholinteractive andPrEP-related Atlanta’s characteristics, 2015GayPrideEventassessingdemographic at had nottestedHIV-positive interceptsurveys completedanonymous Method: We metCDCcriteriaforPrEP found118(43%) mensurveyed 272 sexually active men who have sex withmen(MSM)who 272sexuallyactivemenwhohave and thePrEPScale-Up:Impactson Alcohol InteractivityToxicity Beliefs Seth Kalichman(presenting) Results mirror those that findinteractive toxicitybeliefs Resultsmirrorthosethat theforefrontof (ART) at Antiretroviral therapies arenow - - - POSTER ABSTRACTS 65 66

POSTER ABSTRACTS 72 this difficult to engage population andunaddressedbarrierstocare. population this difficulttoengage inHIVcare, patients gage butretentionremainedlow, possiblyreflecting Conclusion: forreclassification.adjusting thedenominator in63outof119(53%),was anoverallresponsetotheintervention after 27 (49%)wereretainedincareand25(45%)metvisitconstancy. ated, and3(2%)moved. avisitinearly2016,3(2%) attended 3(2%)died, 3(2%)wereincarcer avisit.(4%) schedulingbutneverattending Oftheremaining68patients, leastonevisitin2015and5 at attending resulted in55(43%)patients tion occurredinmostpatients, 127(99%). Continuedoutreachin2015 (6%) wereincarcerated, and128(55%)hadfallenoutofcare. definition ofretentionincare. Results: of2015. second sixmonthinterval the endof2015. to reschedulemissedappointments. collectioncontinuedthrough Data whom contactwasmade, remindersand werecalledforappointment whohadfallenoutofcare. patients visits toreengage Patients, with of care. usedphonecalls,The outreachcoordinator letters, andhome hadmoved,determined ifpatients died, beenincarcerated, orfallenout and retention incare2014(2visitstoanHIVprovider90daysapart) HIV clinic inthepastfiveyearsanddidnotmeetHRSAdefinitionof Methods: of care. whohadfallenout andimproveretentionincareforpatients re-engage toboth The purposeoftheprojectwastouseanoutreachcoordinator Background: Medical UniversityofSouthCarolina Madelyne Ann Bean, LindaScott, HIV inCare For the2014population, didnotmeettheHRSA 233patients attended ourmultidisciplinary We who identifiedpatients Reengage andRetainPatients with Use ofanOutreachCoordinatorto toreen isaneffectiveintervention An outreachcoordinator Retentionincareisalargeproblemourpopulation.

Visit constancy wasdefinedasavisitinthefirstand In 2015, incare, whoreengaged ofpatients Of them77(33%)moved, 14(6%)died, 14 Lauren Richey(presenting)

Interven 11th International Conference on 11th International

There

- - - 74 Abigail Batchelder(presenting) Active SubstanceUsers Francisco. includedThe intervention 5individualsessionsfocusedon incareamongHIV-positiveengagement polysubstanceusersinSan toimprove intervention nostic emotionregulation ART adherenceand Methodology: this population. needed tooptimize ART inHIVcareamong adherenceandengagement people livingwithHIVwhousesubstances. are approaches Innovative addressed,self-care andareofteninadequately particularlyamong Background: 2 1 Judith Moskowitz and engagement incare. and engagement withimproved wasassociated thisintervention indicate ART adherence use, population. results ahard-to-reachandunderserved Preliminary among peoplelivingwithHIVwhometcriteriaforactivepolysubstance Conclusion: helpful. es helpfulandthemajorityreportedfindingtheirself-statements participants reportedfindingthesessionsandpersonalizedtextmessag cell phones, including homelessandmarginallyhousedindividuals. All an app, wewereabletoenrollparticipantswithgovernmentsubsidized internalized stigma. BydevelopinganSMStext-component, than rather to addresspsychologicalbarriers ART adherence, suchasshameand Results: messages. willbecompletedinMarch2016. Follow upinterviews of68%(SD=28%)thebidirectionaltext responded toanaverage sessions and polysubstance userswhocompleted84%ofinterventions the pairedemotionfor2months. We enrolled9HIV-positive have text-response-options, whichtheythenreceivedviatextafterendorsing togetup”learn tohow or “I ammorethanjustajunkie.”)withemotion Participants (e.g., pairedtheirself-statements to fallsdown “Everyone sessions, bi-directionaltextcomponent. aninnovative weemployed daily and ART adherenceandsubstanceuseweekly. After theindividual self-statements.sionate emotion All participants receivedtextsquerying acceptance, self-compassion, todevelopcompas andself-reappraisal pursuing apersonalizedHIVself-caregoalwhileusingnonjudgmental Northwestern University, Chicago, IL, USA University ofCalifornia, SanFrancisco, CA, USA Providers and stakeholders reported a need for an intervention Providersandstakeholdersreportedaneedforanintervention Pilot to Improve HIVSelf-Careamong Pilot toImprove Text-Enhanced EmotionRegulation This pilotwasdeterminedtobefeasibleandacceptable InternalizedstigmaandshamearebarrierstoHIV-related We transdiag developedand open-pilotedalow-cost 2 , Adam Carrico , Adam HIV Treatment andPreventionAdherence 1 1 , JenniferJain 1 , MichaelCohn 1 ,

- - - 75 11th International Conference on 11th International inPNC,enroll late whoareyounger, otherchildren. andwhohave es toimprovepost-partumHIVoutcomesshouldfocusonwomenwho Conclusions: time (p<0.001), butRICdidnot. and1.27,age; 1.09perotherchild, p<0.05forall). VS improvedover month;0.61,1.06 pergestational 0.73per10-yearincreaseinmaternal of otherchildren(aRRsforlackRICand VS respectively: 1.16, PNC enrollment, age, number youngermaternal agreater andhaving at Lack ofRICand age gestational withlater VS werebothassociated women failedtobeRICand63.6% 1yearpost-partum.VS at intoPNCwas16. weekofentry median gestational Overall, 28.2%of was 29, 58.1%wereBlack, mediannumberofotherchildrenwas1, and Results: of delivery, enrollmentinPNC. weekat andgestational children, education, employment, substanceuse, illness, psychiatric year age,for maternal race, foreign-born, maritalstatus, numberofother risk(RR)forfailureofRICand relative regression estimated VS, adjusted 12±3monthspost-partum.load <200copies/mLat Modified Poisson ≤ TN, from1999–2014wereincluded.at RICwasdefinedas1visit visit at Vanderbilt’s ObstetricComprehensiveCareClinicinNashville, Methods: withlackofRICand factors associated 1-yearpost-partum. VS at HIVclinic amultidisciplinary in ring over15yearsat Tennessee toidentify andsmallsamplesizes. data available We pregnanciesoccur evaluated arelimitedby virologic suppression(VS)inthesoutheasternUnitedStates Background: Vanderbilt UniversityMedicalCenter, Nashville, TN, USA Bev Byram, Jessica Castilho, Peter Rebeiro, Clouse, Kate Carpenter, Lavenia Pettit,April SallyBebawy, Megan Turner, William Rodgers, Prenatal Care Suppression amongPregnantWomen in 90 days and at 12±3monthspost-partum.90 daysandat VS wasdefinedasaviral 305deliveriesamong248womenwereincluded; medianage HIV-infected pregnantwomenwith Retention inHIVCareandVirologic Factors AssociatedwithPost-Partum Mary Hopkins(presenting) Mary Studies addressing post-partum retention in care (RIC) and Studies addressingpost-partumretentionincare(RIC)and In this population ofHIV-infectedIn thispopulation womeninPNC, resourc HIV Treatment andPreventionAdherence ≥ 1 prenatal care(PNC) 1 prenatal

- - 81 use and/or high risk sexual behaviors amongparticipantscomparedto use and/orhighrisksexualbehaviors the effectivenessof WISH indecreasingidentifiedhighrisksubstance a pre-test(intake)post-test(6monthsafterintake)designassessed Methodology: Wilmington, Delaware, andsurroundingNewCastleCounty. highriskforHIVandsexuallytransmitteddiseases(STIs)in women at insexworkandother and communitysupportsforwomenwhoengage healthcare expanded andenhancedaccesstomedicalbehavioral (WISH), (BCCS)has Counseling andCommunityServices Brandywine Background: CounselingandCommunityServices,Brandywine Wilmington, DE, USA Jillian Gosselin Infection andTransmission Risk IndividualstoReduceofNewHIV follow-up, X difference inthenumberofparticipantswithchildrenfromintaketo (3, n=794)7.35, p<.1. significant There wasaslightstatistically trialorsentencingfromintaketofollow-up,in respondentsawaiting X group,Intervention significantdifference therewasaslightstatistically increase inunprotectedsexualcontactfromintaketo6month. For the group. For theComparisongroup, significant therewasastatistically significantdifferencesinmeanstheIntervention no statistically highrisksexualbehaviors.sexual contactandassociated There were forunprotected were conductedtocompareIntakeversus6Monthdata follow-up, X group, significantchangefromintaketo therewasalsonostatistically intake tofollow-up, X significantchangeinsexualcontactfrom there wasalsonostatistically follow-up, X significantchangeinsexualcontactfrom intaketo was nostatistically nificant, butslight, increaseinmeans. group,For theIntervention there means. For group, theIntervention sig cigaretteusehadastatistically significantchangesin The Comparisongrouphadnootherstatistically andsignificancelevel.difference inmeansbothtermsofmagnitude and Comparisongroup, agreater grouphaving withtheIntervention forboththeIntervention stance usewerefoundfromintaketofollow-up alcohol use. significantdecreasesinmeansforillegalsub Statistically significantdecreasesinmeansfor Comparison grouphadstatistically follow-up, X significantdecreaseininjectiondrugusefrom intaketo a statistically (2, n=798)26.55, p<.001. For theComparisongroup, therewas significant decreaseininjectiondrugusefromintaketofollow-up, X Results: asusual(TAU). communityservices andrelated treatment womenwhowerereceivingsubstanceabuse a similargroupofat-risk For group, theIntervention therewasastrongstatistically and RetentionStrategieswithAt- Utilizing Peers toDeliverEngagement 2 2 2 2 (1, n=797)3.52, p<.1. (2, n=243)1.53, p=.47. Independentsamplest-tests (1, n=799)2.66, p=.10. For theComparisongroup, (1, n=338)7.68, p<.01. groupand The Intervention Through theprogram, Women inSupportofHealth utilizing A quasi-experimentalcomparisongroupstudy 2 (1, n=343)1.48, p=.22. For theComparison 2

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POSTER ABSTRACTS 67 68

POSTER ABSTRACTS 82 with high rates ofIVP,with highrates STI, andHIV. amongpopulations importanthealthimplications crease IVPcouldhave common inHIV-negative thaninHIV-positive tode womenInterventions Conclusions: HIV negative, p=0.76). HIV negative, p=0.58), commercialdouches(18%HIVpositivevs22% HIV negative, p=0.04), clothes, (22%HIVpositivevs29% wipesorrags negative, p=0.02), (45%HIVpositivevs54% withwater orsoap soap for IVPinthepriormonth: alone(27%HIVpositivevs55% water reason washygiene. Participants reporteduseofdifferentproducts Most women(61, inIVP, engaged 84%)reportedhaving andtheprimary characteristicsandriskfactorsbyHIVstatus.differences indemographic (45 HIVpositiveand27HIV-negative, 34years). age There wereno withIVP.potential harmassociated 72womencompletedquestionnaires IVPwerecommon,that andHIV-positive ofthe womenweremoreaware Results: vs HIV-negative women. tics. Demographics, riskfactorsandIVPwerecomparedinHIV-positive using NVIVO8. wasanalyzedusingdescriptivestatis data Quantitative intheFGD.not participating wasrecordedandanalyzed data Qualitative Questionnaires werecompletedbyHIV-positive andHIV-negative women obtainedintheFGDwasusedtodevelopIVPquestionnaires.Data group discussions(FGDs)withHIV-positive andHIV-negative women. mixed-methods approach. wasobtainedfromfocus data Qualitative Methods: inMiami. riskforHIV(HIVnegative) (HIV positive)orat explores beliefsandpracticesregardingIVPinwomenwithHIVinfection withhighprevalenceofSTIs andHIV.eastern UnitedStates This study increase riskofacquisitionSTIsandHIV. MiamiisacityintheSouth vagina, and withthedevelopmentofbacterialvaginosis areassociated Background: University ofMiamiMillerSchoolMedicine, Miami, FL, USA Maria Alcaide(presenting) Deborah Jones, MargaretFischl, Violeta Rodriguez, the UnitedStates Twenty in3FGD. womenparticipated revealed data Qualitative designwasacross-sectionalstudy,The study utilizinga Women atRiskorInfectedwithHIVin Addressing Intravaginal Practicesin Despitetheirhealthrisks, IVParecommon;andmore Intravaginal practices(IVP), Intravaginal cleansing theinsideof

11th International Conference on 11th International - - - 83 access and identify topics for a computer tailored intervention program.access andidentifytopicsforacomputertailoredintervention Rico, theuseoftechnology, internetaccess, healthinformation wastounderstand,this study amongagroupofyouthwithHIVinPuerto program.they wantforacomputertailoredintervention The purposeof they accessinternetforhealthinformation, typeofinformation andwhat ant toknow, amongyouthwithHIV, theyuse, typeoftechnology what if youthsearchtheInternetforhealthinformation.dence that Itisimport andaccessinformation. waystocommunicate innovative There isevi issue inyouthwithHIV. Youth provides that areexposedtotechnology Background: San Juan, PR, USA University ofPuertoRico, MedicalSciencesCampus, SchoolofNursing, Janet Rodriguez Smartphone Application” Youth withHIVinPuertoRico: “We wanta therefore, qualityoflife. ence, andadherence, resultintheimprovementofdiseasemanagement inHIV,knowledge including determinantsofadher culturalappropriate toenhancethe thistypeofintervention,expected that anapplication they canaccessserious, ofHIV. andtruthfullyinformation updated Itis Conclusions: healthcare provider. can enter, witheachother, communicated bya anditshouldbemanage resultsinresearch.with thelatest They alsowantablogwhereonlythey shouldbeupdated theinformation pants emphasizetheimportancethat program. This wasbecauseoftheissueprivacy, andaccess. Partici insteadofacomputerized tion ofHIVthroughasmartphoneapplication Results: quotesincluded.rized withthreeverbatim study’s topics. Transcripts wassumma werecodedandtheinformation weretranscript,interviews frameworkwasdevelop, athematic withthe Methods: Participants expressedtheirpreferencetoreceivetheinforma Ten youthwithHIV, 18-24, ages wereinterviewed. After Strategy to Improve Adherencefor toImprove Strategy Considering aTechnology Intervention Participants want to have a smartphone application where Participants asmartphoneapplication wanttohave In PuertoRico, despitealltheefforts, adherenceisstillan HIV Treatment andPreventionAdherence ------85 11th International Conference on 11th International acceptability. alternative.an attractive Experiencewithproductusemayincrease couldbeusedbeforeandafterRAImayconstitute a rectalgelthat ligible 28%reportedthiswastheregimentheylikedleast. For them, Conclusions: wanted change, therewasatendency toprefermorevolume. amongthosewho changes fromthe4mLdeliveredbyapplicator; in dailygel, volume 19%inRAIgel);75%ofrespondentsdidnotfavor cosity ofthegel;thosewhowantedachangepreferreditthicker(18% Seventy eightpercentofrespondentsfeltnoneedtochangethevis a 4-pointscale, p<.001)andRAIgel(amd=0.31, p<.001)regimens. times usedforbothdailygel(adjustedmeandifference(amd)=0.29on use improvedsignificantlyfromthefirstfewtimesusedtolast and leastwere28%, 43%, and28%. Participants’ oneaseofgel ratings who likedtheoral, dailygelandRAImostwere73%, 8%, and19%, Results: cross-over designofthestudy. times used. This analysisadjustedforperiodeffecttoaccountthe compare theeaseofproductusefromfirstfewtimesusedtolast preferences. modelwasusedto Equation A GeneralizedEstimating whichregimentheylikedthemostandleast andrelated indicated of sixsequencesthethreeregimens. participants At endoffollow-up before andafterRAI(RAIgel)amongMSM TGW randomizedtoone TDF daily(oral), usingrectal TFV geldaily(dailygel), orusing TFV gel Methods: daily.may rejecttakingmedication Background: 4 3 2 1 R.Javier Lama Curtis Dolezal Alex Carballo-Diéguez(presenting) in ReceptiveAnalIntercourse(RAI) and Transgender Women (TGW)WhoEngage Among MenWhoHaveSex WithMen(MSM) University ofPittsburgh, PA, USA University of Washington, Seattle, WA, USA Impacta Peru, Lima, Peru Columbia University, New York, NY, USA Ofthe187participantsincluded inanalyses, theproportions MTN-017 studied likes and dislikes related totakingoralFTC/ MTN-017 studiedlikesanddislikesrelated Tenofovir MicrobicideGelRegimens Preference ofOralPrEPversusRectal Although mostparticipantspreferredoralPrEP, anon-neg OralPrEPcanpreventHIVtransmission. Yet, people-at-risk 1 , Cheng-ShiunLeu 2 , BarbraRichardson 1 , IvánC. Balán 3 , IanMcGowan 1 HIV Treatment andPreventionAdherence , RebeccaGiguere 1 , III William Brown 4 , RossD. Cranston 1 ,

1 , - 4 - 87 of phonesharingorneedingtorespondSMSinpublic. This may maybeincreasedincases participation orstudy of sexualorientation daily byrespondingtoanSMS-basedsurvey. Concernsaboutdisclosure (Peru, South Africa, Thailand, US)were instructedtoreportproductuse microbicide gel, menandtransgenderwomen(N=187)infourcountries Background: 3 2 1 Alex Carballo-Diéguez R.Javier Lama Curtis Dolezal Rebecca Giguere(presenting) Microbicide Trial? to ReportProductAdherenceinaRectal survey design to gather data morequicklyandcost-efficiently. data designtogather survey about privacy whiletexting, future systemsmayuseamorestreamlined system wereeffectiveandnotburdensome. levelof concern Givenlow Conclusions: messages. over halfdidnotdeletethestudy-related others’attention.not draw and wasunnecessary A fewfeltthe password wasubiquitousandwould textingbehavior orfeelingthat SMS inprivate (82%). BasedonIDI, privacy reasonsforlow concernsincluded: sending (73%) orbeinginstructedtoerasetheSMSsessionfromtheirphone concerned.only 5%very Mostwerenotbotheredbyusingapassword Results: concerns. A sub-sampleof33underwentanin-depthinterview. burden ofprivacy privacy enhancingdesignelementsandSMS-related ishing thestudy, 180participants completedaweb-basedCASItoreport messages.for participantstolockphone/deletestudy-related Uponfin withareminder survey and4)endedevery participation; name orstudy didnotrevealproduct 3)usedtextthat beforesendingsurvey; password totext;2)requiredreceiptofapre-assigned participant wasavailable Methods: MTN-017. to privacy/security enhancingdesignelementsofanSMSsystemin system. We participants’perceptionsofprivacy evaluated andreactions influence participants’interactionswithanadherencemonitoringSMS University ofPittsburgh, PA, USA Impacta Peru, Lima, Peru Columbia University, New York, NY, USA BasedonCASI, 85%werenotconcernedaboutprivacy, with To protectparticipants’privacy, thesystem: 1)askedifthe Privacy andSecuritywhenUsingSMS Are Participants Concernedabout Privacy oftheSMS andsecurityenhancingfeatures DuringMTN-017, of aphase2study Truvada andarectal 1 ,Ho Titcha 2 , IanMcGowan 1 1 , Alan Sheinfil , Alan 3 , RossD. Cranston 1 , III William Brown 1 , MobolajiIbitoye 3 , 1 , IvánBalán

1 ,

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POSTER ABSTRACTS 91 in resourcelimitedsettings. andtrainingmaybeachallengetoachievethisgoal services appropriate inmentalwell-being. andintervene opportunity todiagnose offersan PrEPdelivery that concurrent psychosocialproblemsindicating pared toBraziliangeneralpopulation. Morethanonethirdpresented Conclusion: CI95%1.02-2.87). CI95% 1.39-3.27)and 3.88, respectively), partner(aOR2.13; asteady vshaving nothaving -aOR2.12;CI95%1.13-3.98and2.07;CI 95%1.01- Odds Ratio were: 18-24yearsvs was 7.2%. screening was5.5%, was11.3%andIPV sexualcompulsivebehavior common. Prevalenceofbingedrinkingwas50.5%, positivedepression by 42.9%: marijuana(30.9%)andcocaine/crack(13.3%)werethemost was 29.5years(IQR24-35). illicitSU(last3months)wasreported Any Results: factorswereanalyzedusinglogisticregression. its associated violence (IPV). Syndemicwasdefinedasoccurrenceof partner ofintimate andhistory CSB scale(compulsivesexualbehavior) ASSIST (substanceuse), bingedrinking, PHQ-2(depressionscreening), the screeningvisitincludingA questionnairewasperformedat OMS prophylaxis forHIVpreventioninRiodeJaneiroandSaoPaulo, Brazil. Methods: enrolled tothePrEPBrasilStudy. withsyndemicsamongMSM/TRANS factorsassociated and 2)evaluate to 1)describetheprevalenceofsubstanceuse(SU)andsyndemics; interventions. iscrucialfordevelopingappropriate treatment We aimed nerable toHIVinfection, pronetomodification/ understandingbehaviors men (MSM)andtransgenderwomen(TRANS)aredisproportionallyvul gistically toincreaseHIVrisk(syndemics). sexwith As menwhohave Background: 3 2 1 Raquel deBoni(presenting) Esper Kallas Ricardo Vasconcelos Grinsztejn Beatriz Findings. – Preliminary Transgender Women inthePrEPBrasilStudy Brazilian Institute of Geography andStatistics,Brazilian InstituteofGeography RiodeJaniero, Brazil São Paulo University, SãoPaulo, Brazil CruzFoundation,Oswaldo RiodeJaniero, Brazil 398 MSM/TRANSwereincluded inthisanalysis, medianage PrEP Brasil is a demonstration study onpre-exposure study PrEPBrasilisademonstration Men whohaveSex withMenand Substance UseandSyndemicsamong Syndemicprevalencewas36.2%, factors itsassociated 2 IllicitSUamongMSM/TRANSinPrEPBrasilwashighcom , Mauriciode Vasconcellos Co-occurrenceofpsychosocialproblemsmayactsyner 1 , Valdilea Veloso 2 , Paula Luz ≥ ≥ 36 yearsand25-29vs College education vs

3 , BrendaHoagland 1 1 , JoséMadruga , RonaldoMoreira ≥ 36 years(adjusted ≥ 2 conditionsand 1 ,

The lackof

1 11th International Conference on 11th International ,

1 , - - - 93 an adult outpatient HIVclinican adultoutpatient inMiami-DadeCounty, Florida. open-ended questionsaddressingfactorsimpactingclinic at attendance responsesto analysis ofpatients’ HIV carethroughaqualitative retention. soughttocharacterizebarriersroutine The presentstudy living withHIV/AIDS(PLWHA), butvariousfactorscanadverselyimpact Background: 4 3 2 1 FalconAnthony Anindita Chakrabarti Kira Villamizar Care: AQualitativeStudy Structural-Level BarrierstoHIVOutpatient optimal retention. living withHIVandtoidentifyindividual-structural-levelbarriers perspectives on patients’ planstoincorporate the needfortreatment standing theimportanceofclinic attendance. These findingsunderscore oftheirhealthandunder those barriersprimarilybytakingownership el barriers, weremoresuccessfulinovercoming butregularattenders locus ofcontrol. identifiedbothindividual-andstructural-lev All patients withahigherinternal ofretentiontofactorsassociated their higherrates Conclusions: availability.and appointment structural barriersincluded difficulties, administrative insuranceissues, were citedasindividual-levelbarriers; and lackofreliabletransportation health, lackofcopingskills, denial, depressivesymptoms, workconflicts, use, weremoreoftencitedbynon-attenders. Among allpatients, poor obligations). Comorbidities, suchasdepressivesymptomsandsubstance times, oftheirappointment, notknowing issues, transportation family (work conflicts, waittime, financialreasons, appointment inconvenient reportedexternalreasonsformissedappointments Non-attenders being organized, relationship). maintainingagoodpatient-provider their health, attendance, understandingtheimportanceofappointment ownership of reflectedaninternallocusofcontrol(taking factors that Results: groups. between attendance responsestoopen-endedquestionswere compared torical attendance; and responseswerecodedintothemes. Patients weregroupedbyhis about theclinic; keepappointments) canbedonetohelppatients what isliked/disliked what lifefactorsimpedingattendance; appointments; toclinicbarriers andfacilitators (Whymissed/didnotmiss attendance Methods: Eastern Virginia MedicalSchool, Norfolk, VA, USA Jackson MemorialHospital, Sunrise, FL, USA University ofMiami, FL, USA Florida DepartmentofHealthinMiami-DadeCounty, Miami, FL, USA cited regularattenders’ analysisrevealedthat Thematic Patients (n=444)wereaskedopen-endedquestionsabout Overcoming Individual-and Internal LocusofControlin Qualitatively, attributed withbetterattendance patients Retentionisintegraltobetterhealthoutcomesinpeople 1 , Mercogliano Kathleen 4 , Andrew Wawrzyniak (presenting) 2 , JanePark HIV Treatment andPreventionAdherence 3 , Alexa Parra, Alexa 2 , Alice Long , Alice 2 , Allan Rodriguez , Allan 2 , MorganMetsch 2 2 ,

2 , - - - 94 11th International Conference on 11th International research isneededtoassesstheefficacy ofthisintervention. period,in viewofoursmallsamplesizeandtheshortfollow-up further care. intoHIVprimary stigma amongindividualsre-engaging However, Conclusions: = 0.62), andMeasure4: 7%vs9%;(p=0.71). = 0.64), Measure2: 51%vs53%(p=0.80), Measure3: 54%vs58%(p stigma remainedthesame/increasedalittle: Measure1: 47%vs51%(p (p =0.44), andMeasure4: 23%vs12%(p=0.01). Inthe “control” arm, (p =0.29), Measure2: 50%to46%(p=0.56), Measure3: 44%vs38% arm: intheintervention trends wereobserved Measure1: 38%to30% 30-49 years. BLand When stigmaat T2 werecompared, decreasing Results: responding as all”“not at or “rarely” asnotperceivingstigma. “sometimes” or “often’ weregroupedasperceivingstigmawhilethose duetotheirHIVstatus. treatment they avoided Those respondingas other peoplewereuncomfortablebeingaroundthem;and4. whether byotherpeople;2.avoided whethertheywouldlosefriends;3. whether to:four stigmameasuresrelated 1. felttheyarebeing whetherpatients (BL), 6-months(T1), and12-months(T2). For thisanalysis, weexamined stigma (including baseline stigmascale)whichweremeasuredat Sowell istics, exploredsocialandemotionalaspectsofHIV-related thestudy “standard care” controlarms(N=84). Inadditiontoclinical character (N=86)or fallen outofmedicalcarewereassignedtotheintervention Feb’16) inPLWH urbanHIVclinic. atertiary accessingcareat Patients Methods: HIV (PLWH). toreducestigmainpeoplelivingwith intervention (CSW) re-engagement ment iswell-known. We examined effectaCommunitySocial Work Background: 2 1 Michael Mugavero Ashutosh Tamhane Randomized ControlledStudy a CommunitySocialWork A Intervention: Birmingham AIDS Outreach, Birmingham, AL, USA University of Birmingham,Alabama at AL, USA Overall, 66%weremale, 78% African-American, and54%aged wasconducted(Jul’13- study This randomizedinterventional HIV-Positive Patients and theRoleof Reducing StigmaamongRe-Engaging It is plausible that CSWcouldpositivelyimpactperceived Itisplausiblethat engage impactofstigma onHIVtreatment The negative 1 1 , Batey David , KarenMusgrove 1 , Fatimah Bello(presenting) 2 HIV Treatment andPreventionAdherence , JamesRaper 1 ,

1 - - 96 including BridgeCounselor(SBC)teamto thedevelopmentofaState to addressunmetneedsforPLWH,LINK Projectdevelopedapproaches the prior12months. Initiative,As partoftheSystemsLinkages theNC (PLWH), including 26%withoutevidence ofcare(i.e. HIVRNAtest)in ic. In2013, NorthCarolina(NC)hadover28,000personslivingwithHIV Background: 3 2 1 Sarah Willis Heidi Swygard Arlene C. Seña(presenting) North Carolina HIV LinkageandRe-EngagementtoCarein evidence ofcare, challengesinthispopulation. suggestinggreater more timeworkingwithPLWH lost-to-carewhowerelesslikelytohave harder toreach, theirneedforadditionalservices. indicating SBCsspent andlost-to-carepopulations.diagnosed Younger personsandMSMwere Conclusions: exposure. re-engagement, OR=0.6, 95%CI: 0.4-0.97)thanthosewithheterosexual 1.3-3.6). Fewer MSMachieved VLs (linkage, OR=0.7, 95%CI: 0.4-1.4; 95%CI: groups(40-49y, 1.1-6.2)andre-engagement OR=2.1, 95%CI: 30, with wasassociated olderage (30-39y,VLs in bothlinkage OR=2.6, days and252(52%)showed VLs. ComparedwithPLWH youngerthan services,re-engagement 235(49%)hadevidenceofcarewithin90 and 118(66%)hadreported VLs withinayear. For thosereceiving persons, 113(63%)hadevidenceofcarewithin90daysreferral and 92minutes(IQR40-170)forre-engagement. For newly-diagnosed time spentwas60minutes(interquartilerange[IQR]25-113)forlinkage (n=2400)to482PLWH services re-engagement lost-to-care. Median ments, HIV-infected to180newlydiagnosed personsand transportation) Results: (OR). oddsratios outcomes andestimate characteristicsandthese betweenpopulation associations to evaluate reported viralloadsuppression(VLs). modelswereused Multivariate characteristics, incareandhad wereengaged theproportionthat Methods: lost-to-care populations. and tonewlydiagnosed services andre-engagement provide linkage Duke University, Durham, NC, USA Hill, Chapel University ofNorthCarolinaat NC, USA Raleigh, NC, USA North CarolinaDepartmentofHealthandHumanServices, SBCs provided linkage services (n=764, services SBCsprovidedlinkage e.g., medicalappoint population We todetermineservice analyzedSBC project data Program: AStatewideApproachto Outcomes fromthe “NC LINK” 3 , Amy Heine , Amy

The SouthernUSisespeciallyaffectedbytheHIVepidem The SBC program successfully provided services tonewly The SBCprogramsuccessfullyprovidedservices 2 , JacquelynClymore 2 , EvelynByrdQuinlivan 1 , JennaDonovan 1 , Victoria Mobley , Victoria 1 , Anna Finestone LeViere 3 1 , KristenSullivan

2 , 3

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POSTER ABSTRACTS 97 errors and more meaningful patient engagement incare. engagement errors andmoremeaningfulpatient medication’s intofeweradherence purposeandfunctionmaytranslate and/or functionoftheirprescribedmedications. Periodic reviewofeach ofthepurpose confidenceinknowledge understandingand/orlow low Conclusion: physician andnottheirown. wastheprovinceoftheir knowledge medication-related expressed that conditions(HIV,historically stigmatizing depression). Patients commonly prescribedfor describingfunctionofmedications among patients hadthemostdifficulty.sive medications richerarticulation We observed offunction, explanations attempted that thoseprescribedantihyperten functionedinthebody.of theirprescribedmedications Among patients one ormore leastsomeuncertainty regardinghow expressedat patients storedpillsintheiroriginal containers. that patients Sixty-onepercentof usingmedi-sets,patients rolls, pre-packaged orblisterpacks, and purposebetween medication no significantdifferenceinabilitytostate and couldnotguessthepurposeof1+theirmedications. There was which wereSpanishspeakers. didnotknow Overone-fifthofpatients with HIV; 37%female, 33% African American, and25%Latino, 86%of Results: within-class themes. ments ofpurposeandfunction, toidentify weopen-codedstatements cardiovascular disease. transcriptsforstate After codinginterview medications, diabetesmedications, antidepressants, for andmedication classes:medication antiretrovirals, antihypertensives, lipid-lowering across6USclinicsand Spanishwithpatients prescribed3ormore Methods: pose, functionin thebody. theirmedications andunderstandingofhow death, pur weassessedunderstandingoftheirprescribedmedications’ illnessor for whichahighlevelofadherenceisrequiredinordertoavoid may impedeadherence. withmultiplechronicconditions Among patients purposeandfunction, abilitytounderstandmedications’ patients’ which Background: 7 6 5 4 3 2 1 Rob Fredericksen(presenting) Laura Gibbons Stephanie Loo Kari Alperovitz-Bichell Laurie Smith Kenneth Mayer Donald Patrick Comorbidities: AQualitativeInquiry Patients LivingwithMultipleChronic Georgia RegentsUniversity, Augusta, GA, USA SC, USA Beaufort JasperHamptonComprehensiveHealthServices, Ridgeland, Chase BrextonHealthServices, Columbia, MD, USA University of Birmingham,Alabama at AL, USA Fenway Health, Boston, MA, USA University ofCaliforniaSanDiego, CA, USA University of Washington, Seattle, WA, USA Participants of53years, (n=57)wereameanage 60%living We inEnglish conducted1:1semi-structuredinterviews and PhysiologicalFunctionamong Perceptions ofMedicationPurpose 1 Patients with chronic comorbidities often demonstrated Patients withchroniccomorbidities oftendemonstrated , EmmaFitzsimmons 3 Evidence suggests that low healthliteracy low Evidence suggeststhat impacts 1 1 , Melonie Walcott, 3 , Frances, Yang , HeidiCrane , MichaelMugavero 5 , SharonBrown 1 , Paul Crane 7 , ToddEdwards 4 1 , Lydia Dant

1 , AlexWang 4 , Anna Church , Anna 1 , CristinaGutierrez 1 , ChrisMathews 3 , EdgarPaez 1 , 5 , MonicaGodfrey

1 , Grace Mary Asirot 3 2 2 , , ,

6 , 11th International Conference on 11th International -

1 - , - 98 7 6 5 4 3 2 1 Frances Yang Stephanie Loo Kari Alperovitz-Bichell Laurie Smith Kenneth Mayer Donald Patrick A QualitativeInquiry is paramountinpromotingadherence. clinical andcoordinated mentalhealthneeds cation responsetopatients’ livingwithHIV.adherence presentamajorchallengetopatients Identifi Conclusion: difficulty adjustingtolifewithHIV. includeda barrierdescribedfeelingsthat shame, fearofmortality, and stigmatization. Patients citing “not wantingtoberemindedofHIV” as disclosure,cern overunwantedHIVstatus andsubsequentanticipated timeandspacetotaketheirmedications,difficulty findingprivate con life. Patients citinganxiety/concernoverperceptionsofothersdescribed a barrierdescribedlackofadherenceintermswantingtoendtheir (24%); andstress(12%). whoendorseddepressionas Halfofpatients over perceptionsofothers(31%), notwantingtoberemindedofHIV more. Mostcommonwere: feelingdepressed(39%);anxiety/concern percent identified of HIVinfection11years.casian; meantimesincediagnosis Thirty-six African-American, (76%Spanishspeakers), 33%Latino and27%Cau Results es ininterpretation. belief andpsychologicalbarrieritems;athirdcoderreconcileddifferenc included adherencemeasuresthat reviewofvalidated attitude/ literature coders identifiedsub-themesusingcodesderivedfromacomprehensive ofthemesasnecessary.reconciled differencesininterpretation Two athirdcoder aboutmedications; logical barriersandattitudes/beliefs coded transcriptstoidentifyafixedsetofthemesincluding psycho experience ofmultipleadherencebarriers. Two codersindependently diverseU.S.across 6geographically clinics. queriedpatients’ Interviews reportingevermissingdosesofantiretrovirals Spanish withpatients Methods adherence. HIV andantiretroviralregimensdemotivate mentalhealth, bywhichpatients’ dynamics attitudes, andbeliefsabout livingwithHIV.common amongpatients We soughttounderstandthe Background: Georgia RegentsUniversity, Augusta, GA, USA SC, USA Beaufort JasperHamptonComprehensiveHealthServices, Ridgeland, Chase BrextonHealthServices, Columbia, MD, USA University of Birmingham,Alabama at AL, USA Fenway Health, Boston, MA, USA University ofCaliforniaSanDiego, CA, USA University of Washington, Seattle, WA, USA : of42, Patients (n=113)wereameanage 26%female, 35% : We inEnglishand conducted1:1semi-structuredinterviews Antiretroviral Adherence: Antiretroviral Psychological Barriersto 1 The abundanceandinterplayofpsychologicalbarriersto 7 , EmmaFitzsimmons Psychologicalbarrierstoantiretroviraladherenceare , ToddEdwards 3 1 , Melonie Walcott, 3 , HeidiCrane , MichaelMugavero ≥ 1 psychologicalbarriers;22%identifiedtwoor 5 , SharonBrown HIV Treatment andPreventionAdherence 1 , Paul Crane 1 , Rob Fredericksen(presenting) 4 , Lydia Dant

1 , AlexWang 4 , Anna Church , Anna 1

, CristinaGutierrez 1 , ChrisMathews 3 , EdgarPaez 5 , MonicaGodfrey 1 , Grace Mary Asirot

3 2 2 , , ,

1 6

- - - 1 , - - 106 11th International Conference on 11th International regimens,alternative ifthesebecomeavailable. intentions forlong-termuse. However, 84%ofthesemenwouldprefer Conclusions: advance (aOR4.62;CI2.52-8.46). the prior3months(aOR5.07;CI2.52-10.2), andplanningsexminutesin [CI]2.66-9.03),4.90; 95%confidenceintervals >10sexualpartnersin LAI-PrEP overdaily-PrEPincluded [aOR] <30(adjustedoddsratio age sex, respectively. Inadjustedmodels, withpreferring factorsassociated non-daily epi-PrEP overdaily-PrEPwereeaseofadherenceandhaving equally effective. The mostcommonreasonsforpreferringLAI-PrEPor 22% preferredepi-PrEP, 15%daily-PrEP, and 2%rectalgels, ifallwere comparedtoothermodalities, 2-3monthsifavailable LAI-PrEP every definitely (54%). theywouldprefer Sixtypercentofparticipantsindicated and 71%ofactiveusersintendedtousedaily-PrEPfor weeks (17%). Mostrespondents(87%)werecurrentlyusingdaily-PrEP, sexincludedfor andhaving minutes(20%), hours(53%), anddays/ bacterial STDintheprioryear. Typical oftimebetweenplanning intervals a medianof5analsexpartnersintheprior3months;37%had MSM. was36;78%werewhite.Their medianage Respondentshad Results: with rank-orderedproductpreferences. Exploded-logit regressionmodelswerefittoidentifyfactorsassociated hypothetical productpreferences. Analyses wererestrictedtoMSM. aboutsexualbehaviors,surveys experienceswhenusingPrEP, and clinic specializinginLGBThealthcarewereselectedtocompleteonline aBoston been prescribeddaily-PrEPduring2011-2014(n=663)at Methods: among PrEP-experiencedMSMareunknown. long-acting injections[LAI-PrEP])arebeingstudied. Productpreferences ofPrEP(e.g., formulations alternative episodicoralPrEP[epi-PrEP], sexwithmen(MSM).is increasingamongmenwhohave However, Background: 2 1 Chris Grasso Douglas Krakower(presenting) with Men Fenway Institute, Boston, MA, USA Beth IsraelDeaconessMedicalCenter, Boston, MA, USA Of 324 respondents (response rate = 49%),Of 324respondents(responserate 311identifiedas Between JulyandNovember2015, individualswhohad 2 , KennethMayer Most MSMwhoarecurrentlyusingdaily-PrEPreport Daily oralpreexposureprophylaxis(daily-PrEP)use Experienced MenWhoHaveSex Product PreferencesamongPrEP- 2 1 , KevinMaloney HIV Treatment andPreventionAdherence 1 , KenLevine ≥ 5 yearsorin 2 , ≥

1 - 107 utilization. with improvednutrition, mentalhealth, ART adherenceandhealthcare Hand. wouldbeassociated We theintervention hypothesizedthat and Oakland, providedbyacommunity-basednon-profit, ed afoodsupportpilotforpeoplelivingwithHIV(PLHIV)inSanFrancisco may improveHIVhealthoutcomesinresource-richsettings. We evaluat outcomes, providingfoodassistance examinedhow yetfewstudieshave Background: 3 2 1 Kartika Palar (presenting) Edward Frongillo Sheri Weiser Outcomes: APilotStudy the causalimpactoffoodsupportonHIV-related health. ized-controlled trialofthispilotprogramiscurrentlyunderwaytoassess multiple healthoutcomesforPLHIV, including ART adherence. A random Conclusions: months decreasedfrom10%to3%(p=0.31). 2.74 to1.75times/day(p=0.09), intheprevious3 andhospitalizations spectively), frequency foodordrink decreasedfrom ofconsumingsugary toms andinternalized HIV stigmadecreased(p=0.137andp=0.209, re at α=0.05: significant were notstatistically severityofdepressivesymp to 70%(p=0.046). positivetrendsthat Additional outcomesshowed 33% to13%(p=0.035), and95% ART adherenceimprovedfrom47% food purchasesinordertofillpharmacy prescriptionsdecreasedfrom foodsdecreasedfrom3.63to2.52times/day(p=0.02),fatty deferring insecurity decreasedfrom77%to30%(p<0.001), frequency ofeating and 20%weremarginallyhoused. Comparingbaselinetofollow-up, food male (73%), andnon-white(63%). Medianannualincomewas$16,667 assessments.follow-up Mostparticipants(83%)wereover50yearsold, Results: post changes. continuous anddichotomousoutcomes, respectively, tocomparepre- measures. Paired t-testsandMcNemarexacttestswereusedwith baseline and5monthsusingvalidated assessed pairedoutcomesat nutritional guidelinesforahealthydiet(e.g. andsugar). infat low requirementsandmeet designed tocomprise100%ofdailyenergy Methods: University ofSouthCarolina, Columbia, SC, USA Project OpenHand, SanFrancisco, CA, USA University ofCalifornia, SanFrancisco, CA, USA Thirty PLHIV (out of 45 initiators) had bothbaselineand Thirty PLHIV(outof45initiators) The 6-monthpilotprogramprovidedmealsandsnacks 1 , SimonPitchford Comprehensive, healthyfoodsupport mayimprove Food HIV withmultiplenegative insecurityisassociated Improve ARTImprove AdherenceandHIV Comprehensive FoodSupportMay 3 , LeeLemusHufstedler 1 2 , KimberlyMadsen 1 , TessaNapoles 2 , Seligman Hilary 1 Project Open ,

We 1 , - - - - POSTER ABSTRACTS 73 74

POSTER ABSTRACTS 108 needed. to explorecausalityandthemechanismsoftheseuniquefindingsis with areducedriskofnon-suppressed delivery.VL at Furtherresearch during pregnancy, disclosure tobeassociated toamale partnerappears Conclusions: 0.57; 95%CI: 0.27-1.23). on ART delivery, >16weeks at (RR: wasobserved asimilarassociation of enrolmentandduration VL at ART use. Inasub-analysisofwomen 0.55; 95%CI: 0.38-0.80)afteradjustingforage, socioeconomicstatus, disclosure withareducedriskof non-suppressed wasassociated VL (RR: women.among previously-diagnosed women,Among newly-diagnosed and non-adherence;betweendisclosure andnon-suppressed VL non-adherence. betweendisclosure wereobserved Noassociations tum. Overall, 17%hadnon-suppressed and8%reported delivery; VL at 74% and57%reporteddisclosing toamalepartnerbyearlypostpar duringthispregnancywomen diagnosed overall: (meanage 28.4years), Results: within 30daysofdelivery, respectively. 30 days)andnon-suppressed VL (VL>50copies/mL), bothmeasured and non-adherence(missed ART doseson among disclosurevariance toexploreassociations (reportedasyes/no) HIV-1) wasconducted. We usedPoisson regressionwithrobusterror visits; allstudy adherence wereassessedat VL testing(Abbott RealTime delivery.>12 weeksat Disclosure toamalepartnerandself-reported visit.early postpartumstudy This analysisfocussedonwomen ART andone uptothreeantenatal for theMCH-ART andattended study Methods Town,Cape South Africa. non-suppressed lifelong VL amongpregnantwomeninitiating ART in disclosureexamined HIVstatus toamalepartner, non-adherenceand betweendisclosureexploring associations andHIVviralload(VL). We (ART),of adherencetoantiretroviraltherapy buttherearelimiteddata Background: 2 1 Robert Remien Kirsty Brittain Lifelong ART inCapeTown, SouthAfrica Suppression inPregnantWomen Initiating Columbia University, New York, NY, USA University ofCape Town, South Africa Among 191 women previously diagnosed withHIVand215 Among 191womenpreviouslydiagnosed : ART-eligible carewererecruited womenenteringantenatal 1 , Among newly-diagnosed women initiating lifelong womeninitiating Among newly-diagnosed ART HIV status disclosureHIV status maybeanimportantdeterminant 2 Tamsin Phillips(presenting) , Allison Zerbe , Allison Partners, AdherenceandViral HIV StatusDisclosure toMale 2 , Elaine Abrams , ≥ 2 daysduringthepreceding 1 2 , ClaudeMellins , LandonMyer 1 2 ,

11th International Conference on 11th International - 109 (SSBC). code ofthesocialsupportbehavior were analyzedusinganadaptation of fallingoutcare, andrecruitedbyproviderreferral. Methods: support groupforPLWH. thetypesofsupportandperceptionsthisclinic-affiliateduate online anonymous, board(CMB). onlinecommunity message We aimedtoeval (PL)includesThe Positive Linkssmartphoneapplication accesstoan challengedinaccessingin-personsupport. populations disadvantaged with HIV(PLWH) andcouldbeprovidedvirtually, particularlyforruraland Background: 2 1 Lena Waldman Ava Rebecca Dillingham health andqualityoflifeforPLWH. withbarrierstoin-personsupportandimprove to reachpopulations support throughanonlinecommunity. Conclusions: reportedbyparticipantsinusingtheapp. limitations from readingposts. app. Participants perceivedconnectionandsupportaskeybenefitsofthe (40%), network(27%), esteem(17%), support(13%). andinformational support. providingsupportwerepredominantlyemotional Messages seeking support, ofthreeresponsesproviding therewasanaverage support and433(52%)providingsocialsupport. For eachmessage CMB postsover8months, 115(14%)werecodedaselicitingsocial and 33%werewhite;60%hadunsuppressedHIVviralloads. Results: 0.84 werereached(respectively). of0.90and by 2independentcodersandcodebooksrefineduntilkappas assess theirexperience. Health Decision Technologies, SanFrancisco, CA, USA University of Virginia, Charlottesville, VA, USA Several ofthosewhodidnotpostontheCMBstillperceivedbenefit Participants 3weeksafterenrollmentto completedinterviews Of55participants, was39years;69%weremale meanage Participants wereadultslivingwithHIV, risk newtocareorat userstoseekandprovidesocial allowed The PLapp Socialsupportcanimproveoutcomesforpeopleliving Group forPeople LivingwithHIV Together, Online:AVirtual Support 1

, ClaireDeBolt 1 Technical issuesandinterpersonalbarrierswere , KarenIngersoll HIV Treatment andPreventionAdherence CMB posts and interview contentwasanalyzed CMBpostsandinterview 1 , Tabor Flickinger(presenting) 1 ,Cohn Wendy

This technology hasthepotential This technology 1 , GeorgeReynolds Posts totheCMB Of840 1 2 ,

- 110 11th International Conference on 11th International collectionmethod. order tooptimizeSMSasadata safer sexualbehaviors. The challengesreportedshouldbeaddressed in behavior. throughSMSmaypromoteadherenceand Collectingdata PrEPadherenceandsexual questionsrelated toanswer SMS surveys Conclusions: too repetitive. tosexualbehavior A fewparticipantsfoundthedailyquestionsrelated chargeofparticipantphonesmaderespondingtoSMSdifficult.battery fromhome.came whiletheparticipantwasaway tothe Issuesrelated cluded questions, insufficienttimetoanswer especiallywhenmessages appointment, asclinic theyserved remindersaswell. Challengesin to usecondoms. cameclose Becausethemessages totheirnextclinic to adherenceandcondomuseremindedthemadherethePrEP tion tools, respondingtoquestionsrelated participantsalsoreportedthat sexualpartners.study collec weremeantasdata Although thesurveys theclinic.at Someparticipants reportedsharingtheresponseswiththeir supporttheyreceived SMS becauseoftheinitialtrainingandfollow-up itwaseasytorespondthequestionsthrough ticipants reportedthat men and9womeninHIVserodiscordantrelationships. ofthepar Many Results: surveys. the textmessage to experiencesandperceptionsof analysis identifiedconceptsrelated among HIV-uninfected individualsenrolled inthePMAPStudy. Thematic and Uganda. We conductedsemi-structured, (IDIs) in-depthinterviews inKenya onPrEPadherenceandsexualbehavior daily SMSsurveys withinthePartners Project,substudy Demonstration involvedperiodic Methods: arepoorly understood. adherence andsexualbehavior forPrEP surveys ticipant acceptabilityandexperiencewithtextmessage collection;however, data SMS apotentialtoolforsocio-behavioral par Background: 6 5 4 3 2 1 Betty Nankya Renee Heffron Kenneth Ngure(presenting) Africa Adherence andSexual BehaviorinEast onPre-ExposureProphylaxis(PrEP) Surveys (SMS) Responding toShortMessageService Partners inHealthandResearchDevelopment, Nairobi, Kenya MedicalResearchInstitute,Kenya Nairobi, Kenya Infectious DiseasesInstitute, MakerereUniversity, Kampala, Uganda University of Washington, Seattle, WA, USA Massachusetts GeneralHospital, Boston, MA, USA Universityof Jomo Kenyatta Agriculture and Technology, Juja, Kenya We with17HIV-uninfected conducted26in-depthinterviews The Partners Mobile Adherence toPrEP(PMAP)Study, a 4 , GraceKimemia 3 Most participantsreportedpositiveexperienceswith Widespread availability ofcellularphonesgloballymakes Widespread availability , EllyKatabira Analysis ofParticipant Experiences “It Was Easy”:AQualitative 4 , NellyMugo 1 , JessicaHaberer 6 ,Muwonge Timothy HIV Treatment andPreventionAdherence 5 , BridgetBurns 2 , JaredBaeten 4 2 ,

3 ,

- - - - 112 to retainpeoplelivingwithHIV(PLWH) incare. Project developedaclinic-based clinics protocolusedby5Ryan-White Background: 5 4 3 2 1 Evelyn ByrdQuinlivan Nada Fadul Jenna Donovan (presenting) Retention-in-Care Intervention North Carolina:ResultsofaClinic-Based necessary tofullyidentifyPLWHnecessary needingretentionassistance. leastpartially,at bymissingdata. and whichislikelyexplained, withrelocation VLs remained associated should bedeveloped. duringlong-termcare forsupportingpatients additionalstrategies that Conclusions: VLs within180d(58%vs. 42%;aPR=1.4, 1.21-1.62). carewithin90d(66%vs.likely tohave 48%;aPR=1.43, 1.22-1.67) and within 180d. PLWH weremore whowerecontactedbutdidnotrelocate care intheyearprior(aPR=1.41, with 1.09-1.83)wereallassociated VLs insurance (aPR=1.27, 1.09-1.48), prior VLs (aPR=2.58, 2.02-3.39), and (10yvs.longer timesinceHIVdiagnosis 7.5y, p=0.0018), any having had evidenceof VLs within180d. Age 40-49y(aPR=1.22, 1.03-1.44), 180d. 55%hadtwo year. inthefollow-up VL tests>90dapart 51% ed. Ifcontacted, 58% ofPLWH resumedcarewithin90d, 75%within and careinasmallerclinic withnotbeingcontact wereassociated Results: VL resultswereclassified asnotincareandsuppressed. relocation, priorcareevidence, andprior VL suppression(VLs). Missing (aPR)adjustedforinsurance, with95%confidenceintervals lence ratios characteristicsandHIVRNA(VL)outcomesusingpreva demographic betweenclinical/ associations wereusedtoevaluate data surveillance same clinic ortransferringcare(relocating). and (notrelocating) Service clinic visit. Ifcontacted, PLWH aseitherreturningtothe werecategorized toschedulea care forover6or9monthsandcontactwasattempted Methods: University of North Carolina at Chapel Hill, Chapel University ofNorthCarolinaat NC, USA East CarolinaUniversity, Greenville, NC, USA Wake Forest UniversitySchoolofMedicine, Winston-Salem, NC, USA Duke University, Durham, NC, USA NC, USA North CarolinaDepartmentofHealthandHumanServices, Raleigh, Younger age, nocareinthepreviousyear, priordetectable VL ElectronicmedicalrecordswereusedtoidentifyPLWH without 4 , Amy Heine , Amy Past useofcarestronglypredictsfutureuse, suggesting As part of the Systems Linkages Initiative,As partoftheSystemsLinkages theNCLINK Care inOut-of-CarePLWH in Past CarePredictsFuture Despite using statewide surveillance data, surveillance care Despiteusingstatewide 5 5 , JenniferKeller 1 , KristenSullivan are agreements Wider data-sharing 3 , Anna Firestone LeViere 2 , AimeeWilkin 3 ,

5 , -

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POSTER ABSTRACTS 113 can beusedifresourcesarelimited. highriskforliverfailure.persons at ofIDUforRTC Furtherprioritization PLWH among ornewHCVdiagnoses forRTC re-evaluation facilitated Conclusions: werenewlyfoundtobeRNA-positive. with HCV-unknown status forHCVwithinonemonthofRTC.ation Post-RTC, 46/606(8%)ofthose <0.001). At least70%ofthe730RTC-PLWH evalu receivedlaboratory ofinjectiondruguse(IDU)(54%vs20%, ahistory more likelytohave P HCV testweresignificantlyolder(69%vs36% OOC-PLWH HCVstatus, ornegative withunknown thosewithapositive HCVstatus. ornegative testand606withunknown Comparedwith body fied andreturnedtocare, including 124withapositiveHCVRNAoranti Results: afterRTC registry toassessreceiptofHCVevaluation. HCV surveillance co-infected withHCVforRTC. We usedHCVRNAtestresultsfromthe OOC-PLWH toprioritizeOOC-PLWH registry withtheHCVsurveillance (RTC). In2013, thenamesof theHealthDepartmentbeganmatching OOC clients wereassignedtopublichealthworkersforreturn-to-care reportsfor out-of-care (OOC)(nolaboratory incaretoidentifyPLWHas proxiesforengagement presumedtobe registry CD4 orRNAviralloadresultsreportedtotheHIVsurveillance Methods: ofHCVinPLWHand treatment critical. are highlyeffectiveinpeoplelivingwithHIV(PLWH), makingdiagnosis progressiontolivercirrhosisandfailure.of rapid CurrentHCVtreatments Background: New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, Chi-Chi Udeagu(presenting) Fabienne Laraque, MirandaMoore, ShakaraBrown, Virus CoinfectioninNewYork City of Persons LivingwithHIVandHepatitisC During February 2013-June2015, 730OOC-PLWH wereidenti In 2008, theNew York CityHealthDepartmentbeganusing Integrating HCV surveillance data intheselectionofOOC- data HCVsurveillance Integrating Persons increasedrisk coinfectedwithHIVandHCVareat HIV Data Improved theEvaluationHIV DataImproved Integrating HepatitisCand ≥ 9 months). Onceidentified, ≥ 50 years, P<0.001)and

11th International Conference on 11th International - - - 115 related information including information related SRadherenceusinga3-itemvalidated was conductedtocollectsocio-demographic, behavioral, andtreatment receiving ART ahospital-basedHIVcarepractice. at A baselinesurvey ed adults(18yearsandolder)withdetectableviralloads, whowere Methods: differencesinadherencerates. withtheobserved factors associated (SR) andelectronicdrugmonitoring(EDM)measuresidentified (ART)differences inantiretroviraltherapy adherenceusingself-report usingdifferentmeasures.ferential adherencerates assessed This study Background: University,Brown Providence, RI, USA Ira Wilson, YoojinLee, and ElectronicDrugMonitoringMeasures (ART) AdherenceRatesUsingSelf-Report may wanttokeepthesefactorsinmindwheninterpretingself-reports. significantpositivebiasforadherenceself-reports.statistically Clinicians factors, orbehavioral or othersociodemographic with wereassociated Conclusions: significant inthemodel. controlled forrace, gender, anddepression, whichwerenotstatistically withSR-EDMdifferences.not significantlyassociated Theseanalyses difference betweentheirSRandEDMscores. Socialdesirabilitybiaswas by SAMISSscore)hada7-point( between SRandEDMscores. People whoabusesubstance(measured there wasa1-point( EDM measures. For each1-pointincreaseonthe27-point AUDIT score, DIT-score withdifferencesbetweenSRand waspositivelyassociated the SRandEDMadherencescores. Alcohol usemeasuredby AU increase inage, therewasa5-point( usingSRandEDMmeasures.adherence rates For 10yearsof every Results: including socialdesirabilitybias(usingtheSocialDesirabilityscale). measures. variablesweretested, andbehavioral Sociodemographic usingSRandEDMmeasures,tial adherencerates adjustingforrepeated withdifferen linear mixedmodelwasusedtoidentifyfactorsassociated SR andEDMadherencescoresforeachmedication/bin. A generalized bins. wasdefinedasthedifferencebetween Differentialadherencerate over344 asacontinuousvariablefor63patients scores werecalculated was assessedusingthe3-itemscale. MeanSRandEDMadherence forthe30dayspriortoeachvisitandSRadherence the MedSignaldata visits).baseline (3follow-up EDMadherencewasmeasuredbasedon visits afterthe study monthlyfollow-up wereassessedat ence rates foranalysis.wirelessly transferredtheeventdata SRandEDMadher its use. eacheventofbinopeningand The MedSignalsdevicecaptured MedSignals scale. After thesurvey, participantsweregivenacellularwedge-bottom withdifferentialantiretroviral Age wasstronglyassociated We conducted an observational study among81HIV-infect study We conductedanobservational ® electronic medication-monitoring devicewithtrainingon electronicmedication-monitoring Age, alcoholand druguse, butnotsocialdesirabilitybias Few withdif examinedfactorsassociated studieshave Differential Antiretroviral Therapy Differential Antiretroviral Factors Associatedwith β Yordanos Tiruneh (presenting) =0.99, p<0.0001)increaseinthedifferences HIV Treatment andPreventionAdherence β =6.5, p=0.054)increaseinthe β =4.8, p=0.0004)differencein - - - - - 116 11th International Conference on 11th International adherence. targetthisfactorasapotentiallymodifiableriskforpoor that antiretroviral adherenceinHIV-infected adults, supporting interventions Conclusions: controlling forrace, gender, self-efficacy, andsubstanceuse. adherenceafter were notpredictiveofbothSRandEDMmedication ofHIVcareprovider, rating patient socialdesirabilitybias, andbusyness withtheSRadherence.there wasnosignificantassociation Depression, 8-points decreaseonEDMadherencescale( withan Substance abuse(measuredbySAMISSscore)wasassociated and 14-pointshigherEDMadherencescores( (compared towhites)had8-pointshigherSR( adherence scale( adherence scale( 5-point self-efficacy score, thereisa9-pointincreaseon100-pointSR both SRandEDMmultivariablemodels. For each1-pointincreaseona adherencein medication was themostsignificantpredictoroffollow-up Results: SR andEDMmeasures, accountingforclustering. adherenceassessedby used toidentifyfactorsinfluencingmedication over136bins.for 60patients A generalizedlinearmixedmodelwas 100-point scale. MeanSRandEDMadherencescoreswerecalculated visit.days priortothefollow-up ona Adherence scorewascalculated forthe30 EDM adherencewasassessedbasedontheMedSignalsdata adherence wasassessedusingathree30-dayrecallitemsscaleand using bothSRandEDMmeasures.assess adherencetomedication SR andanalysis.download visitwasheldafteramonthto upstudy A follow for of binopeningandtransmitstherecordswirelesslytoserver baselinevisit.on itsuseat eachevent The MedSignalsdevicecaptured MedSignals risk factors, andself-reportedadherence. Participants weregiven socio-demographic, economic, characteristics, andbehavioral HIV condition. on wasconductedtocollectinformation A baselinesurvey load tests, leastoneotherchronic forat andwhowerealsobeingtreated therapy, oneofthelasttwoviral hadadetectableviralloadat having (18yearsandover)onantiretroviral were81patients for thisstudy adults receivingcareinahospital-basedHIVpractice. Participants Methods: monitoring (EDM)measures. usingself-report(SR)andelectronicdrug adherence toHIVmedication intervention. We predictorsof examinedpsychosocialandbehavioral HIV-infected feasibleadherence adultsisacriticalfirststepforany Background: University,Brown Providence, RI, USA Ira Wilson, YoojinLee, and ElectronicDrugMonitoringMeasures to HIVMedicationsusingbothSelf-Report Self-efficacy (assessedusing14-item ACTGself-efficacy scale) This observational study wasconducted amongHIVinfected study This observational

® electronic medication-monitoring deviceandweretrained electronicmedication-monitoring Self-efficacy isaconsistent, significantpredictorof Identifying factors influencing medication adherencein Identifyingfactorsinfluencingmedication Consistent PredictorofAdherence Self-Efficacy isaStrongand β β =9.9, P<0.0001). Inoursample, blackpatients =9.1, P<0.0001)anda10-pointincreaseonEDM Yordanos Tiruneh (presenting) HIV Treatment andPreventionAdherence β β β =-7.6, P=0.047)but =14.182, P=0.003). =7.6, P=0.038) 119 Scholar) usingMESHheadingsandkeywordsaboutPrEPand/orHIV Methods: ture (PRL)andcontentanalysisofsocialmediapostsaboutPrEP. US MSM, reviewofthepeer-reviewed weconductedasystematic litera toPrEPuseamong barriersandfacilitators comprehensively elucidate sexwithmen(MSM).HIV preventiontoolamongmenwhohave To more Background: 2 1 Alisse Hannaford(presenting) Julia Arnsten Joanna Starrels to thePeer-Reviewed Literature Facilitators ofPrEPamongMSM:Comparison PrEP-related interventions.PrEP-related currentfactorsimportantfordesigningandimplementing capture of thePRL. Traditional maynotcomprehensively researchapproaches review werenotprominentorfoundinasystematic online postingsthat Conclusions: with condoms. decreased anxietyaboutHIVduringsex, andgainingextraprotection a dailyroutine, comparedtoonlinepostings, having whichindicated identified inthePRLwereaccesstosupportservices, andbeingon providers, andinabilitytoadherePrEP. The mostimportantfacilitators postings whichidentifiedstigmaaboutusingPrEP, poorly-informed were cost, lackofPrEPawareness, andside-effects, comparedtoonline tousingPrEP.itators InthePRL, themost commonlyreportedbarriers meeting inclusion criteria. We identified48uniquebarriersand46facil Results: potential differencesbetweenthePRLandonlinepostings. about PrEP. We usedcontentanalysistoidentify themesandcompare Gay Voices, Queerty, andMyPrEPExperienceblog)toidentifypostings from diverse ‘venues’ (e.g., Facebook, Outward, Slate Huffington Post (e.g. newsarticles, opinionpieces, blogsand othersocialmediaposts) searched awiderangeofonlinepostingsandtheirreadercomments on barriers, facilitators, toPrEPuse. orotherfactorsrelated We also prevention. We included originalstudiesamongMSMintheUSreporting Icahn School of Medicine at MountSinai,Icahn SchoolofMedicineat New York, NY, USA Albert EinsteinCollegeofMedicine, Bronx, NY, USA We identified26 peer-reviewed articles and42onlinepostings We (Medline, searchedPRL databases Web ofScience, Google 1 We toPrEPin identifieddifferent barriersandfacilitators Pre-exposureProphylaxis(PrEP)remainsanunder-utilized , Viraj Patel, Viraj 1 Posts toIdentifyBarriersand Using SocialMediaandOnline , JessicaRizzuto 1 , MadeleineLipshie-Williams 2 2 , PhillipCohen 2 ,

1 ,

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POSTER ABSTRACTS 120 address them. to hampertheuseofthesecondomsandeffortsshouldbemade quality condomshowever, genericmythsandmisconceptionscontinue andaccessto byincreasingavailability vention amongkeypopulations Conclusions: intheGoodlifeclinics. inmany available itissoft;fitswell, that but acknowledged iseasytouse, andisreadily itishardtoopen the sociallymarketedbrandhasabadsmellandthat socially marketedcondoms. 21%said Oftherespondentsinterviewed males and46%femaleswasthekeyreasonforbuyingusing used asociallymarketedcondom. HIV/AIDS67% Protectionagainst everused/were the males(59%)andfemales(38%)reportedhaving aboutthesociallymarketedcondomsthan womenwhile knowledgeable marketed condombrandcomparedtotheFSWs. MSMsweremore Female sexworkers. MSMswherethemostlikelytomentionsocially brands amongthefisherfolkand mind shareandarethemostknown Results: werealsoconducted. interviews group.and iii)SexuallyactiveMeninreproductiveage Keyinformant everusedgoodlifeproducts); group andsexuallyactive(thosewhohave givers/mothers ofchildren0-59months;ii) Women inreproductiveage data. T Focus care groupdiscussionswereconductedwith;i)Primary used amulti-cluster randomsampling method forquantitative stratified respondents (beneficiaries)wereselectedforthestudy. team Thesurvey approaches. andqualitative using quantitative A totalof691household Methods: ofsociallymarketedcondoms. availability to establishclient perceptionsaboutquality, packaging, pricing, and through socialmarketing. The UHMGconductedabrandtrackingsurvey ofmalecondoms year USAIDsupportedprojecttoincreaseavailability (FSWs). UgandaHealthMarketingGroup(UHMG)implementedaone sexwithmen(MSM)and femalesexworkers among menwhohave HIVpreventiontargetsespecially them criticalinachievingnational sexually transmittedinfections(STIs), andunplannedpregnancy making Background: Uganda HealthMarketingGroup, Kampala, Uganda Alege G. Stephen(presenting) to ReachCommunitiesinUganda Men whohaveSex (MSM)withMeninHard The socially marketed condoms have thehighesttopof The sociallymarketedcondomshave usedmixedmethodapproach The brandtrackingsurvey SocialmarketingofcondomsplaysabigroleinHIVpre Male condoms offer dual protection against HIVandother Malecondomsofferdualprotectionagainst Female Sex Workers (FSWs)and Social MarketingCondomsfor , Denis Ahairwe, Thomson Ngabirano Denis Ahairwe,, Thomson 11th International Conference on 11th International - - 121 outcomes inHIVpatients. Initiative,As partoftheSystemsLinkages the Background: 5 4 3 2 1 Nada Fadul (presenting) Aimee Wilkin LaWanda Todd Counselors Those whoRequiredReferraltoStateBridge vs.who ReceivedaClinic-basedIntervention and on effective antiretroviral therapy arerequired. and oneffectiveantiretroviraltherapy achieve VLs. Focused toremainincare effortstosupportthesepatients tectable incareor thetimeofreferralandlesslikelytore-engage VL at hadde efforts andwerereferredtotheSBCmorelikelyhave Conclusions: year (OR0.33, 95%CI0.25-0.44). 95% CI0.21, 0.41), andlesslikelytoachievesubsequent VLs within1 in carewithin180days(OR0.29,group werelesslikelytore-engage suppression (VLs)(OR2.04, 95%CI1.53, 2.72). Patients intheSBC (OR 1.33, 95%CI1.00, recentviralload 1.78)andlesslikelytohave to SBC. Patients referredtotheSBCweremorelikelybeuninsured of-care, 264receivedareferraltoSBCand857didnotrequire Results: using multivariablemodelsforthetwogroups. referred totheSBC. andclinical Demographic outcomeswerecompared and rescheduletheout-of-carepatients. Those whowerenotfound became incarcerated. tolocate, Retentionstaffthenattempted contact months ago. PLWH wereremovedfromthelistiftheyhadmoved, diedor than6-9 whowerelastseengreater listsofHIVpatients generate Methods: referred totheSBCs. andweresubsequently clinic-based withoutre-engagement intervention received onlytheclinic-based withthosewhoreceivedthe intervention PLWHgage incare. We comparedoutcomesofHIV-infected who patients BridgeCounselors(SBCs)toretainandre-en systemofState statewide aclinic-basedNC-LINK Projectinitiated retention protocolalongwitha Duke GlobalHealthInstitute, Durham, NC, USA Wake Forest UniversitySchoolofMedicine, Winston-Salem, NC, USA Raleigh, NC, USA North CarolinaDepartmentofHealthandHumanServices, Hill, Chapel University ofNorthCarolinaat NC, USA East CarolinaUniversity, Greenville, NC, USA Between 2013and2014, wereidentifiedasout- 1121patients Electronicmedicalrecordsystems(EMRs)wereusedto 4 , DianeCampbell Patients whowerenotreturned tocarebyclinic retention Retentionincareisasignificantpredictorofhealth 1 Outcomes forHIV-infected Patients Comparison ofRetentioninCare , Abigail Boyer , Abigail HIV Treatment andPreventionAdherence 1 , Anna Finestone LeViere 1 , Amy Heine , Amy 1 , Sarah Willis , 2 , JennaDonovan 5 ,

2 3 ,

- - 122 11th International Conference on 11th International will beneededtoimproveHIVoutcomesinthisgroup. HIV diagnosis. Programsaddressingtheneedsofhomelessindividuals non-retention incareandlackofviralsuppressionupto10yearsafter Conclusions: amongallvariables. had thelargestoddsratio 2.41–3.59).2.94; 95%confidenceinterval Inbothmodelshomelessness el, (adjustedoddsratio homelessnessalsohadasignificantoddsratio 2.40–3.52).2.91; 95%confidenceinterval Intheviralsuppressionmod withnon-retentionincare(adjustedoddsratio wasassociated diagnosis sion, yeardiagnosed, birthcountry, andrace/ethnicity, homelessnessat (P <0.0001). range, Controllingforage birthsex, modeofHIVtransmis were notvirallysuppressedcomparedwith43.2%ofthenon-homeless compared with38.5%ofthenon-homeless(P<0.0001), and70.3% less. Ofthese, 66.0%oftheinitiallyhomelesswerenotretainedincare people werestillaliveincluding 491(80.4%of611)theinitiallyhome diagnosis.(1.1%) werehomelessat Bytheendof2014, 47,669(86.7%) Results: for covariates. during 2014. logisticregressionwasconductedtocontrol Multivariate aviralloadresultwiththelastone<200 copies/mL defined ashaving during2014. least3monthsapart ical visitsat Viral suppressionwas excluded.at least2med Retentionincarewasdefinedasevidenceof System.Surveillance were People diagnosis youngerthan13yearsat years 2004-2013wereobtainedfromtheFloridaEnhancedHIV/AIDS Methods: thetimeofHIVdiagnosis. non-homeless at care andviralsuppressionbetweenpeoplewhowerehomeless infection. ofpeoplelivingwithhumanimmunodeficiencytreatment virus(HIV) Background: 2 1 JoTrepkaMary (presenting) Kristopher Fennie Karalee Poschman 2013, Florida Immunodeficiency Virus Infection, 2004- Homeless People DiagnosedwithHuman Florida International University,Florida International Miami, FL, USA Florida DepartmentofHealth, Tallahassee, FL, USA Of the 54,980 people diagnosed withHIV2004-2013, Ofthe54,980peoplediagnosed 611 wastocompareretentioninHIV The objectiveofthisstudy De-identified data for people diagnosed withHIVfromthe forpeoplediagnosed De-identifieddata Homelessness at HIV diagnosis was associated with wasassociated HIVdiagnosis Homelessnessat Homelessness creates significantbarrierstothe careand Homelessnesscreates Viral Suppressionamong Retention inCareand 2 , Mukherjee Soumyadeep 1 , LoreneMaddox 2 1 , DianaSheehan HIV Treatment andPreventionAdherence 2 ,

2 ,

- - - - 123 who received at least one of these services in2014, leastoneoftheseservices who receivedat wecompared oftheirclientsthe housingstatus annuallytoHRSA. (CM),non-medical casemanagement report orhousingservices Methods: delivery. andservice withplanningresourceallocation will helptheRWHAP andreceiptofsupportservices load suppression(VLS)byhousingstatus underinsured PLWH. providesclinical toun-and AIDS Program(RWHAP) andsupportservices (PLWH) riskofpoorretentionincareanddeath. at Background: Health ResourcesandServices Administration, Bethesda, MD, USA Amy Griffin, JohnMilberg, AIDS Program who received housing services hadhigherretentionbutnot who receivedhousingservices VLS. received medicalCM, SUDTX, and/orMHTX. Among unstably-housedclients, wefoundhigherretentionforthosewho Conclusion: non-medical CM, SUDTXand/orMHTX. not differsignificantlybetweenthosewhoreceivedhousing, medicalCM, who receivednon-medicalCM. CM, SUDTXandMHTX(allChi-squarep higher retentionwasfoundamongthosewhoreceivedhousing, medical VLS 82.8%)(allChi-squarep (retention77.2%,temporary VLS 77.0%)andstable(retention81.7%, and amongunstable(retention72.9%,VLS werelowest VLS 67.1%)vs representedintheunstablehousinggroup. disproportionately 100%federalpovertylevel, orbelow at andclients withMedicaidwere ble. distributionwas83.5%stable,status 11.9%temporary, and4.7%unsta ed medicalcare, and/orhousingin2014, casemanagement housing Results: illness (MHTX). housing, forsubstanceusedisorders(SUDTX)andmental andtreatment housed clients, wefurthercomparedretentionand VLS byreceipt ofCM, demographics, retention, and VLS byhousingstatus. Black/ African Americans, transgenderpeople, clients withincome Of the440,349HIV-positive clients whoreceivedRWHAP-fund RWHAP-funded providersofmedicalcare,RWHAP-funded medicaland Unstably-housed PLWH retentionand hadlower VLS. Lack ofstablehousingplacespeoplelivingwithHIV Outcomes intheRyan WhiteHIV/ Housing andClinicalHIV Understandingdemographics, retentionandviral Rupali Doshi(presenting) < Among unstablyhousedclients, VLS did .0001). Among unstably-housedclients, < .0001), butnotamongthose Unstably-housedclients The Ryan White HIV/ Among clients Among unstably

Retention

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POSTER ABSTRACTS 124 routine HIVclinical throughtreatment. carefromdiagnosis into shouldbeincorporated Mental healthscreeningandinterventions tions toreducepsychologicaldistressamongthishighriskpopulation. cal distress, recentdiagnosis, andlate ART caninforminterven initiation initiation. betweenpsychologi understandingoftherelationship Greater CD4countat withlow particularly amongthoserecentlydiagnosed ART Conclusion: CD4 counts(aOR: (aOR=1.62 (0.95, andhigher 2.76)andthosewithmorerecentdiagnosis CD4counts andlow bythosewithlongertimesincediagnosis followed CD4count(adjustedOR[aOR]: andlow diagnosis 2.0[95%CI 1.4, 3.0]); significant psychologicaldistresswashighestamongthosewithrecent andhigherCD4countsat time sincediagnosis ART initiation, oddsof CD4counts.low Inmultivariablemodels, tothosewithlonger relative distress, 30.9%wererecentlydiagnosed, and20.2%initiated ART with Results: age, sex, education, areaofresidence, status. andrelationship CD4cellcount(100cells/μl)onpsychologicaldistress,low controllingfor of recentdiagnosis,regression modeledtheassociation withandwithout asrecentlydiagnosed.90 dayswerecategorized logistic Multivariate distress. inthepast IndividualswhoreceivedtheirfirstHIVdiagnosis Scale (K10). Scores Psychological distresswasassessedwithKesslerDistress ART sixHIVclinics between2012and2013at inOromia, Ethiopia. Methods: CD4+ cellcountonpsychologicaldistress. initiation, andlow andexaminesthe jointeffectsofrecentHIVdiagnosis prevalence ofsignificantpsychologicaldistressamongPLWHat ART distress amongthoserecentlydiagnosed. This analysisdescribesthe mayintensifypsychological diagnosis and advancedHIVdiseaseat Background: 2 1 Olga Tymejczyk Sarah GorrellKulkarni Denis Nash Columbia University, New York, NY, USA City UniversityofNew York SchoolofPublicHealth, New York, NY, USA Among respondents, 29.5%reportedsignificantpsychological The sampleincludes 1177PLWH 18orolderinitiating aged 1 , Elul Batya Significantpsychologicaldistresswashighlyprevalent, HIV diagnosis maybeasourceofpsychologicaldistress,HIV diagnosis 1 HIV DiagnosisinOromia, Ethiopia Psychological DistressandRecent , Angela Parcesepe (presenting) 1.5[1.1, 2.0]). ≥ 29 were categorized assignificantpsychological 29 werecategorized 1 , Tsigereda Gadisa , Tsigereda 2 , ZenebeMelaku 2 2 , SusieHoffman , RobertRemien 2 2 2 ,

11th International Conference on 11th International - - 126 ate a statewide OOClistforclients astatewide ate whohadevidenceofcarethrougha HIVsurveillance,which incorporates togener careandpreventiondata Methodology: of OOCclients andimprovehealthoutcomesamongPLWH in Virginia. efforts andreengagement linkage who areoutofcare(OOC)tofacilitate toidentifyclients data Care (DtC)ProjectwhichutilizesHIVsurveillance comes. The to Virginia DepartmentofHealth(VDH)developedthe Data riskforadversehealthout agreater fromHIVmedicalcarehave gaged Background: Virginia DepartmentofHealth, Richmond, VA, USA Celestine Buyu, SusanCarr, KimberlyScott, Browder, Mary Anne Rhodes Amanda Saia, HIV: TheVirginia DatatoCareProject Re-Engagement amongPersons LivingWith outcomes forallPLWH alongtheHIVcarecontinuum. effortsforOOCclients, andreengagement linkage thus improvinghealth DtC implementation. Overall, implementingDtCprogramsstrengthen supportin jurisdiction orstatewide in programplanningcanfacilitate inHIVcare.reengagement Further, communitystakeholders engaging and clients forsuccessfullinkage resourcesstatewide andemploying ofOOC toimproveidentification data routinely assessingHIVsurveillance Conclusion: incareasaresultofDtCefforts. reengaged deceased, and1%wereincarcerated. Ofthoseclients notincare, two state, 15%wereunabletobelocated, 5%werenotincare, 4%were Of the117clients investigated, 54%wereincare, outof 21%relocated numbersofPLWH lower tion demonstrate whoweretruly “out ofcare.” Results OOCclientstions tore-engage backintoHIVmedical care. health departments, medicalfacilitiesandcommunity-basedorganiza 2014 orCY2015. local personnelat liststolinkage VDH disseminated prescription incalendaryear(CY)2013butnoevidenceofcareCY CD4 orviralloadlabtest, HIVmedicalcarevisitorantiretroviraltherapy : resultsfromtheproject’s Preliminary firstyearofimplementa Programs implementing DtC initiatives shouldconsider Programs implementingDtCinitiatives Persons livingwithHIVdisease(PLWH) whoaredisen Lauren Yerkes (presenting) The DtCprojectutilizestheCareMarkersDatabase, to Facilitate Linkageand Data Utilizing HIVSurveillance HIV Treatment andPreventionAdherence , Fatima Elamin,

- - - - - 129 11th International Conference on 11th International arerecommended. interventions treatment to offeron-goingsupportforCHWsimplementingHIVpreventionand isneeded.support tooptimizeimplementation Bestpracticestrategies through workshoptrainings;however, ongoingsupervision, training and Conclusions: community trust. on usingthephoneapplication, with clients, buildingrapport andgaining use theapplication. aneedfor additionalguidance CHWsdemonstrated proficiency.or greater wasstoppedduetoinability 1CHWevaluation meanscoreoutof5),Empathy: beginning 3.67(eachcategory indicating 3.67; Collaboration: 3.44; Autonomy/Support: 4.22;Direction: 3.56; sub-optimal performance. The MITIresultsof9CHWswere: Evocation: clients/CHW, range48-185)over4months. 2CHWswerereplacedfor the CHWssuccessfullycounseledatotalof892residents(mean89.2 useandcounselingapproaches.on application Following training, Depending onCHWcompetence, trainingswereconducted 2-4follow-up 5-day trainingonMI-informedcounselinganduseofthemHealthtool. community residentsselectedbyleaders, ina participated of ~4400;theHIVseroprevalenceis~36%. 10CHWs, whowere Results: assess CHWcompetency. Interviewinga modifiedMotivational Integrity(MITI)scaleto Treatment field-based activities. wasperformedusing Apost-trainingevaluation sessions wasdevelopedandimplementedthroughresidential designedtoexpediteandstructurecounseling smartphone application training program. MIconceptsandamHealth A curriculumincorporating tooutlinea Motivation, Skills(sIMB)-basedintervention andBehavior Methods: promote uptakeandadherencetoHIVservices. (MI)concepts and mHealthto interviewing motivational incorporated acommunityhealthworker(CHW)trainingprogram which evaluated hotspots. As partofacluster-randomized trial, weimplementedand andpreventionuptakeadherenceinHIV increase HIVtreatment Background: 2 1 Amanda Long(presenting) Eva Bugos Fred Nalugoda Chang Larry Hotspot UgandanFishingCommunity HIV Treatment andPreventioninanHIV Supported CHWTraining ProgramtoPromote University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA Johns HopkinsUniversity, Baltimore, MD, USA communityhasanadolescent/adultpopulation The study Information, teamusedasituated A multidisciplinary 1 , AlvinThomas 1 , GertrudeNakigozi CHWsweresuccessfullytrainedtobeginnerproficiency Intensive, yeteconomicalapproaches, areneededto 1 , K. Rivet Amico Interviewing-Informed, mHealth- Evaluation ofaMotivational 1 , IsmailMbabali 1

2 , JeremiahMulamba 1 , Maria Wawer, HIV Treatment andPreventionAdherence 1

, HeidiHutton 1 , RonaldGray 1 ,

1 ,

131 prison healthcare, particularlymissedHIVappointments. HIV care prisonsystem;weover-sampledstate in self-reporting a gap inmates acentralinfectiousdiseases(ID)prisonclinicreceiving HIVcareat ina Methods: but thesearenotwell-characterized. the community;nevertheless, likelyfaceuniquebarrierstocare, inmates adherencethanwhenin achieve betterretentionincareandmedication Background: Hill,Chapel NC, USA HillSchoolofMedicine, Chapel University ofNorthCarolinaat Steven Bradley-Bull, CarolGolin, Becky White, David Wohl David Rosen(presenting) Southern PrisonSystem with appointment attendance inprison. attendance with appointment and reducingthediscomfortconcernsaboutconfidentialityinvolved aboutappointments withinmates methods ofimprovingcommunication regardingHIVprovidersorcare.attitudes Futureresearchshouldexplore thanparticipants’ ular totheprisonenvironmentandprocessesrather Conclusion: the fortheirhealthneedsat to advocate “home” facilities. in their “home” prisonfacilitiesandoccasionallyrelyingonIDclinic staff staff providingHIVcare, care butseveralmentioneddifficultynavigating knowledge. Participants generallyexpressedpositiveregardfor IDclinic ments, missedwithout their theymayhave butseveralacknowledged load isundetectable. hisviral fromrecentlabworkthat little benefitiftheparticipantknows (e.g., 4am)forclinic visits, confer appointments andperceivingthat shackling, transportation, waiting), confidentiality,awoken early being becauseofdiscomfortandinconvenience(e.g., appointments attend ofexisting.were notaware they theyhadmissedanappointment were informedafterthefactthat inprison,appointment 7missedduetofactorsbeyondtheircontrol. Six years (range0.2-33). Of26participantswhoreportedmissinganHIV 46years(range21-58),median age 6 andmediantimeincarcerated Results: Participants were79% African American and10%Caucasian, ≥ with39maleinmates We interviews conductedqualitative 6 months. We askedparticipantstodescribeexperienceswith Reasons for missing HIV appointments werehighlypartic Reasons formissingHIVappointments Individuals receivingHIVcareinprisonarethoughtto Appointments amongInmatesina Reasons forMissedHIVCare Thirteen participantsreportedmissingnoappoint , Grodensky, Catherine Anna Miller, The majority(n=19)reportedrefusingto

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POSTER ABSTRACTS 132 selection effectsamongwomenreceivingfoodassistance. duetounmeasurable are neededtofurtherunderstandassociations physicalhealthscores. intakeand lower of dietary fected women, withpoorerquality whilefoodassistance wasassociated mental health, antiretroviraladherence, intakeamongHIV-in anddietary Conclusions: physical healthscores. intake. beverages government foodassistancehadhighersugarandsweet government foodassistancehadhigherdessertintake. Women receiving er depressivesymptoms. withpoorerphysicalandmentalhealthhigh significantly associated did otherwomen. food securityhadhigherintakeofprotein, fruits, and vegetablesthan poorer antiretroviraladherencethandidotherwomen. foodsecurityhadhigherfat, low dessert,with very andmilkintake food securityandassistance, suggestingnobuffering. Results: offoodsecurity.outcomes dependedonthecategory buffering, offoodassistancewith weexaminedwhethertheassociation maximumlikelihoodregressioninStata. using fullinformation outcomes, andclinical controllingforsociodemographic confounders al, low, with andfoodassistancetogetherwereassociated low) andvery teragency HIVStudy. Methods: with foodinsecurityandassistanceinHIV-positive women. intake, ofdietary patterns antiretroviraladherence, andhealthoutcomes impact offoodassistanceonpeoplelivingwithHIV. of foodinsecurityinthegeneralpopulation, aboutthe butlessisknown HIV. Background: 7 6 5 4 3 2 1 Sheri Weiser Kartika Palar (presenting) Mardge Cohen Phyllis Tien Outcomes inHIV-Infected Women Intake, Adherence, Antiretroviral andHealth University ofSouthCarolina, Columbia, SC, USA UniversityofNew State York, Brooklyn, NY, USA UniversityMedicalCenter,Georgetown Washington, DC, USA Rush University, Chicago, IL, USA Albert EinsteinCollegeofMedicine, Bronx, NY, USA Johns HopkinsUniversity, Baltimore, MD, USA University ofCalifornia, SanFrancisco, CA, USA Food assistanceisusedtoalleviate, compensate, orbuffereffects Women receivingnon-governmentfoodassistancehadlower No statistically significantinteractionswerefoundbetween No statistically We from1,251womenenrolledinthe useddata Women’s In 1 , MargotKushel 1 Food withworsephysicaland insecuritywasassociated Food insecurityhasmultipleeffectsonpeoplelivingwith 4 , DanielMerenstein and Food Assistance with Dietary and FoodAssistancewithDietary Association ofFoodInsecurity Lower food security across the four categories was foodsecurityacrossthefourcategories Lower We foodsecurity(i.e., examinedhow high, margin

Women receivingbothnon-governmentand 1 1 , Eryka WentzEryka , , JessicaEscobar 5 , Tracey Wilson 2 , AdebolaAdedimeji 7 , EdwardFrongillo Longitudinalstudies 6 , We examinedthe

Women withhigh Women To testfor 3 ,

7 , 11th International Conference on 11th International

- - - - 134 Methods: comparedtootherracial/ethnicgroups. pain management theseindividualsmayexperiencedisparitiesin research suggeststhat among and management African-Americans PLHIVwhoinjectdrugs, chronic conditions. While thereisadearthofstudiesonpainassessment oftheirpainand andfurtherexacerbation less healthcareengagement chronic pain, whichworsensotherchronicconditions, andresultsin Background: 2 1 Mitchell(presenting) Mary Sarina Isenberg with HIV/AIDS Primarily African-AmericanPersons Living health outcomesamongvulnerablePLHIV. andother withchronicpainanditsroleinmanagement patients in relationship tothepatient-provider suggest theneedforattention careandhealthoutcomes. forqualityofHIVpatient implications Findings inthispopulation, engagement patient-physician whichhaspotential Conclusions: HAART adherence, withviralsuppression. whichwasassociated visits andsex. with inturnwasassociated Patient-provider engagement withbetterengagement,was associated care controllingforprimary engagement, withpoorpatient-provider associated whilesubstanceuse Results: whichpromotetheuseofhealthcareservices. relationships engagement, ofpatient-provider correlates definedaspatient-provider symptoms, substanceuse, carevisitsas andnumberofHIVprimary betweenexperiencingchronicpain,examined relationships depressive African American. modeling, Usingstructuralequation thecurrentstudy whowerecurrentorformerinjectiondrugusersandprimarily Maryland ments andHIVmedicaladherenceamongPLHIVresidinginBaltimore, (Being Active and Alive) (N=383), whichexamined socialenviron Brigham and Women’s Hospital, Boston, MA, USA Johns HopkinsUniversity, Baltimore, MD, USA Chronic painanddepressivesymptomsweresignificantly The present study used baseline data from the BEACON study fromtheBEACONstudy usedbaselinedata The presentstudy Resultssuggesttheroleofchronicpaininpoor Persons riskfor withHIV(PLHIV)whoinjectdrugsareat 1 Engagement inDrug-Using, Chronic Pain andPatient-Provider , Allysha Maragh-Bass , Allysha HIV Treatment andPreventionAdherence 1 2 , TrangNguyen 1 , Amy Knowlton , Amy

- 1 , 138 11th International Conference on 11th International outcomes, including mentalhealth. in alargeurbanhospital. isneededtoassessmorehealth Moredata care optionandispossibletoimplement women isanimportantprenatal been identified. Inaddition, of theCPmodelforHIV-positive adaptation improved healthtrendsamongHIV-positive pregnantwomeninCPhave withinoneyearofimplementation, that needed, shows data preliminary incareandimprovehealthoutcomes.gagement is Although moredata Conclusions: 50-1,000copies/mL(14%vs21%).at delivery,non-detectable viralloadsat weredetectable fewerCPpatients had While asimilarproportion(71%)ofCPandindividualcarepatients those inCP, 0%deliveredbetween32-36weeks(vs8%individualcare). (17%vs. rates no-show women inCPhadlower 21%). Also, among thesamehospital,HIV-seropositive careat womeninindividualprenatal infected and1unknown. Certaintrendswereidentified;comparedto was mostlyheterosexualintercourse(n=10), fourwereperinatally wasmostly13-24weeks(n=8). entry GA at Modeoftransmission half hadan (n=7).AIDS diagnosis povertylevel. 70%metorfellbelow African American, 4Hispanic-American, 4Caribbean-American); Almost Results: adherence,(medication disclosure). the CPsessionswerepreserved, HIV-specific topicswereincorporated oftengroups.an average Although mostofthecorecomponents (GA)metingroupsofsixtoeightfor Women age ofsimilargestational by certifiednurse-midwives/ARNPswhoweretrainedintheCPmodel. Florida, HIV-seropositive serving pregnantwomen. Carewasprovided Methodology: an efforttoimprovehealthoutcomes. ment throughhealthassessment, self-management, andpeersupport, in engage emphasizespatient carethat based modelofgroupprenatal Background: University ofMiamiMillerSchoolMedicine, Miami, FL, USA Lindsay Smith, Jaramillo, Sindy MarisaEchenique, JoNellPotter Olga Villar-Loubet (presenting) HIV-Seropositive Women Fifteen inthefirstyearofprogram(7 womenparticipated The mainprioritiesofthisprogramweretoincreaseen CenteringPregnancy (CP)isapatient-centered, evidence CP was introduced at alarge, CPwasintroducedat urbanhospitalinMiami, Group PrenatalCareProgramfor Implementing andAdaptinga , LunthitaDuthely, NellyDiaz-Mendez,

HIV Treatment andPreventionAdherence - - 139 selors (SBCs), North Carolina state employees who locate and attempt to selors (SBCs), andattempt wholocate employees NorthCarolinastate PLWHperspectives ofrecentlyre-engaged BridgeCoun andtheState ofPLWHmotivation inHIVcare. tore-engage exploresthe This study toaddressbarriersandenhancethe present apromisingapproach facenumerousbarrierstocareengagement. States Background: 3 2 1 Anna Finestone LeViere Heather E. Parnell (presenting) in HIVCareRe-EngagementNorthCarolina enhancing carere-engagement. viewpoints gobeyondthebarriersofclients andaddress thecoreof programsforPLWH.the developmentofeffectivenavigation These mayinform impactHIVcarere-engagement describing factorsthat and theircarenavigators. ofbothperspectives The uniquecombination Conclusions: thus contributingtoclients’ toreturncare. motivation andreferrals,such astransportation andincreasingclient self-efficacy, describing theirroleasbuildingrapport, providinginstrumentalsupport, in care.instrumental intheirre-engagement SBCsechoedclient barriers, though participantsrepresenteddiversebackgrounds, allfeltSBCswere healthcare systems;andmentalhealth/substanceusechallenges. Al stigma;difficultiesnavigating social support;unstabletransportation; oftenhinderedtheircareengagement, that situations including: limited them.were unabletore-engage Participants describedchallenginglife Results: emergent themes. wererecorded,Interviews transcribedverbatim, andcodedinNVivo for clients focusedontheirroleinmotivating toreturncare.interviews riences, reasonsforbeingout-of-care, andexperienceswithSBCs. SBC guide.interview questionsincluded Clientinterview HIVhealthcareexpe them, in-person, wereindividuallyinterviewed utilizingasemi-structured andthe9SBCswhoserved services who hadreceivedre-engagement clients incare. During2014-2015, asampleof11lost-to-carePLWH impactPLWH’sthat andtheSBCroleofre-engaging careengagement Methods: lost-to-carePLWHre-engage inHIVcare. and HumanServices, Raleigh, NC, USA Communicable DiseaseBranch, NorthCarolinaDepartmentofHealth Hill, Chapel Carolina at NC, USA Institute forGlobalHealthandInfectiousDiseases, UniversityofNorth Institute, DukeUniversity, Durham, NC, USA Center forHealthPolicy andInequalitiesResearch, DukeGlobalHealth PLWH werereferredtoSBCsafterlocalclinics inthisstudy assessesthepsychosocialcontexts study This qualitative providesinsightintotheexperiencesofPLWHThis study Persons livingwithHIV(PLWH) inthesoutheasternUnited Patient andNavigatorPerspectives Beyond theBarriers:Exploring 2 , ConstanceJones 1 , MiriamB. Berger 3 , EvelynByrdQuinlivan Care navigators Carenavigators 1 ,

2 - - - POSTER ABSTRACTS 83 84

POSTER ABSTRACTS 143 my in relation totreatment. my inrelation the transitiontoadultclinic autono wherethereisaneedforgreater can assistin that willhelpsusthinkofstrategies these representations emotionally reflectsontheirlivingwithHIV/ AIDS. Awarenessabout Conclusion: adherence totheclinical andantiretroviral treatment. appointments amongHIVinfectedadolescentsandimprove number ofhospitalization to treatment. Working withthisdifficultymightbeusefultodecreasein contributes todecreasetheiradherence accept theirHIVconditionthat Results: infection. itremindthemoftheirHIV tothefact that in theadherencewasrelated had theopportunitytodiscussthenwiththeircolleagues. The difficult difficulties werediscussed withinthegroup, wheretheadolescents school.antiretrovirals duringregularactivitiessuchasworkorat Both andmaintenanceoftheschedule themedications culty toswallow the researchproject. in A totalof35HIV-vertically toparticipate infectedadolescentsagreed tion, abetterenvironmentforfuturetransitiontoadultcare. andcreate The objectivesweretodecreasemorbidityandmortalityofthispopula appointments. and moreabouttheirdifficultieswithmedication know ments. withtheadolescentsto usedanopeninterview The approach and/orclinicfactors involvedinlackofadherencetotreatment appoint Methodology: the feelingsandneedsofadolescentpopulation. takingintoaccount assistance aimedtoimproveadherencetreatment sionals. healthteamisproviding The challengeforthemultidisciplinary subjective issuesinvolvingadolescents, theirfamiliesandhealthprofes Background: 3 2 1 John Lambert Renata Neves(presenting) Elizabeth Machado Can We MakeitBetter? University CollegeDublin, Ireland The RelevanceNetwork, Johannesburg, South Africa Federal UniversityofRiodeJaneiro, Brazil We identifiedadifficulty, have byHIV-infected adolescents, to We believe that the way these teens relate sociallyand We thewaytheseteensrelate believethat 3 The adherence to treatment isaprocesswithseveral The adherencetotreatment We developedaresearch projecttoidentifypossible , IraínaFarias Adolescents intoAdultCare:How Transition ofHIV-Positive 1 , MariadeFatima Garcia The mostfrequentfactorsreportedwerethediffi 1 1 , CarlaGouveia 1 1 , , CraigCarty

2 ,

11th International Conference on 11th International - - - - - 144 focus oftheKaiserPermanente’s Community-basedHIV Test and Treat models, (CBO), positionedwithincommunity-basedorganizations arethe sive tosocial-andenvironmentalconditionsdrivingHIVdisparities. Such care continuumoutcomes, arerespon callingforHIVcaremodelsthat Background: 3 2 1 Lianne Urada Pamela Schwartz Anita Raj Intervention and CapacityNeedsforCommunity-Based Populations: ADiscussionofInfrastructure test and treat effortsarediscussed. test andtreat life-stabilizing resources. Ways tomaximize future CBO-deliveredHIV systems ofHIVcare, andsupport clients’ access to needforimmediate sample inagiventimeframe, staffin intervention successfullyintegrate cally, andwasclearly reflectedina CBOs abilitytoreachalargertarget Conclusion: supportfromotherinternalprogramswasnecessary.ability toleverage werestrained; interventions ofengagement-support tion andevaluation port (healthliteracy, HIVmorbidity). Resourcesforprogramimplementa clients’ requiresubstantialsup abilitiestosustainlong-termtreatment agencies. accesstoHIVcare, CBOswereabletofacilitate butrecognized ing programsweremorebeneficialthanreferralsfromoutsidetesting (MSM), populations ofundiagnosed demographics thoughin-housetest struggled intheirabsence. HIVtestingchallengesreflectashiftinthe up.follow staffbenefitedfromfunded Intervention clinic affiliations, and ofclient engagement facilitated enrollmentand outreach capacities and services access towrap-around communities; moreimmediate Results: CBO-delivered support. cess revealedseveralkeylearningsregardingthefeasibilityandreachof Organizations. Formal third-party discussionswithCBOsaboutthispro tomoretraditionalstand-alonequalified healthservices AIDSService care continuumoutcomes. CBOsrangedfromwell-resourcedfederally novel programmingtoimproveHIV selected toimplementandevaluate were (suburban-Mid-Atlantic/rural-Southeast)] come AfricanAmericans incarcerated, Persons whoinjectdrugs(metropolitanareas), andlow-in MSM,US [Black/Latino Transgender women, Women ofcolor, recently Methodology: Initiative. Kaiser Permanente, Oakland, CA, USA University of Maryland, Schoolof Public Health, College Park, MD, USA University ofCaliforniaSanDiego, CA, USA 1 CBOs wereabletoreachHIV-positive personsintheirtarget , BradelyBoekeloo Diversityinaccesstointernalresourcesvarieddramati 1 , The National HIV/ADS Strategy prioritizesimprovingHIV HIV/ADSStrategy The National Laramie Smith(presenting) Seven CBOs serving priority populations acrossthe prioritypopulations SevenCBOsserving Utilization OpportunitiesforPriority Building HIVTesting andCare 3 , Sankari Ayyaluru , HIV Treatment andPreventionAdherence 2 , JohnEdmiston 1 , Daniel Triplett, 1 3 , Alexandra Caraballo , Alexandra 1 , Jennifer Yore, 1 3 , , ------145 11th International Conference on 11th International OOClists. last viralloadinupdated bestpracticesandinclusionre-training facilitiesonre-engagement of as retentionbenchmarkshadbeenmet. Futureeffortsneedtofocuson effortswereunnecessary furtherre-engagement the perceptionthat OOC patients. from clinicThe removalofpatients listslikelyresultedin of effortsby42%butdidnotimprovere-engagement re-engagement Conclusions: during follow-up. insurance(HR,0.12;95%CI:0.02-0.86)werelesslikely tore-engage vate re-engage. Persons aboveFLP(HR, 0.69;95%CI:0.51-0.95)andwithpri diagnosed persons whowerevirallysuppressed(HR, 1.79;95%CI:1.41-2.27)and within6months. re-engaged vention patients Inmultivariable analysis, evidence ofcare. Ofthe691OOC, 50.5%ofcontroland43.4%inter clinic listswereexcluded duetodeath, imprisonment, outmigration, or arms wereonclinic toeHARS. listsandwerematched 42%onthe Results: suppression, arm. andstudy since diagnosis, age, insurancestatus, povertylevel(FPL), priorviral Variables included race/ethnicity, riskfactor, sex, status, diagnosis years andtimetore-engagement.to determinepredictorsofre-engagement control group. andmultivariableCoxmodelswereconducted Univariate wereusedasthe Clinic listsforthe4monthspriortoimplementation OOClistswerereturnedtotheclinicsUpdated efforts. forre-engagement excluded duetodeath, imprisonment, outmigration, orevidenceofcare. were to theEnhancedHIV/AIDSReportingSystem(eHARS)andpatients list), definedasnocarevisitinthelast6months. Lists werecompared gram whichbeganin2014. Monthly, clinics anOOClist(clinic generate Methods: isneeded. out-of-care(OOC)patients re-engaging efforts. for data oftheeffectivenessusingsurveillance Evaluation Background: 2 1 Tanner Nassau(presenting) Amanda Du Ian Frank Data toCareModel Philadelphia DepartmentofPublicHealth, Philadelphia, PA, USA University ofPennsylvania, Philadelphia, PA, USA 708 individuals from the intervention and442fromthecontrol 708 individualsfromtheintervention 1 START CareisaPhiladelphiaclinic-based pro re-engagement , Baligh Yehia, ≥ 2 , Emily Anderson , 15 yearsago(HR, 1.66;95%CI:1.07-2.58)weremorelikelyto START requiring Caredecreasedthenumberofpatients

Treatment aspreventionisacornerstoneofHIV Findings fromSTART Care, aHybrid Data DrivenRe-Engagement: 1 , MelissaMiller 2 2 , Brady Kathleen HIV Treatment andPreventionAdherence 2 , JacquelineO’Duor 2 ,

1 ,

- - - 147 Methods: adherence betweenwomenandmen. internalized stigmainteractswithpsychosocialvariablestoimpact ART among PLWH. bywhich istoexaminethepathway The aimofthisstudy toaffectbothpsychosocialoutcomesand been observed ART adherence effect ofspecificstigmasubscalesonadherence. Similarly, genderhas ence amongpeoplelivingwithHIV(PLWH), aboutthe yetlittleisknown Background: 2 1 Robert Hogg Psychosocial Factors Adherence:Accountingfor Antiretroviral improvement inwomen’s ART adherence. amongwomen livingwithHIVwouldsupportthegreatest interventions en. ries offeringmodest improvementin among bothmenandwomen, withthereductionofdisclosure wor HIV differently. canreduce depression interventions Stigmaalleviating Conclusions: regression weight: -0.128). directeffectonadherenceamongmen(standardized a smallnegative nisms didnotaffectmen’s adherencedirectly;however, depressionhad ized regressionweights: 0.321and0.299, respectively). Stigmamecha personalized stigmahadmediumdirecteffectondepression(standard dardized regressionweight: -0.192), and self-image whereasnegative directeffectonwomen’sworries hadasmallnegative adherence(stan by whichpsychosocialvariablesaffectadherencegender. Disclosure questionnaire (84.5vs100.0;p<0.001). uniquepathways SEMshowed adherence thanmenintheone-yearperiodpriortocompletingLISA subscale stigmascores. Women median hadsignificantlylower ART andpsychosocialvariablesassessed,mographic including overalland degreeofadversitythanmeninregardstonearly allsocio-de greater Results: modeling (SEM). ART adherence, bysex, stratified wereexploredwithstructuralequation attitudes), takingself-efficacy medication expectation, depression, and (internalized stigma, disclosure worries, personalizedstigma, andpublic (LISA)study, services lary betweenstigmamechanisms therelationship Our findingssuggest, however, prioritizing poverty-reduction that Simon Fraser University, Burnaby, BC, Canada Vancouver, BC, Canada British ColumbiaCentreforExcellenceinHIV/AIDS, Among 763individuals(26.5%women), womenexperienceda Using the Longitudinal Investigation into Supportiveand UsingtheLongitudinalInvestigation Ancil 1 , CariMiller Psychosocialfactorsaffectmenandwomenlivingwith Stigma is a barrier to antiretroviral therapy (ART) Stigmaisabarriertoantiretroviraltherapy adher of GenderedDifferencesin Structural EquationModeling 2 , Angela Kaida , Angela ART adherenceamongwom 2 , Puskas Cathy

2 ------POSTER ABSTRACTS 85 86

POSTER ABSTRACTS 152 may beaneffectivepreventionmethodtoimproveHIVtestinginMSM. componentofPrEPtreatment.which isamandatory PromotionofPrEP PrEP wecanhopetoseeanincreaseincorrespondingtestingforHIV, sistent withCDCguidelines. Conclusions: HIV testcomparedtothosewhohadnot. hadarecent PrEP(AOR:2.56;95%CI:1.81-3.63) weremorelikely tohave care visit(AOR:1.80;95%CI:1.27-2.56)andthosewhohadheardof 18-24.recent HIVtestcomparedtothoseage Those witharecenthealth age 2011 (74.4%vs65.5%). individuals Multivariableanalysisdemonstrated a recentHIVtest, andmoreindividualsin2014weretestedcomparedto Results: recent HIVtest. a analyses wereconductedtodeterminetrendsandpredictorsofhaving those withandwithoutarecentHIVtest. andmultivariable Univariate significant differencesbetweenthe2011and2014 cycles andbetween ofPrEP.and knowledge Chi-squaretestswereperformedtodetermine lastsex,drugs at numberofunprotectedanalsexpartners/12months, visit, outness, numberofpartners/12months, lastpartnertype, alcohol/ past 12months. variablesinclude: Non-demographic recenthealthcare arecent HIVtestdefinedasainthe outcome ofinterestwashaving amongMSMinPhiladelphia. (NHBS)surveys Surveillance Behavioral The Methods: annual HIVtestingamongMSMinPhiladelphia. leastannuallyforHIV.at We soughttodeterminetrendsandpredictorsof allsexuallyactiveMSM shouldbescreened The CDCrecommendsthat includingservices fortheprovisionofpre-exposureprophylaxis(PrEP). Background: 2 1 Tanner Nassau(presenting) Jennifer Shinefeld University ofPennsylvania, Philadelphia, PA, USA Philadelphia DepartmentofPublicHealth, Philadelphia, PA, USA ≥ 45 were 0.43(95%CI:0.27-0.68) times as likely to have hada 45 were0.43(95%CI:0.27-0.68)timesaslikelytohave 1,043 HIV-negative MSMwereincluded inanalysis. 70.2%had Data were used from the 2011 and 2014 National HIV wereusedfromthe2011and2014National Data Nearly a third of MSM did not have a recentHIVtestcon Nearly athirdofMSMdidnothave HIV testingisacriticalcomponentofprevention

HIV Testing amongMSM Tackling theFirst90:Increasing 1 , Brady Kathleen ofandseek As moreMSMbecomeaware 1 1 , Frasca Katherine 2 ,

11th International Conference on 11th International - 153 for patients at anurbanHIVclinic at for patients inRhodeIsland. incare program toimproveHIVvirologicsuppressionandreducegaps our systemtoevaluate management data development ofanintegrated impactisnecessary.practices toassessprogrammatic We describeour HIV care. Inadditiontooutreachandcarecoordination, of evaluation with tosupportconsistentengagement approach a multidisciplinary Background: University,Brown Providence, RI, USA Aadia Rana(presenting) Erna Kojic, Fizza Gillani, JosephGarland, DanielZariczny, Adherence HIVTreatmentApproach toImproving System toEvaluate aPractice-Based and betime-efficientforbusy clinical staff. different rolestomaketheinterfaceuser-friendly, relevantdata, capture existing clinical systems. data Itisimportanttoinvolvediversestaffin the HIVcarecontinuum. thesemethodsinto It ispossibletointegrate toimpact adherencearenecessary toimproveHIVtreatment strategies Conclusion: modifications. entry methods wereminimalandlimitedtominordata the ICAREteam. collection todata Post-implementation modifications within theclinic. Onceactive, onlyonetrainingsessionwasrequiredfor responsibilities additionalcaredelivery ICARE teammemberswhohave totheICDB,direct linkage burdento and4)minimaldocumentation of pertinentsocio-clinical toretention, related data 2)easeofuse, 3) ICARE team. softwareare:The goalsoftheICAREdatabase 1)collection mation Technology, administrator, theICBDdata andmembersofthe structures andrequiredinfrastructuresupportfrominstitutionalInfor Results reports onretentionoutcomesforreviewandqualityimprovement. ongoingoutreachefforts,follow quarterlycomprehensive andgenerate actionstakenbytheteamtoaddressbarriers,track allmulti-disciplinary team memberstoorganizeleadershipforoutreach, and coordinate 2016.training startinginJanuary theICARE allows The ICAREdatabase developed, trackingsystemwasimplementedwith theICAREpatient Center’sto theMiriamImmunology clinical (ICDB). database patient Once accessedviaMicrosoft database Access 2010user-interface andlinked 2015, theteamdevelopedICAREtrackingsystem: aSQLserver viral load(PVL>200copies/mL), andperformtargetedoutreach. In review, incare(>9months)ordetectableHIVplasma withgaps patients to identify,utilizes apractice-basedapproach throughquarterlydatabase psychologist, administrator, adata which andapeerhealthadvocate adherence nurses, casemanagers, socialworkers, asecretary, aclinical Center inProvidence, teamofphysicians, RIisamultidisciplinary and Retention(ICARE)Programat The MiriamHospitalImmunology Methodology: :

The ICARE database wasdevelopedusingpre-existingfunding The ICAREdatabase Cost-effective methods of tracking and evaluating Cost-effective methodsoftrackingandevaluating Impacting theHIVcarecontinuumrequiresimplementing The Ryan White-funded Immunology Center Adherence Immunology White-funded Ryan The Integrated DataManagement Development ofaClinic-Based HIV Treatment andPreventionAdherence

- 154 11th International Conference on 11th International tailor preventionchoices. personalityandlifestylemayhelpthemproviders best patients’ doctor, HIV/STIpreventionandcare. andwantintegrated fromtheir Patients careaboutreceivingdetailedbiologicalinformation Conclusions: (p=.07). private c) likingtokeephealthinformation tothinkabout,you neverhave (p<.01); b)likingtotakerisks, (p<.05)and withpreferringLAI-PrEPwere:associated a)likingapreventionmethod PSAs, orsocialmedia. level,At thepatient personalityfactorsmoststrongly tive methodfor “getting thewordout” aboutLAI-PrEP–aheadofpress, fromapersonaldoctorasthesinglemosteffec one-on-one information (49%),management (28%). orsubstancetreatment Participants ranked (62%). care(47%), Participants primary caredlessaboutco-located case in theeventofinfection(81%), experience anddoctorswithHIVtreatment (94%),from asettingwithon-siteSTItesting/treatment on-siteHIVcare At thesystems-level, participantscaredmostaboutreceivingLAI-PrEP (77%).(94%) andwhethershotswouldstopworkinginsidetheirbody “cons”; instead, participantswereconcernedaboutlong-termsideeffects fromhome(96%). away concernswerenothighlyrated Injection-related “pro” torememberbringpillswhensleeping oftheshotwasnothaving a q3-monthshotand62%preferredq2-monthshot. The highestrated Results: months. least12 23-62 years;56.6%white)whohadtakendailyoralPrEPforat tation. Participants inthisanalysisweregay/bisexualmen(N=53, mightimpactLAIimplemen factorsthat system,- andpatient-level Methods: acceptability anduptakeamongpotentialusers. efits, influence butitssuccesswilldependonunderstandingfactorsthat Background: 2 1 Atrina Brill Users Long-Acting InjectablePrEPamongOral Aaron Diamond AIDS ResearchCenter, New York, NY, USA Hunter College, CityUniversityofNew York, NY, USA Comparedtoadailypill, 77%ofcurrentPrEPuserspreferred 1 READY (R01MH106380)isdesignedtoidentifyproduct-, , Meyers Kathrine LAI-PrEP ishighlyacceptabletocurrentoralPrEPusers. Long-Acting Injectable (LAI) PrEP has many potentialben Long-Acting Injectable(LAI)PrEPhasmany Level Factors InfluenceInterestin Product-, System-, andPatient-

2 , Sarit Golub(presenting) HIV Treatment andPreventionAdherence 1 Understanding - -

- 157 liver fibrosis, HIVRNAlevels, antiretroviralregimens, andpastHCV Methods: withHCVDAAsintwolargeurbanHIVcareclinics. treated ed patients results fromacohortofHIV/HCV-coinfectcharacteristics andtreatment ofmostclinicmay notberepresentative populations. We reportpatient ofchronicHCVinfectionin HIV-coinfected (DAAs) fortreatment patients Background: 3 2 1 Joshua Bayer Sarah Rowan(presenting) Clinics Settings: ResultsfromTwo LargeHIVCare a real-worldsetting. highlevelsofsuccessin inHIV/HCV-coinfected shows treatment patients experienced. weretreatment disease andmany Conclusions: failure. treatment not yetbeenevaluated. with Drugandalcoholusewasnotassociated SVR12, have RNA testing)attained and 14patients relapsed 4patients (n =84), week 8. whowere12weeksormorepost-endoftreatment Ofpatients at week4were losttofollow-up withundetectableHCVRNAat patients wasdiscontinuedbecauseofagastrointestinal hemorrhage,1 patient 2 withotherregimens.patients (96.8%)completedtreatment; 91patients with sofosbuvir-ledipisvir, withsofosbuvir-ribavirin, 13patients and5 es; GT1b=21;1a/b=8;2=9;3=2;mixed=1. weretreated 76patients treatment-experienced. The genotypeswereasfollows: GT1a=53cas (21%)were (38.3%) hadadvancedfibrosis(F3-F4)and20patients Medicare, 7%commercialinsurance, and1%Medicaid. 36patients sources were66%throughthe AIDS Drug Assistance Program, 26% was52.6years. treatment at (16.0%)werefemale. 15patients Payer with HIV-HCV withHCVDAAs. coinfectionweretreated The medianage Results: sary. which were queriedandsupplementedwithchartreviewwhenneces courses inclinictively throughouttheirtreatment trackingdatabases werecollected. status treatment prospec Patients werefollowed University ofColoradoDenver, CO, USA University ofColoradoHospital, Aurora, CO, USA Denver PublicHealth, Denver, CO, USA Drug andalcoholusewastrackedduringtreatment. From 2014throughDecember2015, January 94 individuals 73 (95% of those who completed 12-week post-treatment HCV 73 (95%ofthosewhocompleted12-weekpost-treatment Baseline data regarding patient demographics, regardingpatient Baseline data HCVgenotype, 3

Participants inclinical trialsofdirect-actingantivirals A high proportion of patients inthiscohorthadadvanced A highproportionofpatients , Rogers Maya Individuals inReal-World Clinical Treatment ofHCVinHIV-Coinfected

1 2 , StevenJohnson , LisaSmith 1 , JacobLangness 2 , EdwardGardner This reviewofHCV

2 1 - ,

- - POSTER ABSTRACTS 87 88

POSTER ABSTRACTS 162 tion underway. alargeUSjail,HIV+ menleaving andmakekeytargetsfortheinterven needs, andsocialstigma--predictedcontinuumofcareoutcomesfor Conclusions: of VS (difference=-0.15;95%CI-0.30, 0.00;P=0.05. probability withlower 0.01); andhigherstigmascoreswereassociated 61% vs. (difference=0.21;95%CI0.34, 40%1SDbelow 0.74, p= probabilities of VS foraccesstocarescores1SDabovethemeanwere (difference =-0.17;95%CI-0.31, -0.04;P=0.008. Comparable (difference =-0.16;95%CI-0.29, -0.03;P=0.001), andstigma probabilityofretentionforcompetingneeds scores predictedlower (difference=0.28;95%CI0.14,SD below 0.41;P=0.0001). Higher access tocarescores1SDabovethemeanwere74%and46%for had follow-up.VS at MSM ortransgender. Results: themean,tors 1SDaboveandbelow with95%CIsofthedifference. adjustedprobabilitiesofretentionand estimated VS forvaluesofpredic regressions of1. retentioninHIVcare, and2. VS witheachpredictor, we stigma (12items, alpha=0.77). logistic multivariate Usingseparate = 0.78), competingbasicneeds(5-items, alpha=0.80), andsocial VS (VL<200copies/mL). Predictorswereaccesstocare(6-items, alpha Outcomes were: least1visitsin3months), retentioninHIVcare(at and withviralload(VL)samples. baselineand3monthsfollow-up views at Methods incarceration. HIV careandviralsuppression(VS)forHIV+personsreleasedfrom Background University ofCaliforniaLos Angeles, CA, USA William Cunningham(presenting) Terry Nakazono, JasmineSmith, Jenna Arzinger, DanielleSeiden, Mediators atBaseline Released fromLargeUrbanJail:Potential Suppression amongHIV-Positive MenBeing RetentioninHIVCareandViralto Improve Mean age was39.6;blackswere42%, Meanage 31%;72%were Latinos : We recruited356HIV-positive jailinmates, conductedinter : isneededaboutpredictorsofretentionin Knowledge Potential accesstocare, mediators-- competing basic a Peer NavigationIntervention Randomized ControlledTrial of Nearlyhalf(46%)wereretainedincareand50% Adjusted probabilitiesofretentioninHIVcarefor 11th International Conference on 11th International

- - - 164 accessing and adhering to anti-retroviral therapy (ART).accessing andadheringtoanti-retroviraltherapy Moreinformation vention, behindothersin HIV+womenofcolorcontinuetolag low-income risk.of theirchildrenisalsoat andpre With theadvancesintreatment caregiversandsoleprovidersintheirhousehold,the primary thewellbeing health maynotonlyimpactindividualwomen, theyareoften butgiventhat HIV-infection useofhealthcareservices.rates andlower to The threats women. African American womenevidencethisongoingdisparitywithhigh from consequences incomparisonto AIDS related White andmoreaffluent treatments, compromisedhealthasaresultofHIV infections, have anddie morelikelytobecomeHIV-infected,ately failtoadhereHIVrelated Background: 2 1 Latoya Small(presenting) Income MothersLivingwithHIV enhance theirhealthcareutilization. to maybeapplied understanding ofvariousfactorswhereinterventions adherence. theirHIVtreatment mitigate that advancesour This study Conclusion: (p<.05). levelsofhealthcareutilization withlower associated efficacy adherence(p<.05),with lower treatment towards whichwas symptoms (p<.001)andthesedepressionwereassociated withincreaseddepression levelsofstresswereassociated greater Results: healthcare utilization. parenting stress, andadherenceefficacy hadonperceivedstressand depression,models) wereusedtoexaminetherolethat trauma, wasexamined.appointments models(i.e., Statistical structuralequation Methods: motherswithHIV.sample of134low-income betweenstressandhealthcare useamonga to examinetheassociation physical andemotionalhealth. isanalyzed fromanNIH-fundedstudy Data addresstheir that ofservices informingtheintegration is criticaltowards cascade, andidentifytheirspecificbarrierstoadherence. Thisinformation theHIVtreatment is neededaboutwhytheyfailtosuccessfullynavigate Columbia University, New York, NY, USA Hill, Chapel University ofNorthCarolinaat NC, USA Results suggest that theseconstructswererelated, Resultssuggestthat inthat betweenstressandmedical The complexrelationship Low-income HIV-positive complexbarriers Low-income mothershave IntheUS, women ofcoloraredisproportion low-income Color: AdherenceamongLow- Healthcare UseandWomen of HIV Treatment andPreventionAdherence 1 , ClaudeMellins 2 - - 167 11th International Conference on 11th International should befocused. interventions the analysishighlightsareaswherepreventionandlinkage testing. While neighborhoodwasnotasignificantpredictorofincidence, been successfulinidentifyingincidentHIVcasesthroughaccessible iscriticaltoreducinglong-termHIVinfections.incarcerated CTShave Conclusions: providers. byprivate likely tobeincidentthanthosediagnosed correctionalfacilities(95%CI:0.35-0.72)were50%less at diagnosed (CTS) were38%morelikelytobeincident(95%CI:1.01-1.90)andthose 95% CI:1.15-1.90)). acounselingandtestingsite at Those diagnosed CI:1.99-3.20), 25-34(OR, 1.35;95%CI:1.07-1.70), and35-45(OR, 1.48; those >45+(<18(OR, 3.12;95%CI:1.73-5.63), 18-24(OR, 2.52;95% groups<45+weremorelikelytobeincidentcasesthan Those inallage CI:0.36-0.65) werelesslikelytobeincidentcasescomparedwhites. blacks (OR, 0.58;95%CI:0.46-0.73)andHispanics(OR, 0.48;95% significant predictorsofincidence(p<0.05). Inthemultivariablemodel, type, andtheinteractionbetweenneighborhoodrace/ethnicitywere analyses,univariate year, diagnosis race, age, transmissionrisk, facility were recentand68.3%(n=1,891)long-terminfections. In Results: usingGISsoftware. byrace/ethnicityandmapped were stratified analyses. To identifyvariancesinincidencedensity, recentinfections andstepwisemultivariable inunivariate wereevaluated diagnosis at mission risk, year, diagnosis diagnosis, facilitytypeat andneighborhood for RecentHIVSeroconversion(STARHS). Sex, race/ethnicity, age, trans rized as ‘Recent’ or ‘Long-term’ basedontheSerologic Testing Algorithm identified fromtheEnhancedHIV/AIDSReportingSystemandcatego Methods: highestriskfornewHIVinfections.those at ties andthoselivinginpoverty. We toidentify analyzedincidencedata 2009 -2013. However, affectminori HIVcontinuestodisproportionately Background: Philadelphia DepartmentofPublicHealth, Philadelphia, PA, USA Brady Kathleen Melissa Miller(presenting) Prevention andLinkagetoCare Of 2,768newcaseswithSTARHS results, 31.7%(n=877) Cases for residents >13 diagnosed between2009-2013were Casesforresidents>13diagnosed Routine testingamongnon-whites, persons>45+, andthe Estimated HIVincidencedeclinedEstimated inPhiladelphiafrom Incidence DatatoTarget HIV Rethinking andRefocusingHIV , TannerEmily Anderson,Nassau, HIV Treatment andPreventionAdherence

- - - 171 7 6 5 4 3 2 1 Hugo Farías Luis EduardoPeña P.Kathryn Derose the DominicanRepublic Nutritional NeedsofPeople LivingwithHIVin physical and mentalhealthoutcomesamongPLHIV. statuses. Researchisneededtoidentifyeffectson ART adherenceand insecurity andnutritionalneedsamongPLHIVwithdiverse Conclusion: largercommunitygardenscouldfulfill. tion isalsoacriticalneedthat increased senseofpurpose, therapy. andoccupational Income-genera hasprovidedotherbenefitssuchasreducedsocialisolation,ticipation diversity, contributedtofoodsecurityanddietary gardens have andpar theprogram.PLHIV hasbeenessentialtomaintainingandgrowing The soil withnutrientsissometimesnecessary. Localleadershipamong enabledgardensinconstrainedsettings,changes have andenriching communities; containergardeningandconsideringseasonalweather Results: and aimstobecomeincome-generating. non-profit organization, landfromthe government, hasobtaineddonated to nearly100), asa andthiscommunitygroupisseekinglegalstatus increased; inonecommunity, quadrupled(from25 participantshave handbook. Overthelastyear, thenumberofprogramparticipantshas an urbangardensrecipe/nutrition and withparticipantinputcreated topreparegardenproductsforahealthydiet,provided trainingonhow ing homegardens. After firstharvest, World Food Programnutritionists group trainingsandhomevisitsforsupportindevelopingmaintain total) participated, of andMinistry conducted Agriculture agronomists developed apilotprogram. Initially, 25PLHIVfromthreecommunities (75 intake ofgreenleafyvegetables, andacceptabilityofurbangardens, we insecurity, substantiallevelsofoverweightandobesity, dietary low identifiedhighlevelsoffood PLHIV intheDominicanRepublic(DR)that Methodology: challenge. areneededtoaddressthispersistent and sustainableinterventions (ART)roviral therapy adherenceamongpeoplelivingwithHIV(PLHIV) Background: Dominican Republic de Servicio Atención IntegralLotesyServicios, SantoDomingo, Dominican Republic Grupo deHortelanosSana Alimentación Orgánica, Consuelo, and theCaribbean, Panama City, Panama United Nations World Food Program, RegionalOfficeforLatin America Consejo Nacionalde VIH/SIDA, SantoDomingo, DominicanRepublic of Ministry Agriculture, SantoDomingo, DominicanRepublic Office,(DR) Country SantoDomingo, DominicanRepublic United Nations World Food Program(UN-WFP), DominicanRepublic RAND Corporation, Santa Monica, CA, USA Space, soil quality and water availability vary acrosshomesand Space, vary availability soilqualityandwater 5 Urbangardensareasustainablewaytoaddressfood , JuanaZorilla Food insecurityandpoornutritionarebarrierstoanti-ret researchwith After conductingextensiveformative to AddressFoodInsecurityand A PilotUrbanGardensProject 3

, ElianaSilverio (presenting) 6 , María A. delaCruz 1 , María Fulcar Altagracia 2 , Ramón Acevedo , 7 4 ,

2 ,

- - - - POSTER ABSTRACTS 89 90

POSTER ABSTRACTS 179 disparities following HIVdiagnosis.disparities following did notfindevidencesuggesting TGWexperiencedHIV-related health neither seemssufficientbyitself. Comparedtoallcasescombined, we Conclusions: were 88%, 63%, and68%, respectively. evidence ofHIVcareengagement, retention, andviralloadsuppression method.using thealternative ofcaseswithlaboratory The percentages 61% weredetectedusingtheCDCalgorithm;91% tobelivingwithHIVasofyear-endappeared 2014. Among thesecases, were linkedtocarewithin90daysofHIVdiagnosis. Seventy-five TGW with diagnosed 19(90%) AIDS within12monthsofHIVdiagnosis; infection between2010and2014. Four (19%)ofthesewomenwere Results: and 2014, prevalenceasofyear-end andondiagnosed 2014. continuum specificto TGW, between2010 basedonnewHIVdiagnoses conflicting results. as potentially TGW, including thoseinwhichthetwomethodsproduced individualidentified We caserecordslinkedtoany manuallyre-evaluated birth equalsmaleandcurrentgenderfemaleormale-to-female. methodbased ontwocriteria:algorithm toanalternative sexassignedat 31, 2016. To identify TGW, wecomparedtheoutputofCDC’s transgender reported throughJanuary data surveillance HIVcaseandlaboratory ated Methods: andlivingwithHIVin TGW diagnosed WA. approach,alternative andtodevelopanHIVcontinuumofcarespecific Washington (WA) State touseandcompareCDC’s methodwithan withHIVinfection.(TGW) diagnosed This reportdescribeseffortsin programstoidentifytransgenderwomen andlocalHIVsurveillance state Background: Washington DepartmentofHealth, State Seattle, WA, USA Jason Carr and LivingwithHIVinWashington State We identified21 withHIV TGWwhowerenewlydiagnosed HIV surveillance staff at the staffat HIV surveillance WA DepartmentofHealthevalu Both methodsofidentifying tobeuseful,TGW appear but In late 2015,In late allowing CDCreleased anewmethodology Transgender Women Diagnosed An HIVCareContinuumfor findingstoproduceanHIVcare We usedaggregate 11th International Conference on 11th International - 182 of our behavioral science research platform ontrialconduction. scienceresearchplatform of ourbehavioral (b)reportonenduserperspectivesoftheimpact science interventions; multisitebehavioral describe designofweb-basedsoftwaretodeploy basedtools.ing toaccomplishwithtraditionalpaper We aimedto: (a) tion, security, andaccessarecriticalcomponents, storage andchalleng Background: 4 3 2 1 Tyffany EvansColeman Alex Jones(presenting) Riddhi Modi TrialsIntervention monitoring/improvement intrialimplementation. randomized trialsshouldbeaprioritytopromoteefficienciesandquality user-interface, informatics, inthecontextofmultisite and data-capture toenhanceoursoftware.led toimportantinsightsonhow Optimizing completionas thishas fromusersafterstudy data lection ofqualitative teamindevelopment.study Inaddition, werecommend post-hoccol ofearlyandcontinuousinvolvementthe approach validated platform Conclusion: tions andworklistlayoutwerejudgedleastuseful. as themostusefulfeatures. participantforms, Saving securityrestric use, inonelocation colorflags,data storage and longitudinalworkflow forfuturestudies.in developingadatabase easeof Usersacknowledged ofresearchteam roles/responsibilities andrecommendedparticipation designing/testingphasemadeiteasiertounderstand user database and reusability. collection,real-time data oflongitudinalworkflow, facilitation reporting Results: perspectives onsoftwarefeatures. adoptedfrom 25-item webqualitysurvey user Aladwani et.altoevaluate development. We keysoftwarefunctionalityusinga askeduserstorate insoftware teamtoparticipate intotheinformatics wasintegrated nator sites. tofourparticipating develop softwaretodeploy Center(RISC)teamto Service with theUABResearchandInformatics personswithskillstoenhanceretentionincare.diagnosed We worked and newlyHIV (iENGAGE)seekstoempower Adherence GoalsuponEntry Methods: University of Washington, Seattle, Washington, USA Hill, Chapel University ofNorthCarolinaat NC, USA University ofMichigan, Ann Arbor, Michigan, USA University of Birmingham,Alabama at Birmingham, Alabama, USA Key functionalitiesincluded enrollment, randomization, The NIAID-funded behavioral intervention trial ENGagement trialENGagement intervention The NIAID-fundedbehavioral 1 , MichaelMugavero The successful development of iEngage behavioral research behavioral The successfuldevelopmentofiEngage collec trials;data intervention With multisitebehavioral in participation We that found100%user agreement Platform forMultisiteBehavorial A Web-Based DataCollection 3 HIV Treatment andPreventionAdherence , LaurieSmith 1 , Anne Zinski , Anne 1 , KRivet Amico 4 , James Willig , 1 , SolangeMontue 2

, Alfredo Guzman , Alfredo 1 A researchcoordi 3 ,

1 ,

- - - - - 183 11th International Conference on 11th International other socialdeterminantsofhealthisneeded. timely diagnosis. tions ofHIVcasesandmoretestingopportunitiesmaypromote health region, areaswithhigherconcentra geographic suggestingthat inamoreruralhealthregionthan urban were diagnosed time. However, ifthey late personsweremorelikelytobediagnosed were morelikelytoberetainedincareandvirallysuppressedover Conclusions: virally suppressed(CI, 1.1-2.1). likely toberetainedincare(CI, 1.5-2.9)and1.5timesmorelikelytobe was maintainedin2015, were2.1 timesmore late aspersonsdiagnosed late.1.5- 2.8)thanpersonswhowerenotdiagnosed This relationship 1.3-2.6) and2.1timesmorelikelytobevirallysuppressedin2014(CI, were1.9timesmorelikelytoberetainedincare(CI, late diagnosed (OR)1.7,Ratio (CI), 95%confidenceinterval 1.0-2.9]. Persons whowere thanPLWH late be diagnosed intheEasternregionof Virginia [Odds Results: in 2013andhealthoutcomes20142015. diagnosis, late and late betweenpersonsdiagnosed andb)arelationship location characteristicsandgeographic tionship betweendemographic A seriesoflogisticregressionmodelsassessediftherewas: a)arela ginia in2013. Ofthose, diagnoses. 26%(N=244)wereidentifiedaslate Methods: population. diagnosis, late diagnosed andb)HIVcareoutcomesamongthelate assess: characteristicsand betweendemographic a)theassociation higher riskforreducedresponsetoHIVtreatment. aimsto This study defined asan withinoneyearofHIVdiagnosis, AIDSdiagnosis at are Background: Virginia DepartmentofHealth, Richmond, VA, USA Karen Diepstra, SahithiBoggavarapu, JenniferKienzle, Anne Rhodes Lauren Yerkes (presenting) Outcomes inVirginia PLWH intheNorthwestregionwere1.7timesmorelikelyto withHIVin A totalof946personswerenewlydiagnosed Vir Results suggest that persons who were diagnosed late late personswhowerediagnosed Results suggestthat Persons livingwithHIV(PLWH) late, whoarediagnosed Diagnosis ofHIVonHealth An ExplorationintoLate Continued analysis of late diagnosis by geography and bygeography diagnosis Continuedanalysisoflate , Gilmore, Kate Amanda Saia, SonamPatel, HIV Treatment andPreventionAdherence

- - - 184 between July-November 2015 until reaching thematic saturation.between July-November2015untilreachingthematic Inclu young MSM(N=17), recruitedthroughsocialmediaadvertisements Methods: providers’ (PCP)roleinthePrEPadoptionprocess. care toPrEPuseandbetter understand primary barriers andfacilitators toexplore study conducted aqualitative YMCSM’s perspectiveson ofnewHIVinfectionsintheUnitedStates.highest rates We therefore Background: 2 1 Santoro Anthony Viraj Patel (presenting) Men ofColorwhoHaveSex withMen Prophylaxis (PrEP):Perspectives fromYoung YMCSM into routine primary care. YMCSM intoroutineprimary andsupportforPrEPengage and shouldtargetPCPswitheducation toincreasePrEP adoptionin Interventions YMCSM areurgentlyneeded asimportant decision makingaboutPrEPandserve ‘gatekeepers.’ Conclusions: highriskcominginforroutineand/orsexual healthcare. individuals at and/orprovisionto to somemissedopportunitiesforPrEPeducation byPCPs. andknowledge of PrEPawareness These barrierscontributed tosexualactivityorreasonsforpotentialPrEPuse,related andb)lack barrier toaccessingPrEP, dueto: a)perceivedstigmafromproviders surance aboutPrEPuse. Second, asasignificant PCPsmayalsoserve andtrustwiththeirPCPexists,rapport and/orb)ifPCPsprovidesreas bya)suggestingPrEPuse,an importantfacilitator especiallyifastrong YMCSM. to PCPs. First, PrEPuseby PCPscanbehighlyinfluentialinfacilitating PrEP. Two overarchingthemesemergedfromouranalysispertaining ing aPCP, halftheparticipants(n=9)currentlyused andapproximately (n=15), language mary majorityhadMedicaid(n=13), allreported hav Results: method foranalysis. and theconstantcomparative and/or Latino, andfluentinEnglishorSpanish. We usedgroundedtheory self-report), livingorworkingintheBronx, New York, identifyingasBlack sion criteriaincluded being18-29yearsofage, (by status HIVnegative Hunter College, CityUniversityofNew York, NY, USA Albert EinsteinCollegeofMedicine, Bronx, New York, USA Specifically, as providersmayserve participantsreportedthat All participantsidentifiedasgay, reportedEnglishastheirpri We with conductedindividualsemi-structuredinterviews Young the sexwith(YMCSM)have menofcolorwhohave YMCSM indicate PCPscanbecriticalininfluencing YMCSM indicate HIV PreventionwithPre-Exposure Rolein CareProviders’ Primary 1 , SaritGolub 1 , JunaidChaudhry 2 , Julia Arnsten , 1 , Alison Karasz , Alison 1 1 ,

- - - - POSTER ABSTRACTS 91 92

POSTER ABSTRACTS 185 patients’ adherence.patients’ andneedforadherencecancontributesignificantly inHIV+ treatment Conclusion: p<0.05. predictive ofadherenceat anddrugadherenceweresignificantly ofdrugmanagement knowledge was96.64%±6.95%.study patients’ Inthetwelfthmonthofstudy pharmacyMean patients’ at theendof refillrecordofadherence were on12-hourlyregimenwhile33.90%24-hourlyregimen. counts was143.46±92.72cells/µL. At baseline66.10%ofthepatients was40.39±8.78yearsandmeanbaselineCD4cell Their meanage and208(56.40%)employed. schooleducation (42.70%) hadsecondary 134(54%)weremarried, that showed 148(59.70%)female, 106 Results: onadherence. model wasusedtodeterminetheeffectofknowledge package.lyzed usingSPSSversion15.0statistical Logisticregression wereana was used. completedthestudy that from248patients Data clinical weredone. data Pharmacy refillrecordmeasureofadherence on whomon-goingadherencecounselingandmonitoringofpatients’ objectiveswereadministeredto294eligiblepatients set tomeetstudy out fromDecember, 2006to December, 2010. Validated questionnaires Methods: the effectonadherence. ment. and knowledge assessedvariousaspectsofpatients’ This study adherencetotreat effectonpatients’ varying has beenfoundtohave Background: 2 1 Aba Sagoe Nigeria on AdherenceinaTreatment SiteinLagos, University ofLagos, Nigeria University State Lagos Teaching Hospital, Lagos, Nigeria Social and clinical demographic data analysis of study patients patients Socialandclinical analysisofstudy data demographic This was part of the longitudinal observational study carried study This waspartofthelongitudinalobservational 1 , Fola, Tayo Continuous patient education onHIV, education Continuous patient antiretroviral Patients’ knowledge about HIV and antiretroviral therapy aboutHIVandantiretroviraltherapy Patients’ knowledge HIV and Antiretroviral Therapy HIV andAntiretroviral Effect ofPatients’ Knowledgeof 2 , Roseline Aderemi-Williams(presenting) 11th International Conference on 11th International 2 - - 186 from the IMB Skills Model to explore and determine factors that affect from theIMBSkillsModeltoexploreanddeterminefactorsthat promote adherenceto ART. wastosample The objectiveofthisstudy skills.and behavioral This modelcanbeusedtounderstand, predictand determined bytheleveloftheirHIVpreventioninformation, motivation apatient’sSkills Model(IMB)positsthat is HIVpreventivebehavior (ART).of antiretroviraltherapy Behavioral Motivation The Information were fromtheCaribbean. adherenceiscriticaltotheefficacy Medication born personslivinginthiscountry. Almost 4millionofthesepersons 41,348,066foreign reportsanestimate American CommunitySurvey publichealthconcernintheareaofHIV/AIDS.to agrowing The 2013 Background: Nova SoutheasternUniversity, Fort Lauderdale, FL, USA Silvia Rabionet, Model Descent: AnApplicationoftheIMBSkills of HIV infected patients ofCaribbeandescent. of HIVinfectedpatients shouldfocusontheobjectiveabilityandself-efficacyfor thispopulation skillsandadherence. betweenbehavioral the relationship Interventions skills. andbehavioral information However, needstobepaid to attention Conclusion: predictorofCD4(P=.082). skillswasamoderate Adherence behavioral was 38.58(SD5.43). skillsscorewas57.34(SD7.62). Meanbehavioral of98%(SD11.21).adherence rate score Meanadherenceinformation Results: used todiscussvariablesandfindings. impactadherence.to determinefactorsthat Descriptiveanalyseswere outcomes –CD4andviralload. Regressionanalyseswereperformed adherence wasmeasuredby3dayself-reportrecallwithsecondary ofinstruments.questionnaire whichwasacompilation Medication bornofaCaribbeanislandnative. generation usedastudy Interviews experienced with ART, orthefirst andeitheraCaribbeanislandnative withHIV/AIDS, diagnosed in aconvenientsampleof115adultpatients Methods: adherence to ART ofCaribbeandescent. inpatients 94% of patients self-reportedadherentwithanoverall 94%ofpatients usingface-to-faceinterviews This wasacross-sectionalstudy This population hadoptimalself-reportedadherence,This population IncreasingethnicminoritieswithintheUShascontributed Akesha Edwards(presenting) Therapy inPatients ofCaribbean Adherence toAntiretroviral HIV Treatment andPreventionAdherence 187 11th International Conference on 11th International of transmissionHIVfrommothertothechildduringpregnancy. willsubstantiallyreducetherisk accomplish viralloadsuppressionthat when comparedtotheacceptableadherencelevel>95%required Conclusion: ARV drugs. theyaretaking that others mayknow was becausetheywereafraidthat themainreasonwhytheymissedtakingtheirmedication reported that the HIV-positive isstigma;41(25.6%) pregnantwomeninthis study among second majorrankedriskfactorfornon-adherencetomedication to ARV drugregimenamongtheHIV-positive pregnantwomen. The 46 (48.8%)ranksasthenumberoneriskfactorfornon-adherence (300/300/600mg) onceinadaywas78.8%. Inthisstudy, depression, oftenofovir/lamivudine/efavirenz to takingthefixeddosecombination group of15-44years. The meanself-reportedadherencewithrespect Results: adherence. theself-reported schedulewasusedtocalculate to themedication missedandthemeanscoresofpatient’sof medication adherence ement-semi-structured questionnaires. The numberofprescribeddoses specific16el usingaself-administeredstudy- regimen wasevaluated 160 HIV-positive pregnantwomentaking fixed-dosed, tenofovir-based Methods: pregnancy. benefit ofreducedrisktransmissionHIVfrommothertochildduring adherence level>95%isrequiredtoaccomplishtheaforementioned mission ofHIVfrommothertochildranges20%45%. However, usingantiretroviral(ARV)drugstheriskoftrans without intervention reducing theriskofinfectionbylessthan2%duringpregnancy while oftransmissionHIVfrommothertochildby ed positivelyontherate Background: West African Postgraduate CollegeofPharmacists, Lagos, Nigeria Kenneth Agu, Nigeria Mother-to-Child Transmission ofHIV in TherapyforPreventionof Antiretroviral Majority of the participants (96.25%) were between the age Majorityoftheparticipants(96.25%)werebetweenage This wasacross-sectionalsurvey, wheretheadherenceof adherence reportedsub-optimalmedication The study hasimpact The useofhighlyactiveantiretroviraltherapy Olumuyiwa Omonaiye(presenting) Pregnant Women Receiving Adherence amongHIV-Positive HIV Treatment andPreventionAdherence - - - 188 the UCSF Women’s HIVProgrambetween2012and2014. Methods: incare. engagement tochangesinpatient whether changesinopioidprescribingwererelated opioid prescribinginacohortofHIV-positive women, anddetermine possible. painsyndromesas anddosestofitpatients’ medications closely as to moreclosely scrutinizeopioidprescribingpracticesinordertoadjust statistics, clinicians theUCSF at Women’s HIVProgrambeganin2012 increased five-foldbetween1999and2010. Background: University ofCalifornia, SanFrancisco, CA, USA Jennifer Cocohoba(presenting) O.Mallory Johnson, EdwardMachtinger, Adele Feng, Salvadora, Zhang, Kathryn Mary JaneKang, adherence to ART, and thecarecontinuum. ofchronicpain,interplay betweenthetreatment connectionto clinicians, period. upoverour2yearstudy follow their appointments, lossto themgenerallydidnotdemonstrate tapering opioid use. ment ofchronicpaininpeoplelivingwithHIVrisks Conclusions: = 0.06), incaremoreconstantly(83%vs78%, butengaged p=0.049). adherence(63%vs71%, appointment lower trendedtowards p tapered periodvs57%ofnon-opioidusers(p=0.07). study 6monthsofthe every leastoneappointment 79% ofopioidusershadat vs73%notonopioids(p=0.18),adhered totheirappoinments yet opioid usersunderwentataper. for non-cancerpain. prescribed chronicopioidtherapy ses. period,only hadonevisitduringthestudy orduetocancerdiagno enrollmentperiodof1/2012-6/30/2012,during thestudy becausethey and 2014. Results: constancy. adherenceandappointment measured viaappointment period(2012-2014). to theendofstudy indailymorphine equivalentsfromthestart reduction of25%orgreater non-cancer painduringtheenrollmentperiod. at least 3sequentialopioidprescriptionsfor py wasdefinedasrecieving carewereexcludednot forprimary fromthestudy. included inthestudy. 2012inordertobe visit duringtheenrollmentperiodofJanuary-June period, leasttwovisitsduringthestudy hadat leastone have andat Oftheincluded cohort(n=136), hadbeen 39%(n=53)patients The goalofthisresearchistodescribetheadjustmentsin 212 unique patients were seen at the wereseenat 212 uniquepatients WHP between 2012 76 patients wereexcluded 76 patients avisit becausetheydidnothave Observational retrospective cohort study of women seen at ofwomenseenat retrospectivecohortstudy Observational onchronicopioidsmayadherelessto Although patients Itcanbechallengingforclinicians tobalancemanage Prescription opioid-related deaths in women have inwomenhave deaths Prescription opioid-related Care forHIV-Positive Women Opioid UseandEngagementin Patients that wereseenonlyforHIVconsult, Patients that and 69% of patients onchronicopioids 69%ofpatients Itisimportanttounderstandthe

Engagement incarewas Engagement Inlightofthesesobering wasdefinedas A taper Chronicopioidthera Patients whowere 23%ofchronic

Women must - - - POSTER ABSTRACTS 93 94

POSTER ABSTRACTS 189 attendance andreduceproblemdrinking. attendance boostmedicalHIVcare community canstrengthenmutualsupportsthat Conclusions: (p <.01), withnoparalleleffectsfoundinthecomparisongroup. participants reducedtheirdrinking(p<.01)andbingedays ipants inthecomparisoncondition(p=0.04). Inaddition, intervention forpartic comparedtonearlysixmonthsago visit wasonemonthago themeanperiodsincetheirmostrecentHIVmedicalcare reported that Results: or re-entercare, barriers. andovercometreatment-related convey thebenefitsoftreatment, helpestablishpracticalplanstoenter real-life HIV+friends. The sessionsusedinteractivetechniquesto withotheroftheir socialsupportintervention 7-session care-related a conditionattended of 10networksrandomizedintotheintervention of psychosocialwell-beingandHIVcareengagement. Membersofeach upassessments counseling andcompletedbaseline6-monthfollow their networksofHIV+friends(totaln=85). Participants receivedcare through PLHcommunityandonlinevenues. Seeds, inturn, recruited Russia. 20out-of-careor ART-nonadherent PLH “seeds” werelocated Methods: urgently neededtoboostsupportsforHIVcare. are andwhereinterventions beendiagnosed million infectionshave care. The HIVepidemiccontinuestoexpandinRussia, whereoverone strengthen mutualsupportinassistingoneanothertoenterHIVmedical sible tobringtogetherallHIV-positive membersofasocialnetworkto otherPLHintheirsocial networks.community oftenhave Itmaybepos to enterandremaininmedicalcare. People livingwithHIV(PLH)inthe HIV-positive uponsocialsupportinordertoencourage persons capitalize toHIVcare.life predictsengagement areneededto Newapproaches Background: 2 1 Sergey Tarima Yuri Amirkhanian(presenting) Living withHIVinSt. Petersburg, Russia Federation Botkin HospitalforInfectiousDiseases, St. Petersburg, Russian Medical Collegeof Wisconsin, Milwaukee, WI, USA up,At follow participantswhoreceivedthenetworkintervention This randomizedtrialwascarriedoutinSt. Petersburg, Intervention directed toward socialnetworksofPLHinthe directedtoward Intervention Socialsupportfrompersonsclose toanindividualinreal 1 , Vladimir Musatov , Vladimir HIV CareUptakeamongPeople Boosts Social NetworkIntervention 1 , JeffreyKelly 2 , AlexeiYakovlev 1 , Anna Kuznetsova, Anna 2 ,DiFranceisco Wayne 11th International Conference on 11th International 2 , - - 1

193 Methods: aclinic thesechangesimpactHIVcareat how levelisessential. andproviders.this newpayerstructureforbothpatients Understanding plans, and othermanaged of addalevel ofcomplexitytothenavigation MedicaidHMOs,introduction ofmandated Federally Facilitated Exchanges southeastern UnitedStates, challengesforPLWHA. mayexacerbate The withoutMedicaidExpansion(ME),reform instates suchasthoseinthe incareofPLWHA.tively impactengagement ofhealthcare Implementation Background: University ofMiami, FL, USA Macria Vidal, DanielFeaster, MichaelKolber Allan Rodriguez(presenting) in theSoutheastUnitedStates Care inPLWHA inaLargeMetropolitanCity needed toachievebetterHIV-related healthoutcomesinthisregion. can informthespecificneedsofsystem-levelchangeandinnovation withoutMEsuchasinthesoutheastern UnitedStates,particularly instates healthcarereformchangesmayadverselyimpactvulnerable PLWHA,how Conclusions: clinic-wide sameperiod. viralnon-suppressionof29%duringthat 24(39%)werenon-suppressed(>20copies/ml) comparedto patients; and 5%noinsurance. Priordocumentedviralloadwasobtainedfor61 HMOs;6%Medicare Ryan Share ofCost;8%Private White withMedicaidHMOs;14%Federalassociated Exchanges;10%Medicaid’s theirmedicalappointment. beingpresentat patient Ofthese65, 51%were seen)neededtoberescheduledinspiteofthe 8.5% ofalluniquepatients 161 (20.1%)encounterswereduetoinsuranceissues. Sixty-five(40%; Results: to aninsuranceissueduringthefirst4monthsofimplementation. reason andoutcome. We abstractedandanalyzedeachinteractiondue insurance issues. interactionwiththe A PNlogdocumentedeachpatient andaddressproblemswithscheduling,information walk-ins, andon-site (PN)toprovide county clinic navigator intheSoutheastaddedapatient There were 800 interactions across 765 individual patients; There were800interactionsacross765individualpatients; To centeredmedicalhome, apatient transitiontowards alarge InsuranceissuesworsenHIVcareoutcomes. Understanding Structuralbarriers, particularlyinsuranceissues, cannega Care ReformonEngagementin Understanding theImpactofHealth HIV Treatment andPreventionAdherence ,Clingerman, AndrewWawrzyniak,Sara - 194 11th International Conference on 11th International andNigeria. HIV inBenueState against noone isleftbehindinthefight needed inordertoensurethat Conclusions wife inheritance), criminaltransmissionofHIVandgovernmentpolicies. important variablesencounteredincludes culturalpractices(tribalmarks, uptake andacceptanceofcondomssexualhealthservices. Other ifying responsetocampaigns. Religionplaysahugelimitingroleinthe andmod bylimitingaccesstomedications of HIV/AIDSinBenueState nomic variables(especiallypoverty)playahugeroleintheepidemiology Results: version 10software. armisongoing.The quantitative Nigeria PidginandIdoma. wasanalyzed, Data thematically, usingNvivo February andMay2015. wereconductedin Englishlanguage, Interviews and acrossBenueState conducted inlocations Abuja (FCT)between sampling. Focus were groupdiscussionsandin-depthinterviews work (amixedmethodsproject). Participants wereselectedviapurposive Methods: success ofHIVcampaignsinBenueState, Nigeria. iscrucialtothe average an excessofHIVprevalenceabovenational Nigeria. theselocalfactorsworktoproduce An understandingofhow ofHIVinBenueState, continuetodrivetheepidemiology variables that average.is abovenational The mainaimofthisprojectistoidentifylocal inthemiddlebeltofNigeria)whereHIV/AIDSburden (one oftheStates driven byanumberoflocalfactors. This abstractfocusesonBenueState HIV/AIDSprevalenceinNigeria,that insub-Saharaof acountry Africa, is haran Africa alone. reviewandmeta-analysisfound A recentsystematic illnesses in2014-940, wererecordedinSub-Sa 000ofthesedeaths Background: 2 1 Brittain Inalegwu Oono(presenting) Something Else? Newcastle, Engladn NewcastleUponRoyal Victoria Infirmary Tyne NHSfoundation Trust, Newcastle University, Newcastle, England 1 , MarkPearce 96 participants were interviewed in42meetings. 96participantswereinterviewed Socioeco componentofmyPhD This abstractisbasedonthequalitative : Structuralchangesaswellpolicy changesareurgently Globally, about1.5millionpeoplediedfrom AIDS related Too MuchSex, orIsThere HIV/AIDS inBenueState, Nigeria: 1 1 , EdmundOng HIV Treatment andPreventionAdherence 2 , ZamanShahaduz 1 , Katie - - - 196 viral (ARV)nonadherenceusingpharmacy claims. Objective: andretentionincare. treatments forHIVandcomorbidcondition to promoteadherenceallmedications programsdesigned service coupled withfacetoproactivepatient levels ofculturalcompetency andHIVstigmaawareness. This trainingis education, staffwithadvanceddiseasestate pharmacies have high failure.emergence ofdrugresistanceandtreatment HIV-specialized Background: Walgreens Company, Deerfield, IL, USA Glen Pietrandoni John Hou, Kirkham, Heather using Pharmacy Claims prevent adherencedeclines. to based uponindividualizedneedsandtoproactivelysupportpatients HIV-specializedmacists at pharmacieswillbeabletocustomizesupport Conclusions: also increasedtheriskofnon-adherence. <50)andwithoutcommercialinsurancecoverage Being younger(age Not usingHIV-specialized increasedriskfornonadherence. services with werehighlyassociated abolic andnasalagents ARV non-adherence. pertensives andnotusinganti-hyperlipdemics, vaccines, androgens-an Results: than0.1fromthedecisiontreemodel. were greater importance valuetothedecisiontreemodel model orvariablerelative withnon-adherencefromthelogisticregression significant association variables toidentifynonadherence, i.e., tohave variableswereshown sion, decisiontree, andensemble. Variables asimportant wereflagged models includingthen fittedintomultiplepredicative logisticregres classes.representing eachofthe90therapeutic insurance plantype, andbaselinefillcount, and90binomialindicators (e.g.,ed demographics age, gender), yearofindex ARV fills, patient if anindividual’s PDCwaslessthan0.90. Modeledvariablesinclud patents wereconsiderednon-adherent 1-year periodfromtheirfirstfill; adherence wasmeasuredinproportionofdayscovered(PDC)fora evidence ofbeingontriple ARV-therapy from2013-2015. Medication Method: History ofusinganalgesics,History antidiabetics, antifungals, anti-hy The study sample identified patients withpharmacy sampleidentifiedpatients The study claims To antiretro arepredictiveofpatient identifyriskfactorsthat Byunderstandingriskpredictorsfornon-adherencephar Non-adherence to antiretroviral therapy mayleadto Non-adherencetoantiretroviraltherapy for Antiretroviral Non-Adherence for Antiretroviral Identification ofRiskPredictors

Ambrose Delpino(presenting) These variableswere ,

------POSTER ABSTRACTS 95 96

POSTER ABSTRACTS 197 dynamics andpartnersupportforPrEPuseamongmalecouples. dynamics partnerships. Futureresearchiswarrantedtoexaminerelationship intimacy maycontributetoPrEPadoptionamongmeninprimary Conclusions: 1.02, withPrEPuse. 1.15)eachassociated CI =1.12, 5.62), andcloseness discrepancies(aOR=1.05;95%CI= sex (aOR=2.31, 95%CI: 1.15, 4.63), actualcloseness (aOR=2.51;95% tionship variablesremained, withintimacy forcondomless motivations quality.relationship logisticregressionanalyses, Inmultivariate onlyrela serostatus, race/ethnicity, income, education, type, sexualagreement or PrEP use. age, differencesby There werenosignificantbivariate partner (i.e. with differencebetweenactualandideal)wereeachassociated higher riskperception, actualcloseness, andcloseness discrepancies Results: ship variablesbetweenPrEPusersandnon-users. variables,differences indemographic variables, behavioral andrelation (74.8%) hadelectedtostartPrEP. Self (IOS)scale. only98 toallparticipants;however PrEPwasavailable and “ideal” closeness totheirpartnerusingtheInclusion ofOtherin reported anopensexualarrangement. Participants their rated “actual” and71.8% annually; 38.2%wereinaserodiscordantrelationship; 34.8; 45%wereracial/ethnicminority;32.3%earnedlessthan$20,000 partnerships(N=131,in primary 34.1%). Participants’ was meanage project, analyseswereconductedonasubsampleofHIV-negative men Methods: between PrEPusersandnon-users. for condomlesssex, feelingsofcloseness, andcloseness discrepancies decisions totakePrEP. compared intimacyThe currentstudy motivations with areassociated dynamics relationship examinedhow studies have partnerships.bisexual menoccurinthecontextofprimary However, few Background: 3 2 1 Kailip Boonrai Kristi Gamarel(presenting) SPARK Project Partnerships:in Primary Findingsfromthe Hunter College, CityUniversityofNew York, NY, USA Callen-Lorde CommunityHealthCenter, New York, NY, USA University,Alpert MedicalSchoolofBrown Providence, RI, USA In bivariate analyses, Inbivariate numberofcasualsexpartners, greater As partofanongoingPrEPdemonstration-implementation Findings adesireformorecloseness suggestthat and

3 Approximately one-thirdofHIVinfectionsamonggayand Approximately , SaritGolub use amongGayandBisexual Men Relationship DynamicsandPrEP 3 1 , Asa Radix , Asa A logisticregressionmodelexamined 2 , StephaniePena 3 ,

11th International Conference on 11th International - - 198 adherence program for newly identified and previously diagnosed HIV adherence programfornewlyidentifiedandpreviouslydiagnosed and Communicate Teamwork), alinkage, retention, and re-engagement PROACT(Participate, hascreated (DOH-Broward) Observe, Adhere, Methodology: County.living withHIV)arecurrentlyretainedincareBroward and only 65%ofindividualslivingwithHIV(19,391personsdiagnosed there were993reportedHIVinfectioncaseswith86%linkedtocarebut immunodeficiency intheUnitedStates. virus(AIDS)caserates In2014, immunodeficiency virus(HIV)infectionandfourthhighestacquired tion (CDC), Countyhadthesecondhighestnewhuman in2013Broward Background: County,Florida DepartmentofHealthinBroward Janelle Taveras (presenting) Program inBrowardCounty, Florida effective provisionofservices. the Specialized positionswithinaprogramsuchasPROACTfacilitate to HIV-positive individuals, especiallyinhighHIVmorbidityareas. adherence programshouldbeestablishedtoprovideseamlessservices Conclusion: specificallyforthisprogram. created a database utilizing programeffectiveness andcomparerates to beableevaluate tocare. linkage can improveoutcomesacrosstheHIVContinuumofCare, startingwith HIVpositiveindividuals fornewlyandpreviouslydiagnosed services Results: within 90days, whichishigherthanthecountyrates. rate a95%and96%(respectively)linkage referred toPROACThave Part A program. HIVpositiveindividuals Newlyandpreviouslydiagnosed nity-based organizations, HIVcareprovidersandthelocalRyan White contractedproviders,referred toPROACTthroughDOH-Broward commu Perinatal Coordinator, and1ModifiedDOTNurse. Theseindividualsare (DIS), 2Perinatal andCongenitalSyphilisDIS, Coordinators, 3Linkage 1 Specialists consistsof7HIVDiseaseIntervention positive individualsthat Incorporating anongoingprogramcanprovideseamless Incorporating

A comprehensivelinkage, retention, and re-engagement According totheCentersforDiseaseControlandPreven County The FloridaDepartmentofHealthinBroward Monitoring outcomes across the continuum is necessary Monitoringoutcomesacrossthecontinuumisnecessary Re-Engagement, andAdherence PROACTive Linkage, Retention, HIV Treatment andPreventionAdherence , Yvette Gonzalez , Yvette - - 199 11th International Conference on 11th International forHIVpositivepregnantwomenandtheirneonates. streamline services networksystemshelptoenhanceand byutilizingaperinatal services networkmeetings. monthlyperinatal facilitating ofperinatal Coordination hospitals, practicesyearly, visitingobstetricandgynecological and laboranddelivery grandroundsat can bedonebyprovidingeducational Team andutilization. isessentialtoincreaseprogramawareness This Conclusion: program’s effectiveness. canimprovea coordinator specialistandperinatal disease Intervention HIV. programsuchasaperinatal Specializedpositionswithinaperinatal children, affectedby especiallyamongthosewomendisproportionately ment, increasesoutcomesforHIVpositivepregnantwomenandtheir HIVpositivepregnantwomenintointensivecase manage Engaging HIVpositivepregnantwomen. known for reportingandcasemanaging program, specializedforHIVpositivepregnantwomen, canbeeffective Results: support. retention andmonitoring, and3)antiretroviraladherencecounseling the following: tocare, 2)linkage 1)comprehensiveHIVeducation; HIVpositivepregnantwomen.known includedThe casemanagement Countyhasreported,in Broward all128 trackedandcase-managed Methodology: and 18%wereHispanic. HIVpositivepregnantwomen,known 81%wereBlack, 11%were White among non-Hispanic White womeninBroward. In2015, therewere128 HIV casesamongBlackwomenweremorethan14timeshigher (13-49)andnew the HIVcasesamongwomenwereofchildbearingage ofviralsuppression. rates factors affectingevenlower In2014, 68%of are beingfemaleandbetween1349yearsofage suggests that only 61%arevirallysuppressed. ExaminingFlorida’s ContinuumofCare living withhumanimmunodeficiency virus(HIV)through2014, ofwhich Background: County Florida DepartmentofHealthinBroward Janelle Taveras (presenting) County, Florida Florida DepartmentofHealthinBroward

A comprehensivelinkage, re-engagement, andadherence Promoting the services providedbyaPerinatal Prevention Promotingtheservices In Broward CountyFlorida, InBroward therewere19,391individuals The Perinatal ProgramoftheFloridaDepartmentHealth Baby”: Perinatal Programatthe “Protect Yourself, Protectyour , Yvette Gonzalez , Yvette HIV Treatment andPreventionAdherence - 202 Method: oneprojectsite. at multicomponent intervention cellphones.study-supplied We thetotalcostofthis soughttoestimate via reminderstotakeantiretroviraltherapy and (3)dailytextmessage (MI)counselingsessions, interviewing pre- andpost-releasemotivational intothecommunity, HIVcareuponre-entry tofacilitate coordinator (2) into theircommunities. included:The 6monthintervention (1)alink HIV releasedfromprisonsustainviralloadsuppressionuponre-entry Background: Hill, Chapel University ofNorthCarolinaat NC, USA Jessica Carda-Auten, David Wohl Terence Johnson(presenting) from Prison Suppression ofHIVRNAfollowingRelease community organizations. informs theadoptionofsuchaprogrambycriminaljusticesystemsand tomaintainHIVsuppressioninpeoplereleasedfromprison intervention infrequently completed. ofthecostamulti-component Ourestimate Conclusion: ($24,167), fixedcosts($25,164)andvariablecost($90,211). intervention pants cellphoneswas$71. Othercostincluded: planning intervention 178 miles(roundtrip, $199). Monthlytotalcostofprovidingpartici distancefromtheresearchstaffofficestoeachprisonwas The average counseling sessionswasseven, 39 minutes. andeachsessionaveraged wasonehourand49minutes.link coordinator The meannumberofMI lengthoftimefortheinitialneedsassessmentconductedby average ($259,115) anddirect($13,623)interactionswithparticipants. The wasstafftime,component oftheintervention whichincluded indirect site andthetotalcostperparticipantwas$5,502. The mostcostly Results: andparticipanttrackingdatabase.platform maps. We excluded thetextmessaging withcreating thecostassociated usingGoogle staffmemberswasestimated forintervention and mileage time logsfromfourrandomlyselectedweeks. To estimate Travel time using wasestimated ofstafftimethroughouttheintervention Allocation tion staffmembersincluded twoMIcounselorsandonelinkcoordinator. Cost data werecollectedthroughouttheintervention. Costdata Interven The intervention was provided to 82 participants at oneproject wasprovidedto82participantsat The intervention are interventions Assessment ofthecostsbehavioral ProjectimPACT wasdesignedtohelppeoplelivingwith Intervention toMaintain Intervention The CostofaMulti-Component , CarolGolin, Rosen, David

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POSTER ABSTRACTS 97 98

POSTER ABSTRACTS 203 case-management monitoringsystem. case-management partners ofPLHIV; anddevelopastandardizedreferralalgorithm facilities,drug treatment andprisons;2)introduceroutineHTSforsexual tuberculosisclinics, at services-particularly HTSandtreatment integrate targeting ofHTS, services, strengthenlinkage assureconfidentiality, publichealthactions:suggest severalimmediate 1)improvequalityand Mykolaiv region. To addresstheidentifiedbarriersforenrollment, we Conclusions: incare. priortoregistration additional examinations test results, poorqualityofcounsellingservices, andrequirementsfor reluctance touseHTS, tests, limiteduseofrapid not returningfor drug/alcohol addiction, (HTS)coverage, insufficientHIVtestingservices HIV care: Results: Mykolaiv. enrollmentinHIVcare regardinglate data (PLHIV) andotheravailable populations, data, programmatic ofpeoplelivingwithHIV sizeestimates amongkey general population, surveillance biobehavioral integrated includeddata routineepidemiologicandclinical ofthe monitoringdata review, data. secondary ofavailable synthesisandinterpretation) These Methods: Mykolaiv. enrollmentinHIVcare withlate tion istoidentifyfactorsassociated presenters.registered HIVcasesarelate The purposeofourinvestiga regions withthehighestHIVburden, wherealmosttwothirdsofnewly count costs. InUkraine, aCD4 over50%ofnewlyregisteredHIVcaseshave with increasedmortality, worsehealthoutcomesandhighertreatment identify riskfactorsfordropout. enrollmentinHIVcareisassociated Late eachstepoftheHIVcarecontinuumandto dropoutsat quantify patient Background: 4 3 2 1 Oleksandr Neduzhko Iuliia Novak Region inUkraine Ukrainian InstituteonPublicHealthPolicy, Kyiv, Ukraine Mykolaiv Regional AIDS Center, Myoklaiv, Ukraine Kyiv, Ukraine Ukrainian CenterforSociallyDangerousDiseaseControloftheMOH, Alliance forPublicHealth, Kyiv, Ukraine < 350 cells/mm feelingwell, lackofinformation/motivation, fearof disclosure, We identified the following risk factors for late enrollmentin We riskfactorsforlate identifiedthefollowing We analysis(semi-structured performedatriangulation 1 , IhorKuzin Late enrollmentinHIVcareisaseriousissueUkraine’sLate In consideration ofUNAIDS90-90-90goals,In consideration itiscrucialto in HIVCareaHighlyAffected Factors RelatedtoLateEnrollment 4 , 3 (late presenters). (late Mykolaivisamongseveral Oleksandr Postnov (presenting) 2 ,Bonenko Vasyl 3 , TetianaSalyuk 1 4 ,

11th International Conference on 11th International - 205 1) 24out-of-carePLHrecruitedthroughadvertisementsandreferrals Methods: important forlong-termcareengagement. chronic disease, provisionispotentially continuityofcareandservice and substanceabuse. asa HIVisincreasinglymanaged Giventhat barriers tomedicalcaresuchashousinginstability, mentalhealthcare, providerstoaddresspotential PLH alsoofteninteractwithotherservice tomedicalcareforpeople livingwithHIV(PLH).ant forstablelinkage Background: Medical Collegeof Wisconsin, Milwaukee, WI, USA Quinn,Katherine SarahReed, JustinRivas Michelle Broaddus(presenting) Living withHIV Turnover andProgramDischargeforPeople ation oftheserelationships,ation andofeasingtransitions. ignored. willrequireconsider Programstoincreasecareengagement are unavoidable, their effects on PLH’s in care should not be engagement Conclusions: were alsomarkedbyhighdegreesofturnover. provider.with anewservice providers Previousexperienceswithservice provided,services resultinginclients wantingtoavoid “starting allover” they hadbuiltwiththeirSpecialistsandthebenefitsofintensity fort withbeingdischargedfromtheprogram, oftencitingtherelationship toCareprogramexpressedahighdegreeofdiscom ents oftheLinkage healthcare providersmaybeariskfactorforcaredisengagement. Cli degree ofinstabilityregardingmedicalcare, regimens, medication and Results: providers. with healthandservice readings ofcontinuitycare, reluctancetodischarge, andrelationships for keythemesusingMAXQDAsoftwareandusedtoconducttargeted out ofmedicalcare, incare. riskofdisengaging orat werecoded Data Specialists” forPLHwhowerenewlydiagnosed, recentlyincarcerated, as the toCare”“Linkage program, wasdeliveredby toCare “Linkage abouttheirprogramexperiences.interviewed This program, known client-centered, programin short-termcasemanagement Wisconsin abouttheirbarrierstocare;2)30clientsinterviewed ofanintensive Preliminary findingsfromout-of-carePLHsuggestahigh Preliminary In-depth interviews wereconductedwithtwopopulations: In-depthinterviews Although providerturnoverandmedicalcaretransitions Positive doctor-patient arepotentiallyimport relationships of Care: Challenges of Provider of Care:ChallengesProvider Continuity ofServices, Continuity HIV Treatment andPreventionAdherence , JuliaDicksonGomez, JeffreyKelly, - - - - 206 11th International Conference on 11th International individuals withmoreseveresubstanceuseproblems. maybeparticularlyeffective for HIVstigmainterventions suggests that with stigma, inordertoimprove ART adherence. Further, thisanalysis provide currentsubstanceuserswithsupporttohelpreduceandcope ence amongsubstanceusingPLWH, thisanalysissupportstheneedto between HIV-related stigmaandadher and modifiersoftherelationship Conclusions: individuals withhighlevelsofsubstanceuseseverity. use severity, wassignificantandpositivefor whereastheassociation levelsofsubstance at low HIV stigmaandadherencewasnotsignificant betweeninternalized the association ple slopeanalysessuggestedthat adherence (AOR=0.97, p=.02, 95%CI[0.944, 0.996]. Follow up sim substance useseverityandinternalizedHIVstigmawhenpredicting ART Results: was measuredusingtheshortversionofHIVStigmaScale. Involvement Screening Test (ASSIST). HIV-related internalizedstigma substance usewasassessedusingthe Alcohol, SmokingandSubstance good) andnon-adherent(good, fair, poor, poor). andvery The severityof to?” Responsesweredichotomizedintoadherent(excellentorvery takingyourHIVmedicinesinthewayyouwere supposed you doat by respondingtothequestion “In thelast30days, goodajobdid how Participants alsoself-reportedtheir ART adherenceinthepastmonth whoself-reportedcurrentillicitdruguse.southeastern UnitedStates Methods: HIV-positive substanceusers. adherenceamong stigma andseverityofsubstanceuseonmedication seekstoexaminethecompoundedeffectsofHIV-related This study (ART),to antiretroviraltherapy healthoutcomes. resultinginnegative inillicitsubstanceusearesignificantlylesslikelytoadhere also engage Background: University of Birmingham,Alabama at AL, USA Kempf, ElizabethBaker Kristi Stringer(presenting) Adherence HIV-Related StigmaonART Medication The ImpactofSubstanceUseSeverityand Logistic regressionrevealedasignificantinteractionbetween Data werecollectedfrom172HIV-positiveData adultsinthe Research suggests that peoplelivingwithHIV (PLWH) Researchsuggeststhat who Although furtherresearchisrequiredtoexaminedirection HIV-Positive SubstanceUsers: Medication Adherenceamong , Janet Turan, Bulent Turan, Mirjam-Colette HIV Treatment andPreventionAdherence - - 209 approach toimprovingadherenceamongHIVAYAapproach (13-24yearsold) eo-gaming linkedto WisePill boxopeningsisafeasibleandacceptable ofadherence.rates We soughttodetermineifusinginteractivevid Background: 4 3 2 1 Ganesan Kavitha Caleb Griffith Amanda Castel(presenting) Youth AdherenceamongHIV-InfectedImprove results a pilot intervention isunderwayamongHIVAYA.results apilotintervention home. ofgamingdevicesat widespread availability Basedonthese adherence,its potentialtoimprovetreatment withguardiansconfirming supportive ofexploringthevideo-gamingand WisePill intervention, and Conclusions: help improveadherence. prototypes, mostparticipantswereoptimistic aboutthegames’abilityto bonuses, andbuilt-inremindernotifications. Afterplayingthegame ame characteristicsincluded challenginggameswithavatars, in-game concerns regardingfamilyissues, andsocialisolation. Desiredvideog Self-reported barrierstoadherenceincluded sizeandtasteofpills, includedCommonly usedadherencestrategies alarmsandpillboxes. and themajority(79%)ofHIVAYA on ART wereononce-a-dayregimens. least one gamingdeviceinthehome of guardians(79%)reportedat mightwork. suchanintervention generally optimisticthat The majority time ofdisclosure. After seeingthegameprototype, providerswere being organized, responsiblefortheirmedications, the andyoungerat Results: weregenerated. statistics coding;descriptive wereanalyzedusingthematic data Qualitative disclosure, (ART), antiretroviraltreatment data. andvideogameusage HIVAYA andtheirguardiansthroughwhichwecollecteddemographic, and WisePill boxweredemonstrated. wereadministeredto Surveys FGs amongHIVAYA wereconductedduringwhichthegameprototypes of suchvideogames. Oneproviderfocusgroup(FG)andseveniterative tions ofusingvideogamesforadherence, anddesiredcharacteristics ofadherence,their opinionsregardingbarriersandfacilitators percep providers (n=10), HIVAYA (n=12), andtheirguardians(n=14)eliciting Methods: HIVclinic. anurbanUSpediatric receiving careat Bethesda, MD, USA HIVResearchProgram,Military MJacksonFoundation, Henry Children’s HealthSystem, National Washington, DC, USA Media Rez, Washington, DC, USA School ofPublicHealth, Washington, DC, USA The George Washington UniversityMilkenInstitute Providers reported that adherence facilitators included adherencefacilitators Providersreportedthat HIVAYA Data were gathered from HIV medical and support services fromHIVmedicalandsupportservices weregathered Data 3 Overall, providers, HIVAYA, andtheirguardianswere HIV-infected youthandyoungadults(HIVAYA) low have , NicoleEllenberger Video-Gaming Technology to Attitudes towardsUsingInteractive 4 , NadiaHussein 1 , SabaQasmieh 3 3 , GabrielRalte , TyriesaHoward 1 , DanielGreenberg 2 , Rakhmanina Natella 1 , Lewis Brittany

2 - , 1 ,

- - 3

POSTER ABSTRACTS 99 100

POSTER ABSTRACTS 210 needed foradherencemonitoring, especiallyamong AYA. tion intheriskof to VF inadultsrelative AYA, suggestingbettertoolsare adults. HighMPRswerecommon, reduc withagreater andassociated visits, AYA hadanincreasedriskof VF afterstarting ART comparedto Conclusions: adults (RR0.63p<0.001). of VF, butthisriskwasmutedin AYA (RR0.78p=0.013)comparedto = 0.001). analysis, Inmultivariate MPR>94%portendeddecreasedrisk those withoptimaladherence, 22%of AYA vs.18%ofadultshad VF (p had optimal, 15%hadsuboptimal, and3%hadpooradherence. Among in AYA thanadults(24%vs. 20%p=0.001). Overall, 82%ofpatients for70%ofpatients. wasavailable data VF on ART wasmorecommon Results: VF (HIVRNA>1,000copies/mL)after12monthson ART. betweenage,used toassesstherelationship MPRcategory, andriskof (>94%, 80-94%, <80%. generalizedlinearmodelswere Multivariate since ART initiation, asoptimal, andcategorized suboptimal, orpoor as thenumberof ART dosesdispenseddividedbythenumberofdays for12monthsafter visits) werefollowed ART initiation. MPRwasdefined cal care( inNigeria(APIN)network.Initiative Patients whowereadherenttoclini HIV 10university-affiliated 12/2012 at clinics inthe AIDSPrevention years) andadults(>25whoinitiated ART between1/2009and Methods: adults inNigeria. virologic failure(VF)amongadolescentsandyoungadults(AYA) and (MPR)and possessionratio betweenmedication assess therelationship of virologicfailureinresource-limitedsettings. Ourobjectivewasto Background: 2 1 Susan Regan Ingrid Bassett Aimalohi Ahonkhai(presenting) to Youth inaNigerianCohort Risk ofVirologic Failure forAdultsCompared AIDS Prevention Initiative inNigeria AIDS PreventionInitiative Massachusetts GeneralHospital, Boston, MA, USA ≤ The cohortincluded 1,599 AYA and13,067adults. Viral load We of conductedaretrospectivecohortstudy AYA (15-25 3 months between any twoconsecutiveclinical3 monthsbetweenany orpharmacy 1 In a Nigerian cohort of patients compliant withclinical InaNigeriancohortofpatients Effectivetoolsareneededtoidentifyyouthindanger 1 , ProsperOkonkwo Predict GreaterReductionsinthe High MedicationPossession Ratios 2 1 , ElenaLosina , BolanleBanigbe 1 , KennethFreedberg 2 , Juliet Adeola , 11th International Conference on 11th International 2 , 1 , - - 212 Lora Sabin Pregnant andPostpartum Women inUganda Adherence StudyamongHIV-Positive Implementing aHealth-BasedHIVTreatment 5 4 3 2 1 Barbara Mukasa Rachael Bonawitz Julia Gasuza Salome Kuchukhidze low-resource settings. low-resource support inhighstigma,ity andtheimportanceofdesigningappropriate ditional challenges. These findingshighlightthispopulation’s vulnerabil OptionB+; presentedad women haddifficultyfollowing RTD technology Conclusions: RTD-related issue. chargedwastheprimary remained achallenge;keepingbatteries expressed positiveviewsoftheRTD. Post-randomization, ART retention (21) andfearofHIVdisclosure (13). At onemonth, allretainedsubjects (72, to 55%)andrelated ART maintenance, including fearofsideeffects non-use (2). inRTD Explainedgaps (130total)weremainlybehavioral RTD-related challengesincluded poorsignalstrength(12)andintentional 1 hadafalse-positiveHIVtestresult.miscarried; 2refusedmedications; thefirstmonth11 subjectsfailedtoattend 4 ANC/HIVfollow-up; and toeffectiveuseofRTD, leadingto33(20%)withdrawals. Ofthese, 2016. Inthefirstmonth, weencounteredbarriersbothto ART provision Results: domized. We and continuedtomonitordeviceoperation ART retention. use. At month1, andwereran subjectscompletedadevice-usesurvey one month, in gaps wemonitoredsubjects’deviceuseandinvestigated standard care, andreceiveSMSremindersmonthlycounseling. For device (RTD) dailyforHIVmedications, makemonthlyvisitsper ANC/HIV andEntebbe.Mityana touseareal-timemonitoring Subjectsagreed Methods: compliance withboth ART protocol. standardcareandtheintervention months ofimplementation, to wereportonmultiplechallengesrelated (PPPW) inUganda, inurgentneedofsupport. apopulation After ten outcomesamongpregnantandpostpartum women HIV treatment designedtoimprove isassessinganm-Health-basedintervention Study (ART)viral therapy toallHIV-positive pregnantwomen. The ‘WiseMama’ Background: Makerere University, Kampala, Uganda Boston, MA, USA BostonUniversity,Center forGlobalHealthandDevelopmentat Mildmay Uganda, Kampala, Uganda Massachusetts GeneralHospital, Boston, MA, USA Boston UniversitySchoolofPublicHealth, Boston, MA, USA 165 women were enrolled between June 2015 and January 165 womenwereenrolledbetweenJune2015andJanuary We enrolledpregnantwomeninitiating ART hospitalsin at 1 , Mary BachmanDeSilva (presenting) Mary 3 , JosephKyebuzibwa

The first months of study implementation found that foundthat implementation The firstmonthsofstudy WHO’s callsforprovision ofantiretro OptionB+initiative Fire?): ChallengesEncountered Out oftheBubble(andinto 3 , LisaJ. Messersmith 1 , Anna Larson Williams , Anna 2 , Justin Tepe, HIV Treatment andPreventionAdherence 1 3 , Allen L. Gifford , H. Davidson Hamer 1 4 , SegganeMusisi 1 1 , HarrietChemusto , NafisaHalim 1 ,

5 ,

1 , 3 - , - -

- Boggavarapu, Sahithi Bogart, Laura Boekeloo, Bradely Blashill, Aaron Blackstock, Oni Bien, Cedric Betancourt, Joseph Bessong, Pascal Berman, Claire Berger, Miriam Bengtson, Angela Bello, Fatimah Beer, Linda Bebawy, Sally Beauchamps, Laura Beattie, Christopher Madelyne Ann Bean, Bayer, Joshua Batista, Daniela Batey, David Batchelder, Abigail Bassett, Ingrid Barrett, Kimberly Banigbe, Bolanle Bangsberg, David Balán, Ivan Baker, Elizabeth Bailey-Webb, Jeannette Baeten, Jared Bacon, Oliver Bachman DeSilva, Mary Babawarun, Oloruntoba Azuero, Andres Ayyaluru, Sankari Aunon, Frances Asirot, Grace Mary Asiimwe, Stephen Arzinger, Jenna Arnsten, Julia Arnold, Trisha Armstrong, Wendy Arayasirikul, Sean Andrews, Krista Andrew, Erin Anderson, Peter Anderson, Emily Anabwani, Gabriel Amirkhanian, Yuri Amico, K. Rivet Amaro, Hortensia Al-Tayyib, Alia Alperovitz-Bicahell, Kari Allison, Susannah Alegria, Margarita Stephen, Alege Alcaide, Maria Ahonkhai, Aimalohi Agu, Kenneth Agbaji, Oche Aderemi-Williams, Roseline Adeola, Juliet Adedimeji, Adebola Acevedo, Ramon Abrams, Elaine Abas, Melanie Aaron, Erika Name 11th International Conference on 11th International ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 22, 26, 27, 59, 75 Page Number(s) 14, 16, 17, 54 39, 45, 81, 90 24, 57, 66 32, 77, 91 25, 27, 74 17, 61, 62 HIV Treatment andPreventionAdherence 31, 100 32, 33 33, 36 37, 83 64, 67 23, 71 22, 26 41, 84 72, 73 27, 59 30, 60 85, 89 19, 94 72, 73 65, 78 100 100 100 100 51 31 69 99 62 32 50 43 60 88 20 23 57 55 32 23 61 25 49 61 68 93 24 92 82 89 61 30 91 84 24 47 58 49 48 71 20 53 66 87 Chen, Bing Chemusto, Harriet Chayama, Loulou Chaudhry, Junaid Charalambous, Salome Chapman, Jennifer Chang, Larry Chamberlin, Stephanie Chakrabarti, Anindita Celum, Connie Cedric-Crouch, Pierre Cazares, Rebeca Cavassini, Matthias Castro, Rodolfo Castillo-Mancilla, José Castilho, Jessica Castel, Amanda Carty, Craig Carrico, Adam Carr, Susan Carr, Jason Carpenter, Lavenia Cardenas, Gabriel Carda-Auten, Jessica Carballo-Diéguez, Alex Carballo, Alexandra Caraway, Patricia Caraballo, Alexandra Campbell, Diane Calixto, Diego Calabrese, Sarah Cabral, Howard Byram, Bev Bwana, Mwebesa Buyu, Celestine Bushman, Lane Burns, Bridget Burack, Jeff Bulya, Nulu Bull, Lois Bukusi, Elizabeth Bugos, Eva Bugnon, Olivier Buchbinder, Susan Bucek, Amelia Brown, Sharon Brown, Shakara Brown, Larry III,Brown, William Browder, Mary Brooks, Ronald Broaddus, Michelle Brittain, Kirsty Brittain, Katie Brincks, Ahnalee Brill, Atrina Braunstein, Sarah Brady, Kathleen Bradley-Bull, Steven Bradley, Heather Boyer, Abigail Boum, Yap Boswell, Stephen Boonrai, Kailip Bonenko, Vasyl Bonawitz, Rachael Bologna, Estefany ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 15, 21, 53 85, 86, 89 26, 27, 59 22, 26, 75 31, 100 31, 100 72, 73 46, 76 25, 74 14, 16 31, 97 41, 85 52, 80 44, 45 27, 59 27 20 69 80 63 98 95 23 87 81 78 22 47 96 98 20 34 39 91 30 23 81 21 70 36 46 58 64 60 67 99 84 66 80 90 67 32 69 84 60 78 51 47 30 67 22 60 59 55 81 58 36 Cole, Stephen Cohn, Wendy Cohn, Michael Cohen, Stephanie Cohen, Phillip Cohen, Mardge Cocohoba, Jennifer Clymore, Jacquelyn Clouse, Kate Clingerman, Sara Cleland, Charles Clark, Michele Clark, Jesse Clark, Devon Claborn, Kasey Church, Anna Christopoulos, Katerina Chinedu, Onyekatu Ann Mary Chiasson, Chhabra, Rosy Cherutich, Peter Chen, Ying-Tung Chen, Wei-ti Doshi, Rupali Donovan, Jenna Donnelly, Jennifer Donnell, Deborah Dombrowski, Julia Dolezal, Curtis Doblecki-Lewis, Susanne Dilworth, Samantha Dillingham, Rebecca DiFranceisco, Wayne Diepstra, Karen Dickson Gomez, Julia Diaz-Mendez, Nelly Dhanireddy, Shireesha Derose, Kathryn Delpino, Ambrose del Rio, Carlos DeGroote, Nicholas Deem, Thomas DeBolt, Claire de Vasconcellos,Mauricio de laCruz, Maria de Guzman, Rebecca de Boni, Raquel Davila, Jessica Daughtridge, Giffin Daskalakis, Demetre Dark, Heather D’Arata, Michael Dant, Lydia Dale, Sannisha Dadem, Nancin Curtis, Virginia Cunningham, William Cunningham, Chinazo Cropsey, Karen Croome, Natasha Craw, Jason Cranston, Ross Crane, Paul Crane, Heidi Craker, Lacey Conyngham, S Coleman, Jenell ...... �� ...... �� ...... �� ...... �� 16, 19, 26, 41 31, 47, 48 71, 75, 78 47, 72, 73 32, 36 72, 73 44, 47 26, 41 27, 69 19, 94 16, 19 64, 70 42, 45 72, 73 17, 88 72, 73 74 66 77 82 93 71 67 94 36 64 18 55 50 21 32 63 60 79 25 59 35 32 44 74 91 98 83 35 89 95 23 17 25 74 70 89 18 28 63 44 62 24 20 32 43 61 16 69 20 18 30 AUTHOR INDEX 101 102

AUTHOR INDEX Geng, Elvin Genberg, Becky Gaynes, Bradley Gay, Cynthia Gasuza, Julia Garvie, Patricia Garofalo, Robert Garland, Joseph Gardner, Edward Garcia, MariadeFatima Ganesan, Kavitha Gandhi, Monica Gamarel, Kristi Galvan, Frank Galarraga, Omar Gadisa, Tsigereda Gachara, George Fulcar, Altagracia Fujimoto, Kayo Frongillo, Edward Freeman, Robert Freedberg, Kenneth Fredericksen, Rob Frazier, Remi Frasca, Katherine Frank, Ian Fogel, Cathie Flynn, Patrick Flickinger, Tabor Flash, Charlene Fitzsimmons, Emma Fischl, Margaret LeViere,Finestone Anna Fernandez, Nilo Fennie, Kristopher Feng, Adele Felsen, Uri Feaster, Daniel Farias, Iraína Farias, Hugo Falcon, Anthony Fadul, Nada Coleman,Evans Tyffany Escobar, Jessica Erguera, Xavier Elul, Batya Ellenberger, Nicole Elkington, Katherine Elamin, Fatima Ekerete-Udofia, Christy Edwards, Todd Edwards, Akesha Edmiston, John Edelstein, Zoe Echenique, Marisa Eaton, Lisa Earnshaw, Valerie Duthely, Lunthita Duran, Jesus Duke, Chris Duerr, Ann Du, Amanda Du Pasquier, Renaud Drainoni, Mari-Lynn Downing, Martin Dowdy, David Dovidio, John ...... �� ...... �� ...... �� ...... �� . �� ...... �� . �� ...... �� 29, 37, 71, 75, 78, 83 39, 73, 82 23, 32, 94 29, 37, 90 38, 60, 87 31, 100 44, 47 33, 34 16, 19 72, 73 44, 45 72, 73 75, 78 72, 73 41, 84 39, 47 100 49 86 85 31 31 74 42 68 70 79 93 33 84 89 70 82 44 80 99 27 80 50 92 28 83 65 83 63 16 40 85 58 30 21 30 47 24 48 29 49 49 86 84 99 44 96 63 80 58 89 Hogg, Robert Hoffmann, Chris Hoffman, Susie Hoagland, Brenda Ho, Titcha Hirshfield, Sabina Heine, Amy Heffron, Renee Hecht, Jen Hecht, Fredrick Heaton, Anne Haughton, Lorlette Hartman, Christine Harris, Rebecca Harrington, Robert Hare, Brad Hansen, Nathan Hannaford, Alisse Hamer, Davidson Hall, Gerod Halim, Nafisa Halfin, Janet Haberer, Jessica Gwadz, Marya Guzman, Alfredo Gutierrez, Cristina Guthrie, Kate Gurung, Sitaji Groves, Jennifer Grov, Christian Grossberg, Robert Gross, Robert Grodensky, Catherine Grinsztejn, Beatriz Grimes, Richard Grimes, Deanna Griffith, Caleb Griffin, Amy Gremel, Garrett Greenberg, Daniel Green, Gill Gray, Ronald Grasso, Chris Grant, Robert Gouveia, Carla Gould, Michelle Goulart, Silvia Gouaux, Ben Gosselin, Jillian Goss, Stephanie Gorrell Kulkarni, Sarah Gooden, Lauren Gonzalez, Yvette Golub, Sarit Golin, Carol Golden, Matthew Goggin, Kathy Godfrey, Monica Giordano, Thomas Gilmore, Kate Gillani, Fizza Gilbert, Hannah Giguere, Rebecca Gifford, Allen Gibbons, Laura Ghiam, Michael Genn, Leah ...... 11th International Conference on 11th International ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 22, 26, 27, 43, 59, 75 28, 43, 87, 91, 96 22, 26, 27, 59, 75 48, 71, 75, 78 31, 81, 97 31, 100 31, 100 31, 100 21, 80 96, 97 72, 73 42, 45 28, 91 40, 85 16, 19 72, 73 64, 70 84 31 70 38 67 36 23 35 17 86 24 69 72 64 23 30 80 70 69 21 36 39 38 32 45 50 35 36 47 77 53 57 90 55 29 31 35 32 23 81 53 53 99 79 16 99 51 81 73 44 HIV Treatment andPreventionAdherence Jagielski, Christina Isenberg, Sarina Irvine, Mary Ingersoll, Karen Ibitoye, Mobolaji Hygie-Enwerem, Grace Hutton, Heidi Hussein, Nadia Huo, Yanling Hunt, Peter Hughes, Lyndsay Huebner, David Hsu, Joanne Howard, Tyriesa Houang, Steven Hou, John Hotton, Anna Horwitz, Jessica Horvath, Keith Hopkins, Mary Honig, Sylvie Holt, Sally Hollod, Laura Kojic, Erna Koester, Kimberly Koenig, Helen Knowlton, Amy Knight, Kevin Klein, David Kirkham, Heather Kimemia, Grace Kienzle, Jennifer Kidoguchi, Lara Khan, Iman Keruly, Jeanne Kershaw, Trace Kersanske, Laura Kennedy, Kristin Kempf, Mirjam-Colette Kelly, Jeffrey Keller, Jennifer Kegeles, Susan Kaul, Pamposh Katabira, Elly Karasz, Alison Kang, Jane Kang Dufour, Mi-Suk Kamal, Susan Kallen, Michael Kallas, Esper Kalichman, Seth Kalichman, Moira Kaida, Angela Kacanek, Deborah Jones, Rhondette Jones, Deborah Jones, Constance Jones, Alex Johnson, Terence Johnson, Steven Johnson, Rachel Johnson, Mallory Johnson, Kendra Jaramillo, Sindy Jain, Sachin Jain, Mamta Jain, Jennifer ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 20, 22, 26, 27, 59, 75 14, 15, 34, 44, 57 26, 27, 59 43, 57, 99 19, 94, 98 44, 45 18, 30 22, 75 52, 91 44, 45 55, 56 44, 45 27, 65 40, 85 18, 53 16, 19 86 82 31 17 95 61 47 47 15 75 56 91 93 58 45 70 27 49 36 68 83 90 97 87 18 42 83 33 23 66 43 82 21 74 69 50 81 99 49 22 61 56 99 21 95 49 44 60 67 37 18 11th International Conference on 11th International Marquez, Samantha Maragh-Bass, Allysha Manhaeve, Cecile Mandler, Raul Maloney, Kevin Malee, Kathleen Magnus, Manya Madsen, Kimberly Madruga, José Maddox, Lorene Mackey-Amiti, Ellen Mary Machtinger, Edward Machado, Iona Machado, Elizabeth Luz, Paula Lu, Hongzhou Lowenthal, Elizabeth Losina, Elena Loo, Stephanie Long, Amanda Long, Alice Logie, Carmen Locatelli, Isabella Lizcano, John Liu, Honghu Liu, Albert Litwin, Alain Little, Kristen Lipshie-Williams, Madeleine Lima, Helena Lim, Sungwoo Li, Xianhong Lewis, Brittany Levison, Julie Levine, Ken Leu, Cheng-Shiun Leonard, Noelle Lemus Hufstedler, Lee Lelutiu-Weinberger, Corina Lehmann, Corrine Leech, Ashley Lee, Yoojin Lee, Sonia Lee, Christine Lazar, Rachael Lawrence, Sean Laraque, Fabienne Lanzi, Robin Lanier, Chisa Langness, Jacob Lambert, John Lama, Javier Lalley-Chareczko, Linden Lake, Jordan Kyebuzibwa, Joseph Kuznetsova, Anna Kuzin, Ihor Kutnick, Alexandra Kutner, Bryan Kushel, Margot Kurth, Ann Kuhns, Lisa Kubeka, Griffiths Krakower, Douglas Konkle Parker, Debbie Kolber, Michael Kolawole, Grace ...... �� ...... �� ...... �� ...... �� . �� ...... �� 33, 34, 76, 77 HIV Treatment andPreventionAdherence 31, 100 39, 73 64, 70 72, 73 26, 41 32, 36 27, 69 16, 19 39, 73 40, 69 19, 94 16, 19 26, 41 47, 73 42, 57 32, 94 100 81 70 57 58 63 32 30 77 51 53 60 99 61 73 43 55 30 49 32 15 17 76 48 42 87 84 18 64 98 60 82 49 30 24 24 82 58 23 73 49 47 70 79 62 93 64 84 60 23 Nakku-Joloba, Edith Nakigozi, Gertrude Nakazono, Terry Myers, Julie Myers, Janet Myer, Landon Muzoora, Conrad Muwonge, Timothy Mutchler, Matt Musyoki, Helgar Musisi, Seggane Musinguzi, Nicholas Musgrove, Karen Musatov, Vladimir Murphy-Swallow, Dorothy Mulamba, Jeremiah Mukherjee, Soumyadeep Mukasa, Barbara Mujugira, Andrew Mugo, Nelly Mugavero, Michael Mounzer, Karam Moskowitz, Judith Moreira, Ronaldo Moorthy, Ganesh Moore, Richard Moore, Miranda Moore, David Moore, Allison Montue, Solange Montoya, Jessica Modi, Riddhi Mobuto, Tonderai Mobley, Victoria Mitchell, Mary Miller, Melissa Miller, Cari Miller, Anna Milberg, John Miertschin, Nancy Meylakhs, Anastasia Meyers, Kathrine Metsch, Morgan Metsch, Lisa Messersmith, Lisa Messer, Lynne Merenstein, Daniel Mercogliano, Kathleen Menefee, Jenna Mena, Leandro Mellins, Claude Melaku, Zenebe Mejia, Dianna Medtiz, Amie McGowan, Ian McEwen, Dean McDavitt, Bryce McAuliffe, Timothy Mbabali, Ismail Mayer, Kenneth Mavhandu, Lufuno Mattson, Christine Mathews, Chris Matheson, Tim Marx, Grace Marukutira, Tafireyi Martin, Jeffrey ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 47, 48, 71, 72, 73, 90 �� 20, 22, 26, 59, 75 22, 26, 27, 59, 75 27, 49, 74, 88 24, 47, 72, 73 47, 48, 72, 73 14, 17, 54 31, 100 31, 100 31, 100 20, 42 44, 45 25, 74 26, 41 22, 26 85, 89 40, 85 37 82 70 31 80 61 60 69 38 17 19 81 58 23 38 23 22 20 81 88 28 22 17 71 94 62 81 79 59 18 66 70 18 48 76 38 35 90 38 90 30 71 82 81 79 42 19 87 70 23 Olaiya, Oluwatosin Okonkwo, Prosper Okatch, Harriet O’Duor, Jacqueline Odoyo, Josephine Oderinde, Tosin O’Cleirigh, Conall Nwafor, Samuel Novak, Iuliia Nogg, Kelsey Nguyen, Trang Ngure, Kenneth Neves, Renata Nerlander, Lina Neilands, Torsten Neduzhko, Oleksandr Nassau, Tanner Nash, Denis Nash, Binford Napravnik, Sonia Napoles, Tessa Nankya, Betty Nalugoda, Fred Puga, Ana Psaros, Christina Primbas, Angela Prejean, Joseph Predhomme, Julie Potter, JoNell Postnov, Oleksandr Poschman, Karalee Pollack, Lance Pitpitan, Eileen Pitchford, Simon Pisarski, Emily Pietrandoni, Glen Pierre-Louis, Catherine Phillips, Tamsin Pettit, April Petroll, Andrew Peterson, John Personti, Domenica Person, Anna Pence, Brian Pena, Stephanie Pena, Luis Pearce, Mark Paul, Mary Patrick, Rachel Patrick, Donald Patel, Viraj Patel, Sonam Pasalar, Siavash Parsons, Jeffrey Parra, Alexa Parnell, Heather Park, Jane Parcesepe, Angela Palar, Kartika Paez, Edgar Packer, Tracey Packard, Rebecca Ouellet, Lawrence Ott, Corilyn Oono, Inalegwu Ong, Edmund Omonaiye, Olumuyiwa ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 22, 26, 59, 75 14, 15, 34, 44 24, 48, 62 85, 86, 89 39, 57, 73 33, 77, 91 39, 73, 82 24, 100 21, 80 31, 48 22, 75 39, 73 20, 59 25, 74 64, 67 47, 48 72, 73 29, 35 37, 83 72, 73 49 43 40 17 60 83 98 79 56 46 95 62 54 56 52 64 96 89 95 49 35 91 42 70 70 80 36 44 62 43 95 95 93 54 23 85 59 50 50 98 17 82 84 54 98 42 81 AUTHOR INDEX 103 104

AUTHOR INDEX Searls, Kristina Scott, Linda Scott, Kimberly Scott, Hyman Schwartz, Pamela Schneider, MariePaule Schneider, John Scheer, Susan Savage, Robert Sauceda, John Santoro, Anthony Sanders, Chris Samet, Jeffrey Salyuk, Tetiana Salvadora, Kathryn Salomon, Nadim Salcuni, Paul Saia, Amanda Sagoe, Aba Safren, Steven Saccoccio, Michael Sabin, Lora Saberi, Parya Ruth, Kathleen Roytburd, Katya Rowan, Sarah Rosen, David Rooney, Alexandra Rojas, John Rogers, Maya Rodriguez, Violeta Rodriguez, Janet Rodriguez, Allan Rodgers, William Robertson, McKaylee Robbins, Rebekkah Rizzuto, Jessica Rivas, Justin Ritchie, Amanda Rietmeijer, Cornelis Richey, Lauren Richardson, Barbra Rhodes, Anne Reynolds, George Restar, Arjee Rendina, H. Jonathon Remien, Robert Regan, Susan Reed, Sarah Rebeiro, Peter Rebchook, Greg Raymond, Jeannette Raper, James Ranadive, Nikhil Rana, Aadia Ramsey, Susan Ramchandani, Meena Ralte, Gabriel Rakhmanina, Natella Raj, Anita Raffanti, Stephen Radix, Asa Rachal, Nikki Rabionet, Silvia Quinn, Katherine Quadri, Yasmeen Qasmieh, Saba Puskas, Cathy ...... �� ...... �� ...... �� ...... �� ...... �� 24, 29, 43, 48, 61, 62 33, 34, 42, 86 14, 15, 34 25, 38, 87 23, 70, 94 28, 80, 91 25, 74, 80 31, 100 41, 84 14, 15 80, 91 81, 97 18, 53 64, 67 16, 19 29, 35 64, 67 41, 84 54, 98 40, 85 100 92 55 36 37 38 87 68 68 21 21 77 98 38 66 69 74 28 98 56 27 71 39 55 35 99 99 64 96 17 92 42 99 60 66 80 36 58 49 36 43 91 54 41 98 93 19 28 Tymejczyk, Olga Turner, Megan Turan, Janet Turan, Bulent Tshume, Ontibile Tsai, Alexander Triplett, Daniel Trepka, Jo Mary Towe, Vivian Todd, LaWanda Tiruneh, Yordanos Tindimwebwa, Edna Tien, Phyllis Thrun, Mark Thomas, Vasavi Thomas, Jesse Thomas, Alvin Teran, Richard Tepe, Justin Tembo, Doreen Tebas, Pablo Tayo, Fola Taveras, Janelle Tassiopoulos, Katherine Tarima, Sergey Tan, Judy Tamhane, Ashutosh Tam, Melanie Swygard, Heidi Sullivan, Margaret Sullivan, Kristen Stringer, Kristi Stockton, Jan Stitzer, Maxine Stinnett Miller, Emily Stella, Iwuagwu Starrels, Joanna Stanley, Melinda Spellman, Dawn Sparks, Jennifer Smith, Whitney Smith, Renee Smith, Lisa Smith, Lindsay Smith, Laurie Smith, Laramie Smith, Jasmine Small, Latoya Sloan, Caroline Singh, Tejinder Simoni, Jane Sima, Jessica Silverman, Elizabeth Silverio, Eliana Shouse, R. Luke Shlay, Judith Shiu, Cheenghee Shireman, Theresa Shinefeld, Jennifer Sheinfil, Alan Sheehan, Diana Shahaduz, Zaman Sena, Arlene Selwyn, Peter Seligman, Hilary Seiden, Danielle Sehhat, Asemaneh Seghatol, Victoria ...... 11th International Conference on 11th International ...... �� ...... �� ...... �� ...... �� ...... �� ...... �� 39, 41, 46, 84 48, 57, 63, 99 48, 57, 63, 99 37, 71, 75 48, 57, 63 72, 73, 90 16, 19 33, 34 64, 67 41, 84 76, 77 96, 97 19, 94 20, 59 43, 99 55, 56 55, 56 88 88 18 53 60 18 89 14 38 60 86 69 79 95 71 50 73 88 58 63 80 23 22 79 18 78 59 82 25 36 18 81 21 31 51 18 92 49 56 71 71 30 23 30 50 77 45 35 49 87 83 HIV Treatment andPreventionAdherence Warne, Patricia Ware, Norma Wang, Honghong Wang, Alex Walters, Sarah Waldron, Levi Waldman,Lena Ava Walcott, Melonie Wagner, Glenn Voorhees, Kelly Villar-Loubet, Olga Villaran, Manuel Villamizar, Kira Vidal, Macria Veloso, Valdilea Velasque, Luciane Vasconcelos, Ricardo van denBerg, Jacob Urada, Lianne Underhill, Kristen Umlauf, Anya Udoh, Ifeoma Udeagu, Chi-Chi Zupp, Athena Zorilla, Juana Zlotnick, Caron Zinski, Anne Zhong, Yaoyu Zheng, Jia-Hua Zhang, Mary Zerbe, Allison Zawitz, Chad Zariczny, Daniel Young, Jeremy Youn, Bora Yorio, Carolyn Yore, Jennifer Yoon, Irene Yerkes, Lauren Yehia, Baligh Yang, Joyce Yang, Frances Yakovlev, Alexei Xue, Xiaonan Wyatt, Monique Woodson, Tammie Woods, Tiffany Wohl, David Wingood, Gina Wilson, Tracey Wilson, Ira Wilson, Erin Willis, Sarah Willig, James Wilkin, Aimee Wiewel, Ellen Whitfield, Thomas Whiteley, Laura White, Becky West, Brady Wentz, Eryka Wendel, Karen Weiser, Sheri Weiser, John Weber, Shannon Wawrzyniak, Andrew Wawer, Maria Washington, Terry ...... �� ...... �� 25, 33, 34, 42, 76, 77 71, 78, 80, 81, 82, 83 28, 52, 80, 91 39, 57, 73, 82 20, 24, 59 57, 72, 73 31, 81, 97 18, 53 25, 74 33, 34 55, 56 41, 84 72, 73 19, 94 20, 59 42, 57 75, 78 18, 53 31, 81 70, 94 72, 73 64, 70 41, 84 44, 45 46, 76 18 89 42 90 60 93 62 86 62 21 85 60 50 80 57 82 57 90 35 20 16 82 38 16 36 81 57 27 60 53 21 74 17 25 83 40 70 94 64 70 34 47 38 11th International Conference on 11th International Medicine for Institute Postgraduate ACCREDITED PROVIDERS Providers of AIDS Care of Association International SPONSOR HIV Treatment andPreventionAdherence Washington, DC, USA amfAR, for The Foundation AIDS Research Gregorio Millett, MPH Boston, MA, USA Health Fenway Kenneth Mayer, MD Pavia, University ofPavia Franco Maggiolo, MD West Yorkshire,UK University ofHuddersfield Ian Hodgson, MA, PhD Houston,USA TX, University Baylor Thomas P. Giordano, MD, MPH Atlanta, GA, USA Sister Love Dázon DixonDiallo, MPH, DHL Aberdeen, of Aberdeen University Marijn deBruen, PhD Denver, CO, USA University ofColorado, Denver Marla A. Corwin, LCSW, CAC III San Francisco, CA, USA School ofPharmacy SanFrancisco University ofCalifornia Jennifer Cocohoba, PharmD, MAS Lima, Heredia Universidad PeruanaCayetano Carlos Cáceres, MD, PhD, MPH Ann Arbor, MI, USA University ofMichigan K. RivetAmico, PhD CO-CHAIR PLANNING COMMITTEE PERU ITALY SCOTLAND Steven A. Safren, PhD Stellenbosch, Stellenbosch University Jean B. Nachega, MD, PhD Nairobi, Hospital National University ofNairobiandKenyatta Nellie R. Mugo, MBChB, MMed, MPH Birmingham,USA AL, of Alabama University Michael J. Mugavero, MD, MHSc CO-CHAIR Washington, DC, USA International ofProviders Association José M. Zuniga, PhD, MPH Waterloo, ON, Wilfrid LaurierUniversity Alan Whiteside, DEcon Geneva, World HealthOrganization Marco Vitória, MD Bethesda, MA, USA InstituteofMentalHealth National Michael J. Stirratt, PhD Seattle, WA,USA of Washington University Jane M. Simoni, PhD Fort Lauderdale, FL, USA Nova SoutheasternUniversity Elizabeth Sherman, PharmD Pomona, CA, USA Western University James D. Scott, MEd, PharmD Miami, FL, USA University ofMiami of AIDS Care of AIDS KENYA SWITZERLAND SOUTH AFRICA CANADA

ACKNOWLEDGEMENTS 105 106

ACKNOWLEDGEMENTS Houston,USA TX, University Baylor Thomas P. Giordano, MD, MPH Denver, CO, USA Denver PublicHealth Edward M. Gardner, MD Bethesda, MA, USA Instituteof National and Allergy Vanessa Elharrar, MD, MPH Atlanta, GA, USA Sister Love Dázon DixonDiallo, MPH, DHL Durham, NC, USA FHI360 Amy Corneli, PhD San Francisco, CA, USA SanFrancisco University ofCalifornia Jennifer Cocohoba, PharmD, MAS Washington, DC, USA University George Washington Amanda Castel, MD, MPH Storrs, CT, USA University ofConnecticut K. RivetAmico, PhD ABSTRACT REVIEWCOMMITTEE Infectious Diseases School ofPharmacy

Bethesda, MD, USA Instituteof National and Allergy Tia Morton, RN, MS Atlanta, GA, USA DiseaseControlandPrevention Centers for Yuko Mizuno, PhD Rockville, MD, USA Health Resourcesand John Milberg, MPH Boston, MA, USA Health Fenway Kenneth Mayer, MD Pavia, University ofPavia Franco Maggiolo, MD Bethesda, MD, USA InstituteonDrug National Abuse Shoshana Kahana, PhD West Yorkshire,UK University ofHuddersfield Ian Hodgson, MA, PhD Washington, DC, USA International ofProviders Association Reuben Granich, MD, MPH Washington, DC, USA InstituteofMentalHealth National Christopher M. Gordon, PhD Infectious Diseases Administration Services Care of AIDS ITALY 11th International Conference on 11th International

HIV Treatment andPreventionAdherence Jane M. Simoni, PhD Fort Lauderdale, FL, USA Nova SoutheasternUniversity Elizabeth Sherman, PharmD Atlanta, GA, USA DiseaseControlandPrevention Centers for Salaam Semaan, DrPH Pomona, CA, USA Western University James D. Scott, MEd, PharmD Birmingham,USA AL, of Alabama University Michael J. Mugavero, MD, MHSc Washington, DC, USA International ofProviders Association Jose M. Zuniga, PhD, MPH Washington, DC, USA International ofProviders Association Benjamin Young, MD, PhD Washington, DC, USA Social Workers of Association National Evelyn Tomaszewski, MSW, ACSW Bethesda, MA, USA InstituteofMentalHealth National Michael J. Stirratt, PhD Seattle, WA,USA of Washington University of AIDS Care of AIDS Care of AIDS

! International International ofProviders Association AIDS Care President/CEO José M. Zuniga, PhD, MPH Sincerely, Care (IAPAC) andthe Postgraduate InstituteforMedicine (PIM). conference wasjointlysponsoredbytheInternational ofProviders Association AIDS May 9-11, 2016, HotelandResortinFort theDiplomat at Lauderdale, FL, USA. This 3-day ConferenceonHIV 11th International Treatment andPrevention Adherence, held attended the ______that This letterisaconfirmation To Whom ItMayConcern: MAY 9-11,2016•FORTLAUDERDALE Adherence 2016 AND PREVENTION 11th International HIV TREATMENT Conference on ADHERENCE

October 13-14, 2016 • Geneva, Switzerland

The International Association of Providers of AIDS Care, in collaboration with the Joint United Nations Programme on HIV/AIDS, AIDS Healthcare Foundation, and other partners (to be announced), will host its fifth annual summit aimed at leveraging antiretroviral therapy to end AIDS as a public health threat by 2030.

The summit will feature discussion about the implementation of treatment as prevention and pre-exposure prophylaxis as well as provide a forum for exploring HIV prevention and care continua optimization.

Co-Chairs

Kenneth Mayer, MD Julio SG Montaner, MD Fenway Institute/Harvard University British Columbia Centre for Excellence in HIV/AIDS Boston, MA, USA Vancouver, BC, Canada

For More Information Summit information and online registration will be available soon at www.iapac.org. The 11th International Conference on HIV Treatment and Prevention Adherence is co-hosted by the International Association of Providers of AIDS Care (IAPAC) and the Postgraduate Institute for Medicine (PIM), who wish to express their deepest gratitude to the institutional and commercial supporters whose generosity has made this decade anniversary conference possible.

Institutional Supporters

Commercial Supporters

Corporate Sponsor