Adherence 2015 Conference Program

WELCOME

Welcome to the 10th International Conference on HIV Treatment and Prevention Adherence!

This conference marks a decade of coming together from around the world to share, support, and sustain scientific advances towards fully leveraging available behavioral and biomedical treatments to promote health and well-being of people affected by and those living with HIV.

Over more recent years, the focus and content of this conference have flexed and expanded in line with advances and discoveries in the fields of HIV treatment and prevention to now include engagement in care more broadly and adherence to biomedical prevention technologies. Thankfully, the context and culture of the conference have not changed. Consistently reported as one of the most unique aspects of our annual gathering is the conference’s spirit of collaboration and collegiality. Synergies, connections, insights, expanding our understanding and perspectives, and lasting professional relationships and friendships emerge from this brief opportunity to come together united by the charge of ameliorating the quality of research, care, policy, and treatment of those at risk, living with, and affected by HIV.

This year, almost 500 delegates from 25 countries will come together here in Miami. We sincerely thank each of you for making this conference a priority in what are undoubtedly busy schedules. We hope you make every opportunity to engage with a truly amazing community of diverse delegates. You will notice a number of conference-supported activities in the program that will help to create these opportunities, which we believe are an important means the International Association of Providers of AIDS Care (IAPAC) is providing to strengthen networking among a diverse group of professionals in this field.

This conference would not be possible without considerable contributions from many individuals and supporters:

• Intellectual and programmatic guidance from IAPAC President/CEO José M. Zuniga, PhD, MPH, has facilitated the creation of yet another year of high-quality plenaries and thematic oral sessions. • We recognize the invaluable contributions of Benjamin Young, MD, PhD, IAPAC’s Senior Vice President/Chief Medical Officer, and Michael J. Stirratt, PhD, a Program Chief at the National Institute of Mental Health/National Institutes of Health, in developing the scientific program, and an internationally renowned team of experts who reviewed abstract and program content. • We are grateful for our distinguished conference faculty, including our Keynote speaker, Ambassador Deborah L. Birx, MD, the US Global AIDS Coordinator, and our Memorial Lecturer, Quarraisha Abdool Karim, PhD, of the University of KwaZulu-Natal. • We appreciate the operational support from IAPAC Conference Manager Jonathan Hess and other staff whose work allows for the successful implementation of the conference. • Moreover, we also are grateful for commercial support provided by AbbVie, Gilead Sciences, Merck & Co., and corporate sponsorship from ViiV Healthcare.

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 ...... 2

Continuing Education ...... 3

Networking Opportunities ...... 5

Hotel Maps ...... 6

Faculty Roster ...... 7

Pre-Conference Symposia ...... 8

Conference Program - Sunday, June 28, 2015 ��9 TABLE OF CONTENTS TABLE

Conference Program - Monday, June 29, 2015 ��10

Conference Program - Tuesday, June 30, 2015 ��11

2015 Honorees...... 12

Oral Abstracts Schedule...... 13

Oral Abstracts ...... 16

Poster Abstracts ...... 46

Acknowledgements ...... 147

10th International Conference on HIV Treatment and Prevention Adherence 1 CONFERENCE INFORMATION

TARGET AUDIENCE PROGRAM OVERVIEW The target audience for the 10th International Conference on HIV Adherence 2015 will provide a forum where the state-of-the- Treatment and Prevention Adherence (Adherence 2015) 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 2.5-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 the state-of-the-science in relation to achieving gagement in care. Poor or non-adherence to treatment, as well individual, community, and public health goals by optimizing as suboptimal linkage to and engagement in care, can lead to the HIV care continuum the resumption of rapid viral replication, decreased survival rates, • Apply evidence-based strategies to enhance adherence to HIV and virus mutation to treatment-resistant strains of HIV. Similarly, treatment in order to mitigate drug resistance and achieve linkage and adherence to biomedical prevention interventions is long-term virologic suppression critical to curbing HIV acquisition rates among at-risk populations. • Integrate into clinical practice biomedical prevention interventions, including evidence-based strategies to enhance Implementing evidence-based behavioral, clinical, and structural adherence to pre-exposure prophylaxis interventions to enhance linkage to and adherence to HIV treat- • Provide appropriate care and counsel for patients and their ment and biomedical prevention, as well as long-term engage- families ment in the continuum of HIV care, is critical to attain individual, community, and public health objectives. GENERAL INFORMATION

GENERAL INFORMATION

MEETING VENUE INTERNET ACCESS Adherence 2015 is being held at the Eden Roc Miami Beach. Ple- Complimentary Internet access is available for Adherence 2015 nary, Oral Abstract, and Breakout Sessions, as well as the Poster delegates. Wireless Internet can be accessed by connecting to Session will be held on the second level (see the Hotel Maps and EdenRocGuest. the Program Schedule on page 7 and pages 10-12, respectively). SLIDE PRESENTATIONS/ABSTRACTS MEALS Slide presentations will be available at www.iapac.org post-con- Complimentary breakfast will be provided daily in Ocean Ball- ference. The Program and Abstracts book will be distributed at room 1, which is located on the first level of the Eden Roc Miami registration, and electronic versions will be available at www. Beach. Lunch is available for purchase daily in the Mona Lisa iapac.org post-conference. room as well as the Cabana Beach Bar.

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 2015 event for live updates on the conference. Join the conference’s social media conversation: #Adherence2015

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].

2 10th International Conference on HIV Treatment and Prevention Adherence PHYSICIANS, NURSES, & 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 Disclosure of Unlabeled Use the International Association of Providers of AIDS Care (IAPAC). This educational activity may contain discussion of published The Postgraduate Institute for Medicine is accredited by the ACC- and/or investigational uses of agents that are not indicated by ME to provide continuing medical education for physicians. the US Food and Drug Administration (FDA). The planners of this activity do not recommend the use of any agent outside of the Credit Designation labeled indications. The opinions expressed in the educational The Postgraduate Institute for Medicine designates this live ac- activity are those of the faculty and do not necessarily represent tivity for a maximum of 19.75 AMA PRA Category 1 Credit(s)™. the views of the planners. Please refer to the official prescribing Physicians should claim only the credit commensurate with the information for each product for discussion of approved indica- extent of their participation in the activity. tions, contraindications, and warnings.

Disclosure of Conflicts of Interest Disclaimer The Postgraduate Institute for Medicine (PIM) requires instructors, Participants have an implied responsibility to use the newly acquired planners, managers, and other individuals who are in a position to information to enhance patient outcomes and their own professional control the content of this activity to disclose any real or apparent development. The information presented in this activity is not meant to conflict of interest (COI) they may have as related to the content of serve as a guideline for patient management. Any procedures, medica- this activity. All identified COI are thoroughly vetted and resolved tions, or other courses of diagnosis or treatment discussed or suggest- according to PIM policy. PIM is committed to providing its learned in this activity should not be used by clinicians without evaluation of ers with high quality CME activities and related materials that their patient’s conditions and possible contraindications on dangers in promote improvements or quality in healthcare and not a specific use, review of any applicable manufacturer’s product information, and proprietary business interest of a commercial interest. comparison with recommendations of other authorities. A Disclosure of Conflicts of Interest handout is inserted in the CONTINUING EDUCATION Program and Abstracts book. The handout reflects reports of fi- Evaluation nancial relationships or relationships to products or devices fac- Participants may complete an online evaluation at ulty, planners, and managers, or their spouses/ life partners, have www.cmeuniversity.com. On the navigation menu, click on “Find with commercial interests related to the content of this CME ac- Post-Tests by Course” and search by Course ID 10580. Upon tivity. If you do not find this handout inserted in your Program and successfully completing the evaluation, a CME certificate will be Abstracts book, please visit the conference’s Registration Desk. made available to each participant.

CONTINUING EDUCATION - PSYCHOLOGISTS CONTACT HOURS - NURSES

Psychology Sponsorship Statement Nursing Accreditation Statement Postgraduate Institute for Medicine is approved by the Ameri- Postgraduate Institute for Medicine is accredited as a provider can Psychological Association to sponsor continuing education of continuing nursing education by the American Nurses Cre- for psychologists. PIM maintains responsibility for this program dentialing Center’s Commission on Accreditation. and its content. Nursing Credit Designation Psychology Credit Designation This educational activity for 19.75 contact hours is provided by This program offers 18.5 continuing education credits for Postgraduate Institute for Medicine. psychologists.

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 10580. Upon successfully completing the evaluation, a CE certificate will be made available to each participant.

10th International Conference on HIV Treatment and Prevention Adherence 3 PHARMACISTS

CONTINUING EDUCATION IN PHARMACY Nova Southeastern University College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. ACPE#. This program has been approved for up to 8.0 contact hours (.8 CEUs). Following are sessions that have been approved for credit hours.

SUNDAY, JUNE 28, 2015 MONDAY, JUNE 29, 2015 TUESDAY, JUNE 30, 2015 10:00 A.M. - Noon • Pompeii 8:00 A.M. - 8:30 A.M. • Ocean Ballroom 2 8:00 A.M. - 8:30 A.M. • Ocean Ballroom 2 [2 Hours] [0.5 Hour] [0.5 Hour] Pre-Conference Symposium 1: High-Impact Keynote Address Reinforcing Adherence as a Touchstone to Technology: Closing the Gaps in the Continu- Achieving 90% Viral Suppression Doing the Right Thing, in the Right Place, um of HIV Care at the Right Time: Focusing HIV Efforts and Learning Objectives: Learning Objectives: Resources to End AIDS • Describe methods to reinforce HIV • Characterize the state of the continuum Learning Objectives: antiretroviral adherence and their role in of HIV care in various populations in the achieving viral suppression • Describe current, promising resources United States • Describe actions a pharmacist can take and efforts which are aimed at ending the • Identify technologic assets that can help to reinforce adherence and help patients AIDS epidemic close gaps in the continuum of care achieve viral suppression. • Describe the barriers for controlling the • Compare and contrast technologic HIV epidemic advances used to close gaps in the continuum of care 8:30 A.M. - 9:00 A.M. • Ocean Ballroom 2 • Discuss the role of pharmacy-based [0.5 Hour] 8:30 A.M. - 9:00 A.M. • Ocean Ballroom 2 technology in helping to close gaps in the Closing Quality and Relevance Gaps – [0.5 Hour] continuum of care Harnessing Technology to Facilitate HIV Care Addressing the Role of Stigma, Discrimination, Scale-Up and Punitive Laws in Disrupting the HIV Care Continuum Learning Objectives: CONTINUING EDUCATION 1:00 P.M. - 3:00 P.M. • Pompeii [2 Hours] Learning Objectives: • Identify methods that utilize technology to Pre-Conference Symposium 2: Preview of the close quality gaps in HIV care • Identify laws which may clearly or inad- 2015 IAPAC Guidelines for the Optimization of • Identify common features of successful vertently disrupt the HIV care continuum the HIV Care Continuum technology-based interventions to facili- • Describe the role of stigma in disrupting tate community-based HIV care Learning Objectives: the HIV care continuum • Cite three recommendations for optimizing the care continuum for people living with HIV 1:45 P.M. - 2:15 P.M. • Ocean Ballroom 2 1:30 P.M. - 2:30 P.M. • Pompeii • Describe the role of pharmacists in improv- [0.5 Hour] [1 Hour] ing the HIV care continuum Developing an “HIV Prevention Cascade”: Current Policy, National Programs, and Structural • Identify helpful interventions to improve Approaches and Future Directions Strategies to Ease Transitions Between Pillars ART adherence in the cascade in the HIV Care Continuum Learning Objectives: • Identify appropriate tools for pharmacists to use to improve ART adherence in the Learning Objectives: • Describe the role of combination preven- treatment cascade tion efforts in closing gaps across the • Identify barriers that prevent patients’ suc- continuum of care cessful entry into and engagement in HIV care • Identify potential prevention efforts that • Outline clinical and bio-behavioral 4:00 P.M. - 4:30 P.M. • Pompeii pharmacists can engage in to help close interventions to optimize the HIV care [0.5 Hour] gaps in care continuum Gary S. Reiter, MD, and Andrew Kaplan, MD, • Describe structural interventions that Memorial Lecture can ease transitions between HIV care Implementation Science: Identifying Real- cascade pillars World Strategies to Optimize the HIV Care Continuum Learning Objectives: • Define the term “implementation science” • Provide two examples of implementation science research as relates to optimizing the HIV care continuum

4 10th International Conference on HIV Treatment and Prevention Adherence NETWORKING OPPORTUNITIES

GROUP INTEREST NETWORKING HOUR 5:15 p.m. - 6:15 p.m., Monday. June 29, 2015, Penthouse (take Penthouse Elevator)

Adherence 2015 covers a vast spectrum of issues. Come break it down with us in a less conference-like environment. IAPAC invites you to stop by the Networking Hour to mix and mingle among colleagues and new friends. This unique and casual networking opportunity

The Group Interest Coffee Talk will focus on the individuals who serve people living with HIV/AIDS:

• Pharmacists • Psychologists • Nurses & Nurse Practitioners • Physicians

ISSUE INTEREST COFFEE TALK 7:00 a.m. - 7:50 a.m., Tuesday, June 30, 2015, Mona Lisa

The Issue Interest Coffee Talks will focus on special populations of individuals living with or affected by HIV/AIDS:

• Men who have Sex with Men • Transgender Individuals • Women/Young Women • Children/Adolescents

RUNNING CLUB 6:00 a.m. - 6:45 a.m., Monday, June 29, 2015 & Tuesday, June 30, 2015, Meet in Hotel Lobby

Calling all runners! Come meet us every morning for a pre-conference run around North Miami Beach. Adherence 2015 participants and runners of all endurance, paces, distances and experience levels are encouraged to come run together in a non-competitive atmosphere as a way to get to know each other in a relaxed, informal environment. See you there! NETWORKING OPPORTUNITIES

Disclaimer: Runners acknowledge that they are participating at their own risk and waive all claims of every nature against the organizers, sponsors, and any other participating groups with respect to any personal loss, illness, bodily injury or death resulting from participating in this event. Participants also fully understand the rigors of this activity and have prepared themselves physically for the event. Please use caution when performing exercise and/ or engaging in strenuous physical activity. Please consult your physician before beginning exercise program. Participants should stay on sidewalks, use crosswalks and stay alert to traffic and pedestrians. Participants will be required to sign a Release and Liability Disclaimer prior to participating in a pre-conference run.

10th International Conference on HIV Treatment and Prevention Adherence 5 EDEN ROC MIAMI BEACH HOTEL MAPS

6 10th International Conference on HIV Treatment and Prevention Adherence K. Rivet Amico, PhD Vanessa Johnson, JD James D. Scott, MEd, PharmD University of Michigan Ribbon Consulting Group Western University of Health Sciences Ann Arbor, MI, USA Washington, DC, USA Pomona, CA, USA

Michele Andrasik, PhD, EdM, MA Quarraisha Abdool Karim, PhD Jason Sigurdson, MPA, LLB University of Washington University of KwaZulu-Natal Joint United Nations Programme on HIV/AIDS Seattle, WA, USA Durban, SOUTH AFRICA Geneva, SWITZERLAND

José A. Bauermeister, MPH, PhD JoAnne Keatley, MSW Kenly Sikwese University of Michigan University of San Francisco African Community Advisory Board Ann Arbor, MI, USA San Francisco, CA, USA Lusaka, ZAMBIA

Ambassador Deborah L. Birx, MD Ann Kurth, PhD, CNM, MPH Jane M. Simoni, PhD Office of the Global AIDS Coordinator New York University University of Washington Washington, DC, USA New York, NY, USA Seattle, WA, USA

Heidi Crane, MD Kenneth Mayer, MD Michael J. Stirratt, PhD University of Washington Fenway Institute/Harvard University National Institute of Mental Health Seattle, WA, USA Boston, MA, USA Bethesda, MD, USA

Jeffrey S. Crowley, MPH Eugene McCray, MD Patrick Sullivan, PhD, DVM Georgetown University Centers for Disease Control and Prevention Emory University Washington, DC, USA Atlanta, GA, USA Atlanta, GA, USA ROSTER FACULTY

Bich Dang, MD Rafael Mazín, MD, MPH Alan Whiteside, DEcon Baylor College of Medicine Pan American Health Organization Balsillie School and Wilfrid Laurier University Houston, TX, USA Washington, DC, USA Waterloo, ON, CANADA

Dazon Dixon Diallo, MPH Julio S.G. Montaner, MD Phill Wilson Sister Love BC Centre for Excellence in HIV Black AIDS Institute Atlanta, GA, USA Vancouver, BC, CANADA Los Angeles, CA, USA

Julia Dombrowski, MD, MPH Steve Morin, PhD Patrick Yankee University of Washington University of California Detroit Department of Health and Wellness Seattle, WA, USA San Francisco, CA, USA Detroit, MI, USA

Jason Farley, PhD, MPH, CRNP, FAAN Michael J. Mugavero, MD, MHSc Baligh Yehia, MD, MPP, MSHP Johns Hopkins Center for AIDS Research University of Alabama at Birmingham University of Pennsylvania Baltimore, MD, USA Birmingham, AL, USA Philadelphia, PA, USA

Reuben Granich, MD, MPH Glen Pietrandoni, RPh Benjamin Young, MD, PhD International Association of Providers Walgreens Boots Alliance International Association of Providers of AIDS Care Deerfield, IL, USA of AIDS Care Washington, DC, USA Washington, DC, USA Celso Ramos, MD, MSc Robert Grant, MD, MPH Federal University of Rio de Janeiro Sean Young, PhD, MS San Francisco AIDS Foundation Rio de Janeiro, BRAZIL University of California, San Francisco, CA, USA San Franciso, CA, USA Dianne M. Rausch, PhD Jessica E. Haberer, MD, MS National Institute of Mental Health Anna Zakowicz, MA, MIH Harvard University Bethesda, MD, USA AHF Europe/GNP+ Boston, MA, USA Amsterdam, NETHERLANDS Robert Remien, PhD Catherine Hanssens, JD Columbia University José M. Zuniga, PhD, MPH Center for HIV Law & Policy New York, NY, USA International Association of Providers Washington, DC, USA of AIDS Care Jorge Saavedra, MD Washington, DC, USA Sharon Hillier, PhD AIDS Healthcare Foundation University of Pittsburgh Mexico City, MEXICO Pittsburgh, PA, USA

10th International Conference on HIV Treatment and Prevention Adherence 7 SUNDAY, JUNE 28, 2015

Symposium 1 10:00 a.m. - Noon / Pompeii

High-Impact Technology: Closing the Gaps in the Continuum of HIV Care

Moderator: Jane M. Simoni, PhD, University of Washington, Seattle, WA, USA

Panelists: Heidi Crane, MD, University of Washington, Seattle, WA, USA Ann Kurth, PhD, CNM, MPH, New York University, New York, NY, USA Patrick Sullivan, PhD, DVM, Emory University, Atlanta, GA, USA Sean Young, PhD, MS, University of California, San Francisco, San Francisco, CA, USA

CME accredited

Symposium 2 1:00 p.m. - 3:00 p.m. / Pompeii

Preview of the 2015 IAPAC Guidelines for the Optimization of the HIV Care Continuum

Moderator: Benjamin Young, MD, PhD, International Association of Providers of AIDS Care, Washington, DC, USA

Presenter: Julio S.G. Montaner, MD, BC Centre for Excellence in HIV/AIDS, Vancouver, BC, CANADA

Panelists: Ann Kurth, PhD, CNM, MPH, New York University, New York, NY, USA Celso Ramos, MD, MSc, Federal University of Rio de Janeiro, Rio de Janeiro, BRAZIL PRE-CONFERENCE SYMPOSIA James D. Scott, MEd, PharmD, Western University of Health Sciences, Pomona, CA, USA Anna Zakowicz, MA, MIH, AHF Europe/GNP+, Amsterdam, NETHERLANDS

CME accredited

8 10th International Conference on HIV Treatment and Prevention Adherence SUNDAY, JUNE 28, 2015

TIME ACTIVITY POMPEII

10:00am-Noon Pre-Conference High-Impact Technology: Closing the Gaps in the Continuum of HIV Care Symposium 1 Moderator: Jane Simoni, PhD Panelists: Heidi Crane, MD; Ann Kurth, PhD, CNM, MPH; Patrick Sullivan, PhD, DVM; Sean Young, PhD, MS

Noon-1:00pm Lunch on Own

1:00pm-3:00pm Pre-Conference Preview of the 2015 IAPAC Guidelines for the Optimization of the HIV Care Continuum Symposium 2 Moderator: Benjamin Young, MD, PhD Presenter: Julio S.G. Montaner, MD Panelists: Ann Kurth, PhD, CNM, MPH; Celso Ramos, MD, MSc; James D. Scott, MEd, PharmD; Anna Zakowicz, MA, MIH

3:00pm-3:30pm Break

OPENING SESSION • OCEAN BALLROOM 2

3:30pm-4:00pm CONFERENCE WELCOME AND AWARDS PRESENTATION José M. Zuniga, PhD, MPH K. Rivet Amico, PhD PROGRAM SCHEDULE Michael J. Mugavero, MD, MHSc

4:00pm-4:30pm GARY S. REITER, MD, AND ANDREW KAPLAN, MD, MEMORIAL LECTURE Implementation Science: Identifying Real-World Strategies to Optimize the HIV Care Continuum Quarraisha Abdool Karim, PhD

4:30pm-5:30pm Perspectives on the Cascade of Care: How Does it Resonate with Affected Communities? Moderator: Phill Wilson Panelists: Vanessa Johnson, JD; Kenly Sikwese; Anna Zakowicz, MA, MIH

5:30pm-5:45pm Break

TIME ACTIVITY LOCATION

5:45pm-7:00pm Poster Session & Ocean Ballroom 1 Exhibit Session

WELCOME RECEPTION • WATERVIEW TERRACE

7:00pm-8:00pm ¡Bienvenidos a Miami!

10th International Conference on HIV Treatment and Prevention Adherence 9 MONDAY, JUNE 29, 2015

TIME ACTIVITY 6:00am-6:45am Morning Run (Meet in Hotel Lobby) 6:30am-7:50am Exhibit Session & Breakfast (Ocean Ballroom 1) 7:50am-8:00am Break

MORNING SESSION • OCEAN BALLROOM 2

8:00am-8:30am KEYNOTE ADDRESS: Doing the Right Thing, in the Right Place, at the Right Time: Focusing HIV Efforts and Resources to End AIDS Ambassador Deborah L. Birx, MD

8:30am-9:00am Addressing the Role of Stigma, Discrimination, and Punitive Laws in Disrupting the HIV Care Continuum Jason Sigurdson, MPA, LLB

9:00am-10:00am Three Top-Rated Oral Abstracts

10:00am-10:15am Break

TIME ACTIVITY OCEAN BALLROOM 2 PROMENADE POMPEII 10:15am-11:15am Thematic Oral SESSION 1 SESSION 2 SESSION 3 Abstract Sessions Perspectives and Performance Innovations in ART Adherence PrEP Dissemination and of Care Engagement Measurement Implementation 11:15am-11:30am Break 11:30am-12:30pm Thematic Oral SESSION 4 SESSION 5 SESSION 6 Abstract Sessions Re-Engagement Interventions ART Adherence Potpourri Implementation Science in

PROGRAM SCHEDULE across Contexts Biomedical HIV Prevention 12:30pm-1:30pm Lunch on Own 1:30pm-2:30pm Thematic Panels Why Do Individuals Behave as Community Efforts to Improve Policy, National Programs, and They Do Across the HIV Care the HIV Care Continuum Structural Strategies to Ease Continuum? Moderator: Transitions between Pillars in Moderator: Dazon Dixon Diallo, MPH the HIV Care Continuum Dianne M. Rausch, PhD Panelists: Moderator: Panelists: Michele Andrasik, PhD, EdM, MA Benjamin Young, MD, PhD Jason Farley, PhD, MPH, CRNP JoAnne Keatley, MSW Panelists: Robert Remien, PhD Patrick Yankee José A. Bauermeister, MPH, PhD Jane M. Simoni, PhD Bich Dang, MD Jason Farley, PhD, MPH, CRNP Glen Pietrandoni, RPh 2:30pm-2:45pm Break

PANEL • OCEAN BALLROOM 2

2:45pm-3:45pm Data to Care: Leveraging Public Health Partnerships Across the HIV Care Continuum Moderator: Patrick Sullivan, PhD, DVM Presenter: Eugene McCray, MD Panelists: Julia Dombrowski, MD, MPH; Jorge Saavedra, MD; Baligh Yehia, MD, MPP, MSHP

3:45pm-4:00pm Break

TIME ACTIVITY OCEAN BALLROOM 2 PROMENADE POMPEII 4:00pm-5:00pm Thematic Oral SESSION 7 SESSION 8 SESSION 9 Abstract Sessions The “Big Picture” Psychosocial and Cognitive Linkage and Retention: Epidemiological Approaches Correlates of ART Adherence Global Perspectives to the Care Continuum 5:00pm-5:15pm Break

PRACTICE SETTING NETWORKING HOUR • PENTHOUSE 5:15PM-6:15PM Pharmacists Nurses Social Workers Psychologists Physicians

10 10th International Conference on HIV Treatment and Prevention Adherence TUESDAY, JUNE 30, 2015

TIME ACTIVITY 6:00am-6:45am Morning Run (Meet in Hotel Lobby) ISSUE INTEREST COFFEE TALKS (breakfast provided) • MONA LISA 6:30am-8:00am MSM Substance Users Sex Workers Children/Adolescents Women

MORNING SESSION • OCEAN BALLROOM 2

8:00am-8:30am 90:90:90 - Reinforcing Adherence as a Touchstone to Achieving 90% Viral Suppression Steve Morin, PhD

8:30am-9:00am Closing Quality and Relevance Gaps: Harnessing Technology to Facilitate HIV Care Scale-Up Reuben Granich, MD, MPH

9:00am - 9:15am Break

TIME ACTIVITY OCEAN BALLROOM 2 PROMENADE POMPEII 9:15am-10:15am Thematic Oral SESSION 10 SESSION 11 SESSION 12 Abstract Sessions Linkage and Retention: Facilitating ART Adherence: Large-Scale Programs to Domestic (US) Perspectives Individual, System, and Enhance Individual and Public Technology Interventions Health Outcomes 10:15am-10:30am Break

TIME ACTIVITY OCEAN BALLROOM 2 POMPEII 10:30am-11:30am Late-Breaker Oral SESSION 1 SESSION 2 Abstract Sessions Multiple Layers and Dimensions Large-Scale Programs to Enhance Individual PROGRAM SCHEDULE of HIV Adherence and Public Health Outcomes 11:30am-11:45am Break

TIME ACTIVITY OCEAN BALLROOM 2 PROMENADE POMPEII 11:45am-12:45pm Invited Speakers Health Financing Public Policy Legal Barriers Alan Whiteside, DEcon Jeffrey S. Crowley, MPH Catherine Hanssens, JD 12:45pm-1:45pm Lunch on Own

AFTERNOON SESSION • OCEAN BALLROOM 2

1:45pm-2:15pm Developing an “HIV Prevention Cascade”: Current Approaches and Future Directions K. Rivet Amico, PhD

2:15pm-3:15pm Biomedical HIV Prevention: Adherence Across Diverse Contexts and Cultures Moderator: Jessica E. Haberer, MD, MS Presenter: Kenneth Mayer, MD Panelists: Robert Grant, MD, MPH; Sharon Hillier, PhD; Rafael Mazín, MD, MPH

3:15pm-3:30pm Break

3:30pm-4:15pm RAPPORTEUR SESSION: Highlights from Adherence 2015 Michael J. Stirratt, PhD

4:15pm-5:15pm CLOSING PANEL: A 10-Year Journey Toward a Sustainable System of HIV Prevention and Treatment Adherence Moderators: K. Rivet Amico, PhD; Michael J. Mugavero, MD, MHSc Panelists: Kenly Sikwese; Julio S.G. Montaner, MD; Anna Zakowicz, MA, MIH; José M. Zuniga, PhD, MPH

5:15pm Adjourn

10th International Conference on HIV Treatment and Prevention Adherence 11 IAPAC is proud to honor two individuals at this year’s decade anniversary of the International Conference on HIV Treatment and Prevention Adherence with awards recognizing their contributions to HIV adherence science and practice. They were nominated by their peers on the conference Planning Committee, which had the unenviable duty of selecting two honorees from among a distinguished roster of equally deserving nominees. IAPAC extends its congratulations to the honorees and their fellow nominees.

2015 PIONEER AWARD FOR OUTSTANDING CONTRIBUTIONS 2015 RISING STAR AWARD FOR PROMISING EARLY CAREER TO HIV ADHERENCE SCIENCE/PRACTICE SCIENTIST/PRACTITIONER The Pioneer Award recognizes the achievements of an indi- The Rising Star Award for Promising Early Career Scientist/ Prac- vidual whose career has made significant contributions to titioner recognizes young researchers who demonstrate inno- the field of HIV adherence science/practice. The recipient will vation, originality, and quality in the field of HIV medication ad- have demonstrated a history of leadership or advocacy that herence science/practice. The honoree must be under age 40 has enhanced knowledge, education, implementation, or pol- and/or have completed their terminal professional training in the icies in HIV care. previous 10 years.

Steven A. Safren, PhD Jessica E. Haberer, MD, MS 2015 HONOREES Dr. Safren received his doctor of Dr. Haberer received her medical philosophy in clinical psycholo- degree from the Yale University gy from the University at Albany School of Medicine, as well as a (State University of New York) in master’s degree in Health Ser- 1998, and completed his intern- vices Research from Stanford ship and post-doctoral fellow- University. She completed an ship at Massachusetts General internship and residency in In- Hospital/Harvard Medical School. ternal Medicine at the University He is a Professor of Psychology of California, San Francisco. After in the Department of Psychiatry at Harvard Medical School and finishing her training, Dr. Haberer worked for the William J. Clin- Massachusetts General Hospital (MGH), an Affiliated Investigator ton Foundation HIV/AIDS Initiative in Beijing, China, where she at Fenway Health, the Director of the Behavioral and Social Sci- served as a Clinical and Research Advisor to the Chinese Cen- ences Core of the Harvard University Center for AIDS Research ter for Disease Control and Prevention/National Center for AIDS. (CFAR), and Director of Behavioral Medicine at MGH. After 18 Upon returning to the United States, she joined the Department years working in the Harvard University system, however, Dr. Sa- of Medicine at the University of California, San Francisco as a fren is starting as a Professor of Psychology at the University of Clinical Educator. Dr. Haberer developed an interest in adher- Miami in August 2015. Dr. Safren’s adherence-related research ence to antiretroviral therapy (ART) while in China and began has involved interventions to promote adherence, and a particu- studying multiple measures of ART adherence among children lar focus on mental health and substance use related syndemics. and adults in developing world settings. She joined the Massa- He developed and tested one of the first behavioral interventions chusetts General Hospital Center for Global Health and Harvard for increasing adherence to antiretroviral therapy (called Life- Medical School Department of Medicine in 2008, where she is Steps), which has subsequently been adapted for use as both a actively involved in the study of real-time adherence monitoring stand-alone intervention and part of multi-faceted interventions and intervention strategies for ART and pre-exposure prophylax- in a variety of domestic and international settings for HIV treat- is against HIV infection. Her current projects are based in Kenya, ment and in pre-exposure prophylaxis. Dr. Safren has completed South Africa, and Uganda. several trials of interventions that address mental health and substance use problems in the context of HIV/AIDS, including three adherence interventions for individuals with HIV and depression, and two secondary prevention trials for men who have sex with men with HIV. He has worked domestically and internationally supported by National Institutes of Health grants, as well as through the AIDS Clinical Trials Networks. Accordingly he has been principal investigator or protocol chair of 12 federally funded studies, and has over 230 peer-reviewed publications.

12 10th International Conference on HIV Treatment and Prevention Adherence MONDAY, JUNE 29, 2015

THREE TOP-RATED ORAL ABSTRACTS

9:00 A.M. – 10:00 A.M. / Ocean Ballroom 2 • Moderators: K. Rivet Amico, PhD; Michael J. Mugavero, MD, MHSc

34 Effect of Peer Mentoring to Improve 132 Delivery of Antiretroviral Therapy 174 Evidence that PrEP can “Do More”: Retention in HIV Care and HIV Viral Load Adherence Support Services by HIV Care Synergistic Effects on Primary Care, in Hospitalized, Out-of-Care Patients Providers in the United States Insurance Status, and Mental Health Thomas Giordano presenting John Weiser Presenting Sarit Golub presenting

THEMATIC ORAL ABSTRACT SESSIONS

SESSION 1 SESSION 2 SESSION 3 Perspectives and Performance Innovations in ART Adherence PrEP Dissemination and of Care Engagement Measurement Implementation 10:15 a.m. – 11:15 a.m. / Ocean Ballroom 2 10:15 a.m. – 11:15 a.m. / Promenade 10:15 a.m. – 11:15 a.m. / Pompeii Moderator: Amanda Castel, MD, MPH Moderator: Marijn de Bruin, PhD Moderator: Kenneth Mayer, MD

223 The Impact of Care Coordination Ser- 42 Experiences of Wisepill-Facilitated 184 “Kiki with your Doctor?!?” Developing a vices on HIV Care Outcomes among HIV Disclosure in Rural Southwestern Novel Social-Media Based Linkage-to- Formerly Incarcerated Individuals in Uganda Care Intervention for Men Who Have Sex Virginia Emily Pisarski presenting With Men (MSM) and Transgender (TG) Anne Rhodes presenting Individuals in New York City 179 Co-Calibration of Two Validated, Viraj Patel presenting 109 Improved Care Engagement and Self-Reported Measures of ART Adher- Viral Load Suppression among HIV ence in the CFAR Network of Integrat- 41 HIV Pre-Exposure Prophylaxis Capacity, Care Coordination Clients with Poor ed Clinical Systems (CNICS) Research Experience, Knowledge, Attitudes, and Mental Health, Unstable Housing, and Network and STTR Consortium Barriers among a National Sample of Substance Use at Baseline Heidi Crane presenting US Primary Care Providers and HIV Stephanie Chamberlin presenting Providers

210 Feasibility and Acceptability of Hair- Andrew Petroll presenting ORAL ABSTRACTS SCHEDULE 201 Client Perspectives on the HRSA/ SPNS and Dried Blood Spot-Derived ARV Systems Linkage and Access to Care Biomarkers as Objective Measures of 114 Familiarity with and Preferences for Oral Initiative Interventions: “People are Treatment Adherence in South Africa versus Long-Acting Injectable PrEP in a better off Having Services Like That Reuben Robbins presenting Nationally Representative US Sample of Available” Gay and Bisexual Men Kimberly Koester presenting 241 Utility of Dried Blood Spot-Derived ARV Jeffrey Parsons presenting Biomarkers as an Objective Measure 170 Project ACCEPT: Acceptability of a of Treatment Adherence in South Africa 118 All Science is Local: Engaging Commu- Behavioral Intervention to Promote Patricia Warne presenting nities to Enable Successful Imple- Engagement in Care for Youth Newly mentation of Antiretroviral Prevention Diagnosed With HIV Strategies Diana Lemos presenting Jessica Terlikowski presenting

10th International Conference on HIV Treatment and Prevention Adherence 13 MONDAY, JUNE 29, 2015 (continued)

SESSION 4 SESSION 5 SESSION 6 Re-Engagement Interventions ART Adherence Implementation Science in across Contexts Potpourri Biomedical HIV Prevention 11:30 a.m. – 12:30 p.m. / Ocean Ballroom 2 11:30 a.m. – 12:30 p.m. / Promenade 11:30 a.m. – 12:30 p.m. / Pompeii Moderator: Evelyn Tomaszewski, MSW, ACSW Moderator: Steven A. Safren, PhD Moderator: Benjamin Young, MD, PhD

17 Re-linkage and Retention in Care of 19 Effectiveness and Cost-Effectiveness 183 Diffusion 0f HIV Pre-Exposure HIV-Diagnosed Persons Presumed to of the Adherence Improving Self- Man- Prophylaxis into Specialist and Primary be Out-of-Care Based on New York agement Strategy (AIMS) Delivered in Care: A Qualitative Study with Primary City HIV Surveillance Data HIV Care Care Providers Chi-Chi Udeagu presenting Marijn de Bruin presenting Douglas Krakower presenting

161 Short-Term Navigation Can Lead to 39 Meanings of SMS Reminders for 10 Feasibility of Providing HIV Post- Successful Re-Engagement of Out-of- Adherence Support among Adults Exposure Prophylaxis Starter Kits in New Care Patients with HIV: Results of San Initiating ART in Rural Southwestern York City Sexually Transmitted Disease Francisco’s LINCS Navigation Program Uganda Clinics Erin Antunez pre¬senting Norma Ware presenting Emily Westheimer presenting

30 Out-of-Care PLHIV in St. Petersburg, 214 Multi-Level Barriers to Antiretroviral 74 Significant Uptake of Truvada for Pre- Russia, Can be Located and Suc- Treatment (ART) Adherence among Exposure Prophylaxis Utilization in the cessfully Reached in the Community Hijra-/Thirunangai-Identified Trans US in 2014 Through their Social Network Connec- Women in India: A Qualitative Investi- Staci Bush presenting tions gation Yuri Amirkhanian presenting Divya Ravi presenting 189 Impact of Option B on Mother-to- Child HIV Transmission in Rwanda: An 176 Personal Outreach by a Trained Social 51 Binge Drinking Decreases Weekend Interrupted Time Series Analysis Worker is an Effective Intervention to Adherence in an RCT from Low-/ Monique Abimpaye presenting Re-Engage Patients with HIV in Care Middle-Income Countries Lauren Richey presenting Raquel de Boni presenting

SESSION 7 SESSION 8 SESSION 9 The “Big Picture” Epidemiological Psychosocial and Cognitive Linkage and Retention: Approaches to the Care Continuum Correlates of ART Adherence Global Perspectives ORAL ABSTRACTS SCHEDULE 4:00 p.m. – 5:00 p.m. / Ocean Ballroom 2 4:00 p.m. – 5:00 p.m. / Promenade 4:00 p.m. – 5:00 p.m. / Pompeii Moderator: Thomas P. Giordano, MD, MPH Moderator: Tia Morton, RN, MS Moderator: José M. Zuniga, PhD, MPH

259 Diminishing “Clinic Viral Load” in a 206 Association between Alcohol and Sub- 175 Quantifying Variability in Missed Phar- Nationally Distributed Cohort in the stance Use Severity and Antiretroviral macy Visits among HIV-Infected Patients United States: What’s Adherence Got to Therapy (ART) Adherence over time in a after Initiation of Antiretroviral Therapy Do with It? Nationally Distributed Cohort of Patients in Zambia Jane Simoni presenting in Care across the United States Nancy Czaicki presenting Heidi Crane presenting 216 Feasibility of Using HIV Care Continu- 57 The MSM HIV Care Cascade in um Outcomes to Identify Geographic 182 Depressive Symptoms Mediate HIV-Re- Rio de Janeiro, Brazil Areas for HIV Testing lated Physical Symptoms on Adherence Rodolfo Castro presenting Amanda Castel presenting to Antiretroviral Medications Moka Yoo presenting 177 Social Support through Observational 20 Retention in HIV Care among a Trial Participation among HIV Patients in Commercially Insured Population, 204 The Impact of Disclosure on Adher- Southwest Uganda 2006-2012 ence in HIV-Infected Adolescents in Bridget Burns presenting Kathy Byrd presenting Botswana: A Longitudinal Study Harriet Okatch presenting 199 Age Matters: Inconsistent HIV Care 68 The Paradox of Retention among Adolescents and Young Adults in Daniel Feller presenting 116 The Role of Neurocognitive Function- Nigeria ing in the Day-Level Association be- Aimalohi Ahonkhai presenting tween Substance Use and Medication Adherence among HIV-Positive Gay and Bisexual Men H. Jonathon Rendina presenting

14 10th International Conference on HIV Treatment and Prevention Adherence TUESDAY, JUNE 30, 2015

THEMATIC ORAL ABSTRACT SESSIONS

SESSION 10 SESSION 11 SESSION 12 Linkage and Retention: Facilitating ART Adherence: Large-Scale Programs to Domestic (US) Perspectives Individual, System, and Enhance Individual and Public Technology Interventions Health Outcomes 9:15 a.m. – 10:15 a.m. / Ocean Ballroom 2 9:15 a.m. – 10:15 a.m. / Promenade 9:15 a.m. – 10:15 a.m. / Pompeii Moderator: Deborah Konkle-Parker, PhD, FNP Moderator: Jane M. Simoni, PhD Moderator: Christopher M. Gordon, PhD

26 From Their Own Perspectives, Why 193 The Effect of Antidepressant Treatment 33 Adherence to Pre-Exposure Prophylaxis Are Out-of-Care HIV-Infected African on HIV and Depression Outcomes: (PrEP) among Gay and Bisexual Men: American MSM Out of Care? Results from the SLAM DUNC Ran- Prevalence and Predictors of Missed Jeffrey Kelly presenting domized Controlled Trial Doses Brian Pence presenting Thomas Whitfield presenting 8 Clinical and Behavioral Characteristics in US HIV-infected Young Adults 205 Antiretroviral Prescription Delivery 188 Low Adherence in Vaginal Microbicide Linda Beer presenting for Persons Living with HIV/AIDS in Gel Trials? Opinions of Former Trial Alabama: Do Mailed Medications with Participants on Improving Adherence 21 Most Accurate Data Sources for Ob- Enhanced Pharmacy Services affect Lori Miller presenting taining Contact Information on Adults Biologic Outcomes? Diagnosed with HIV for Public Health Will Rutland presenting 104 Intentions to Initiate PrEP among Purposes Gay and Bisexual Men are Driven by Stanley Wei presenting 87 SMS Interventions to Improve An- Demographic Factors, Sexual Risk, and tiretroviral Therapy Adherence: A Pilot Perceptions of Providers: Results from a 1 HIV Care Measured Over Multiple Time Randomized Controlled Trial Nationally Representative Sample Periods Varies by Race and Ethnicity Jessica Haberer presenting H. Jonathon Rendina Michael Horberg presenting 171 Engagement is Key to Effectiveness of 244 “I Am Not a Man”: Trans-Specific Barri- Individualized Texting for Adherence ers and Facilitators to PrEP Acceptability Building (iTAB) Among HIV-Positive among Transgender Women Methamphetamine Users Jae Sevelius presenting David Moore presenting

LATE-BREAKER ORAL ABSTRACT SESSIONS ORAL ABSTRACTS SCHEDULE

SESSION 1 SESSION 2 Multiple Layers and Dimensions Large-Scale Programs to Enhance Individual and of HIV Adherence Public Health Outcomes 10:30 a.m. – 11:30 a.m. / Ocean Ballroom 2 10:30 a.m. – 11:30 a.m. / Promenade Moderator: Michael J. Stirratt, PhD Moderator: Reuben Granich, MD, MPH

281 Treatment to Improve Adherence and Depression among People 274 Treatment Refusal in South Africa in an Era of Expanded Antiretro- Living with HIV in Zimbabwe viral Therapy Availability – A Prospective Multi-Site Cohort Study Melanie Abas presenting Ingrid Katz presenting

287 Difference in Self-Reported Adher¬ence on Different Recall Intervals 280 The HIV Care Continuum for Housing Program Clients and over Time Between Males and Females in MACH14 Study Persons Living with HIV/AIDS Overall, New York City, 2013 Yan Wang presenting Ellen Wiewel presenting

276 Predictors of Adherence in Youth with HIV Enrolled in a Prospec- 269 Providing Technical Assistance to Health Departments on the tive Longitudinal Follow-Up Study of a Randomized Advance Care use of HIV Surveillance Data to Improve Health and Prevention Planning Intervention Kathleen Green presenting Patricia Garvie presenting 282 Improvements in Retention in Care and Viral Suppression: 289 Multilevel Factors Contributing to Women’s Entry, Engagement, Results from the First Year of the Medical Care Coordination and Adherence to HIV Treatment and Care Program in Los Angeles County Marcia Holstad presenting Wendy Garland presenting

10th International Conference on HIV Treatment and Prevention Adherence 15 16 1

HIV care. foroptimal These differencesshouldinformtargetingsub-populations be betteramongLatinos, thiswasnotreflectedinprescriptionsorBLQ. and thusBLQbyrace/ethnicity. and retentionmayeven While linkage equal accesstocare, we see Conclusions: ART. Further, theoveralldifferencesin%BLQdiminishedovertime. other racial/ethnicgroups, prescribed butnotwhenlimitedtopatients groups. Overall, %BLQwasalsohigheramong Whites comparedwithall percents prescribed ART inallyearscomparedwithotherracial/ethnic but notBlackscomparedwith Whites. higher Whites hadstatistically hadbetterretention(p<0.05)than Latinos Whites orBlacksinallyears, year. byrace/ethnicityforany differenceinlinkage statistical However, 5% Asian/Pacific Islander, and5%Other/Unknown, Therewasnota Results: ethnicity, withdifferencesassessedbychi-squarestatistics. mL lastmeasuredinyear). For eachyear, wecomparedmetricsbyrace/ months ofDHHS-defined ART inyear), andBLQ(HIVRNA<200copies/ ( patients; “linkage” (1stvisit/CD4within90daysofbeingidentifiedHIV+fornew in 2010(N=13,557), 2011(14,253), and2012(14,871). We measured HIV-positive KPmembers nia, Maryland, Virginia, all andtheDistrictofColumbiaweevaluated system providingequalaccessto Methodology: with equalaccesstocare. ORAL caresystem ferences byrace/ethnicityinthesemetricsanintegrated (ART),therapy andachievingviralsuppression(“BLQ”). We dif evaluate diagnosis,care at “retention” Background: 8 7 6 ABSTRACTS5 4 3 2 1 Jackie Blank William Towner Michael Horberg(presenting) ≥

2 medicalvisitsinyear Kaiser Permanente SouthernCalifornia, Los Angeles, CA, USA Kaiser Permanente NorthernCalifornia, SanLeandro, CA, USA Kaiser Permanente, Oakland, California, USA Kaiser Permanente Mid-AtlanticStates, Washington, DC, USA Oakland, CA, USA Kaiser Permanente NorthernCaliforniaDivisionofResearch, ofKaiserPermanente,HIV Initiative Oakland, CA, USA ofKaiserPermanente,HIV Initiative Rockville, MD, USA Mid-Atlantic States, Rockville, MD, USA Mid-Atlantic Permanente ResearchInstituteofKaiserPermanente Periods Varies byRaceandEthnicity HIV CareMeasuredOverMultipleTime The population was46% The population White, 24%Black, 20%Latino, ≥ 1 medicalvisitinyearforestablishedpatients), “retention” 1 , CourtneyEllis While outcomesgenerallyimprovedovertime, evenwith High qualityHIVcareisdefinedbyefficient “linkage” to 6 Kaiser Permanente health (KP)isaninsuredintegrated , Peter Kadlecik ≥ ≥ 60 daysapart), “prescription” (filled 13 yearsoldwith 3,4

significant differencesin ART prescription, in care, “prescription” ofantiretroviral , MichaelSilverberg 7 1,2 , CarolRemmers

, LeoHurley care forallmembers. InCalifor 3,4 ≥ 8 monthsmembership , DanielKlein

8 , RebeccaGambatese 3,4

5 ,

≥

- 3 10th International Conference on 10th International - 8 , 8 of prevention services witholderadults(n=12,835). of preventionservices chi-square teststocomparetheirclinical status, behaviors, andreceipt characteristics ofHIV-infected youngadults(n=359)anduseRao-Scott collectedbetween6/2009-5/2012,weighted MMPdata wedescribethe HIV-infected adultsreceivingmedicalcare intheUnitedStates. Using sampleof amongarepresentative clinical surveillance andbehavioral Methodology: described. the characteristicsofHIV-infected notbeenwell youngadultshave 25+(“olderadults”).continuum comparedwiththoseaged However, eachstepoftheHIVcare pooreroutcomesat (“young adults”)have Background: 1 R. LukeShouse Linda Beer(presenting) health; enhanced services foryoungadultsmaybeneeded. health; enhancedservices HIV-infected barrierstoachievingoptimal youngadultsmayfacegreater and 66%werenotdurablyvirallysuppressed. Evenamongthoseincare, levelsofyoung adultshadsignificantlylower ART useandadherence, asevidencedbyregularviralloadtesting,similar levelsofengagement young adults, werealsomorecommon. sexualriskbehaviors Despite Conclusions: duction counselingbyahealthcareprovider(73%vs. 43%, p<0.0001). <0.0001). Moreyoungadultsthanolderreceivedsexualriskre partner, comparedto24%and12%ofolderadults, respectively(bothp status orunknown out acondomand24%didsowithanHIVnegative respectively (allp=0.4044). Inthepast12months, 39%hadsexwith the past12months, comparedto91%, 86%, and61%ofolderadults, the pastthreedays, and33%weredurablyvirallysuppressedover (ART),taking antiretroviraltherapy 73%wereadherentto ART over Results: Centers forDiseaseControlandPrevention, Atlanta, GA, USA in USHIV-Infected Young Adults Clinical andBehavioralCharacteristics Among HIV-infected youngadultsincare, 70%werecurrently Although receiptofpreventioncounselingwashigherin Recent data indicate HIV-infected 18-24 indicate personsaged Recentdata The MedicalMonitoringProject(MMP)conducts 1 HIV Treatment andPreventionAdherence 1 ,

Christine Mattson 1 , JosephPrejean 1 ,

- - 10 10th International Conference on 10th International variety ofmedicalfacilities. awide into regularclinical at such asPEPcanbeincorporated services testingmaybeburdensome.ciated BiomedicalHIVpreventionstrategies regimen inclinical settingswhereprovisionofthefullcourseandasso providing PEPinNYCSTD Recommendations: theinitialreferralappointment. attended full 28-dayregimen. Facilities 87%(149/172)ofpatients reportedthat calls, reachedreportedcompletionofthe 105of111(96%)patients reported takingthemedication. toDay30 responserate Despitealow starter kitacceptedit. reachedonDay2, Of167patients 163(98%) through December2014, Lessons Learned: appointments. follow-up at attendance patients’ and successfullinkage. Referralfacilitieswerecontactedtoconfirm DOHMH STDstaffonDays2and30todetermineregimenadherence testing. Patients whoacceptedthestarterkitwerecontactedbyNYC ing theremainderof28-daycoursemedication, HIV andfollow-up evaluation,comprehensive medicalandlaboratory assistanceinobtain with referraltoanotherfacility. Referralfacilitieswereresponsiblefora 3-day “starter kits” ofa3-drug Description: select high-riskexposuresinthepast36hourswereeligible. (STD) ClinicsbeganofferingPEP ‘starter kits’in2014. Patients reporting Health andMentalHygiene’s (NYCDOHMH)Sexually Transmitted Disease forHIVprevention.utilized intervention The New York CityDepartmentof tion afterahigh-risksexual Introduction: 1 Shruti Ramachandran Thomas Cherneskie Emily Westheimer (presenting) Clinics New York CitySexually Transmitted Disease NY, USA New York CityDepartmentofHealthandMentalHygiene, New York, Exposure ProphylaxisStarterKitsin Feasibility HIVPost- ofProviding We conductedafeasibilityassessmentofprovidingfree, Use of antiretroviral medication forpreventionofHIVinfec Use ofantiretroviralmedication Acceptance ofPEPstarterkitswashigh. From April 1 , Pei-Chi Chung Use of3-daystarterkitsisafeasiblemethod 1 , SusanBlank

97% (202/209) of eligible patients offeredthe 97% (202/209)ofeligiblepatients clinics ofthe fortimelyinitiation andallows

exposure (PEP)hasbecomeanincreasingly

PEP regimentoeligiblepatients, along 1 , JulieMyers 1 1 , MayraOrtiz HIV Treatment andPreventionAdherence 1 ,

1 ,

- - - 17 Methods: withretention-in-careafterre-linkage. associated andre-linkthemtocare.to locate We examineretentionandfactors toidentifyPLWH registry surveillance presumedtobeout-of-care(OOC) in-care inUS. In2008, theNYChealthdepartmentbeganusingitsHIV mortality andriskofonwardHIVtransmission;only51%areretained- tion incontinuouscaretoimproveclinical outcomes, reduceHIV-related Background: 1 Sarah Braunstein Chi-Chi Udeagu(presenting) Data Surveillance be Out-of-CareBasedonNewYork CityHIV fully lead to reengagement andlong-termretention-in-care.fully leadtoreengagement andthenre-linkthemtoHIVcarecansuccess data using surveillance Conclusion: with malesex, Hispanicethnicityandage 49% inyear5. Retention-in-careand VL suppressionwereassociated to-care increasedfrom52%inyear2to64%4, thendippedto Proportions ofPLWH withsuppressed VL aftertheirreturn(77%inyear2to56%5).year offollow-up ≥ care, leastonecareappointment, 76%-86%keptat and57%-65%kept Hispanic (30%), oraged Most OOC-PLWH whoreturned-to-careweremale(59%), black(64%)or re-linked tocare, ofwhom92%re-linkedwithin6months;44%refused. care (35%), moved(5%), died/otherreasons(3%). Ofthe803OOC, 56% were confirmedtobeOOCinNYC;othersfoundcurrent-with- Results: for assessingretention-in-careintheyearofdeath. wereexcluded recordsmatching fromthedenominator surveillance-vital data.was confirmedusingsurveillance PLWHhave died via confirmedto PLWH lackinglabreportsfor receiving care. From 1/08-12/12, andre-link1585 wesoughttolocate

2 appointments. UniquePLWH wereconsistentlyretained-in-careeach New York CityDepartmentofHealthandMentalHygiene, New York, NY, USA We traced1,402/1,659 (85%)presumedOOC-PLWH: 803(57%) HIV-Diagnosed Persons Presumedto Re-Linkage andRetentioninCareof A CD4or wasconsideredaproxyfor VL reporttosurveillance Health department-based initiatives to identifyOOC-PLWH Healthdepartment-basedinitiatives Persons livingwithHIV(PLWH) andreten requirelinkage 1 ≥ 40 years(68%). Inyears2-5afterreturn-to- ≥ 1 9 months. Returnandretention-in-care , Christopher Williams , ≤ ≥ 400 copies/mLafterreturn- 40 years. 1 ,

- - ORAL ABSTRACTS 17 18 19

be consideredforthewide-scaleadoptioninroutinecare. thelong-termimpact. willestimate ongoing modellingstudy AIMS should effective andmostlikely Discussion: ranges from55%to95%. more effectivethan TAU), andtheprobabilitythat AIMS iscost-effective that cost-effectiveness analysesshow and AIMS wasdominant(cheaper thisfinding.corroborate costswere$94/patient/year. Theintervention All analyses(OR:3.09,1.06-3.89) andtreatment-failure 95%CI1.18-7.94) 7.23, p=.008). detectable-undetectable(OR:2.03,The secondary 95%CI that log-transformed viralloadsshow AIMS waseffective(F(1,199) = of14.5months.follow-up effectivenessanalysesusing The primary Findings: willingness-to-pay. were costperunitreductioninviralloadandQALY, to inrelation a societalandhealthcareperspective. outcomemeasures Primary bothfrom a timehorizonofoneyear(trial-basedeconomicevaluation); ity-adjusted lifeyears(QALYs) andunitsimprovementinviralloadwith (logistic) regressionmodels. Cost-effectivenesswasexaminedforqual viral loads). analyseswereconductedusingmixed-effects Intent-to-treat failure(definedas2consecutivedetectable undetectable andtreatment outcomeswereviralloaddetectable/ come waslogviralload;secondary domised to AIMS or Methodology: and cost-effectivenessof AIMS comparedwithtreatment-as-usual. ORAL theeffectiveness multi-centre RCTwasdesignedtodefinitivelyevaluate impact onadherenceandviralloadinasingle-centreRCT. The current inputinapilot-study.HIV nursesandpatient an Ithasdemonstrated designed tofitinroutineHIVcare, with anddevelopedcollaboratively intervention (AIMS)isatheory-based Strategy ing self-Management on adherence, viralsuppression, andcosts. The Adherence Improv Antiretroviral forHIV Therapy Background: ABSTRACTS4 3 2 1 Silvia Evers Marijn deBruin HIV Care (AIMS)Deliveredin Management Strategy

Maastricht University, Maastricht, Academic MedicalCenter, Amsterdam, NETHERLANDS University of Amsterdam, NETHERLANDS University of Aberdeen, SCOTLAND 213/223participantscompletedthetrialwithamean of the Adherence Improving Self- of theAdherenceImproving Effectiveness andCost-Effectiveness 4 , Wolfgang Viechtbauer This trial demonstrated that the that is This trialdemonstrated AIMS-intervention Few topromoteadherence scalableinterventions 223 patients in7HIVclinics223 patients intheNetherlandswere ran

(presenting)

treatment-as-usual. effectivenessout The primary

cost-effective evenwithinthetrialperiod. An

have demonstrated ameaningfulimpact demonstrated have 1 , EdwinOberje 4 , JanPrins NETHERLANDS 2 3 , Hans-ErikNobel

, 10th International Conference on 10th International

- - - - 20 defined as six-months ofthe24-monthretentionperiod. Retention-in-carewas during each12-monthperiod, andwith persons aged codestoidentifyPLWHICD-9-CM diagnosis andrestrictedanalysesto of PLWH whowereretained, continue, incare. andre-engaged We used Commercial claims to databases Methodology: 51% ofpersonslivingwithHIV(PLWH) areretainedincare. viral loadsuppressionand Background: 1 Kathy Byrd(presenting) 2006-2012 through receipt of HIV-related laboratory services. through receiptofHIV-related laboratory incare definition continuedengagement who didnotmeetthestudy continued incareforanextendedperiodoftime. A significant proportion mercially insuredcohortare Conclusions: testing. HIV-related laboratory Thirty-five to43%ofPLWH considerednot-in-care continuedtoreceive (allP<0.05).hol abuseweremorelikelytoexperienceagap-in-care experience agap-in-care, withsubstance/alco whilethosediagnosed mental illnessdiagnoses, andthose40-59yearswerelesslikelyto incare.care; 70%ofthesere-engaged PLWH with continued-in-care for84months. 1,551PLWH experienced were retained-in-careand, Results: withgaps-in-care. associated Cox proportionalhazardsmodelswereconductedtodeterminefactors care, tests, whoreceivedHIV-related laboratory wasalsodetermined. care as defined asnoofficevisit claimfor>6monthsandre-engagement-in- visit claim duringeachsubsequentsix-monthinterval. was Gap-in-care first 24-monthperiod. wasdefinedas Continuation-in-care

Centers forDiseaseControlandPrevention, Atlanta, GA, USA ≥ Of 7,913commerciallyinsuredPLWH identifiedin 2006, 77% 1 claim afteragap-in-care. The proportionofpersonsnot-in- Commercially InsuredPopulation, Retention inHIVCareAmonga ≥ 1 officevisit claim duringeachsix-monthperiodofthe ≥ Our estimates ofretentioninHIVcareamongthiscom Our estimates Poor withdecreased retentioninHIVcareisassociated We usedthe2006-2012 Truven HealthMarketScan 18 yearswith HIV Treatment andPreventionAdherence 1

, MelissaFurtado increased mortality. Nationally, anestimated

among thosecontinuouslyenrolled, 65%

higher than national estimates.higher thannational The majority ≥ 10 monthsofcontinuousenrollment

determine theunweightedproportion ≥ 1 officevisit claim inthefirst 1 ,Bush Tim ≥ 1 co-morbidities, 1 ≥ ≥ 1 gaps-in- 1 office

- - 21 10th International Conference on 10th International personsinHIVcare.make themmorehelpfulforre-engaging would databases intocasesurveillance importing contactinformation data. providingthemostaccurate ities andHIVsurveillance Routinely successin greater Conclusion: respectively. and Ryan in53%,White data 44%, 18%, 16%, and11%ofcases, system,surveillance peoplesearchengines(e.g., Accurint orSpokeo), by HIVcarefacilities, HIVcase surveillance, disease anintegrated persons,1,191 (60%)located contactwasprovided allowing information didnot. as2%injurisdictionsthat reportsandaslow laboratory Among from routinelyimportedcontactinformation as 41%injurisdictionsthat wasashigh data phone numbercouldbeidentifiedfromsurveillance respectively. The proportionofsampledpersonsforwhomanaccurate address, orHIVcarefacilityfor20%, 41%, and72%ofsampledpersons, phonenumber,at leastoneaccurate of identification allowed lance data Among 1,992personswithcompleterecruitmentdata, HIVcasesurveil Results: source andaccuracy ofcontactinformation. 2,000sampledpersons, andinterview sourcestolocate data recording areas. From November2012-June2014, tousemultiple weattempted care, andmetropolitan registriesinfivestate fromHIVcasesurveillance sampleofHIV-diagnosed adults,tative including thosenotreceivingHIV projectisapilotHIV stration Methodology: hasnotbeenperformed. sourcesinthispopulation different data sons. from comparisonoftheutilitycontactinformation A systematic andcontactingHIV-diagnosed per relyonlocating health activitiesthat incareareimportantpublic Understanding andimprovingengagement andHIV risk fordeath Background: 7 6 5 4 3 2 1 Stanley Wei (presenting) Amy Rock-Wohl Kendra Johnson Mabel Padilla Health Purposes Adults DiagnosedWithHIVforPublic

Centers forDiseaseControlandPrevention, Atlanta, GA, USA Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, DepartmentofHealth,Mississippi State Jackson, MS, USA Washington DepartmentofHealth, State Shoreline, WA, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA andKingCounty,Public HealthSeattle Seattle, WA, USA We sourcetypesforcontactinformation. queried24data for ObtainingContactInformationon Most AccurateDataSources Use of multiple sources of contact information likelyyielded Use ofmultiplesourcescontactinformation 1 , SusanBuskin HIV-infected persons not receiving HIV care are at elevated HIV-infected elevated personsnotreceivingHIVcare areat The Case-Surveillance-Based Sampling(CSBS)demon The Case-Surveillance-Based 7 5 , JosephPrejean , LeandroMena

contacting HIV-diagnosed adultswithHIVcarefacil

transmission comparedtothosereceivingcare. 1

surveillance system that selectsarepresen systemthat surveillance 2 , Alison Hughes , Alison 5 1 , SusanScheer , Alexandra Oster , Alexandra HIV Treatment andPreventionAdherence 3 , Thomas Jaenicke , Thomas 3 , Chi-ChiUdeagu 1 , JacekSkarbinski

4 , 6 , - - 1 - , - - 26 the perspectivesofout-of-carePLHIVthemselves, especially African views,about treatment-related barriers, ofcarefrom andfacilitators non-retention,examined predictorsoftreatment butlittleisknown efforts cannotachievefullpublichealthimpact. Somestudieshave medical care, andtreatment-as-prevention theirhealthisthreatened care systems. into orre-engaged Untiltheyarereachedandengaged persons whoneverenteredcare, droppedoutofcare, orbecamelostto infection intheUSarenot Background: 2 1 Justin Rivas Jeffrey Kelly(presenting) American MSMOut-of-Care? care are essential for better engaging care areessentialforbetterengaging African-American MSMincare. with medicalcare, counteringstigma, andbolsteringsocialsupportsfor initiation. substanceuseandmentalhealthservices Betterintegrated emphasizing benefitsofearlyin thecommunitywithmessages ART tion ofillness. Conclusions: protect health, anddevelopmentofillnesssymptoms. social supportforcare, acceptanceofone’s to conditionandmotivations withproviders.cating Factors were careengagement felttofacilitate substance useandmentalhealthissues;(4)difficultiescommuni fear aboutrejectionin African-American andchurchcommunities;(3) isneededonly treatment Results: MAXQDA softwaretoidentifykeyemergingthemes. perspectives. weretranscribed, Interviews coded, andanalyzedusing fromthemen’sof reasonsformedicalcarenon-engagement own wereconductedtogainanunderstanding interviews In-depth qualitative whoreportednorecentHIVmedical carevisits.ican MSMinMilwaukee protocol torecruitacommunity Methodology: American MSM. Medical Collegeof Wisconsin, Milwaukee, WI, USA Milwaukee,USA WI, Center for Research,AIDS Intervention MedicalCollegeof Wisconsin, Reasons forbeingoutofcareincluded: medical (1)beliefsthat are Out-of-CareHIV-Infected African From TheirOwnPerspectives, Why 1 , KevinBrown

ART isoftenseenasneededonlywhenill, notforpreven Between one-third and half of persons diagnosed withHIV Between one-thirdandhalfofpersonsdiagnosed Community-level interventions areneededtoreachPLHIV Community-level interventions Online andvenue-basedannouncementswereusedina

when illnesssymptomsdevelop;(2)stigmaand

1 receiving regularmedicalcare. These include 1 , Yuri Amirkhanian , MichelleBroaddus

sample of30HIV-positive African-Amer 1 1 , JuliaDicksonGomez - 2 - - , ORAL ABSTRACTS 19 20 30

segment of PLHIV who are otherwise very difficulttoreach. segment ofPLHIVwhoareotherwisevery engagement, re-engagement, andadherenceamongalargepopulation toincreasecare promisefordeliveringintervention holdsgreat strategy by meansoftheirsocial Conclusions: (n =10)refused ART and16%(n=8)stopped ART. to 51%(n=26), notstartedyet, 14%(n=7)wereofferedbuthave 20% adherence. Among 31%(n=51)noton ART, wasneveroffered therapy = 114)wereon ART, and32%ofthem(n=36)reportedsuboptimal ART >6months).care appointments Among 165participantsincare, 69%(n enrolled. 26%(n=58)ofPLHIVnetworkmemberswerenotincare(no median =4). 54%(n=223)outof411namednetworkmemberswere networks. The networkssized Results: and measured theirHIVcareengagement ART adherence. network. Assessments confirmedparticipants’HIV-positive and status PLHIVfriends,asked toinvitetheirown establishinga2-ringsociocentric her HIV+friendsintothestudy, who–whenrecruitedinturnwere or reportedpoor ART adherence. At enrollment, eachseedinvitedhis/ to recruitHIV+ “seeds” inthecommunitywhowereoutofmedicalcare Petersburg, Russia, online, ORAL Methodology: cascade. treatment inmedicaltreatment,reached toengage aneglectedpointon theHIV the largepoolofout-of-carePLHIVhiddenincommunitymustbe ment-as-prevention toachieveitsfullimpactonapublichealthscale, never entered, droppedout, orbecamelosttocaresystems. For treat care. in Careengagement ABSTRACTSIntroduction: 2 1 Anna Kuznetsova Yuri Amirkhanian(presenting) Through TheirSocialNetworkConnections Successfully ReachedintheCommunity Botkin HospitalforInfectiousDiseases, Moscow, Milwaukee,USA WI, Center for Research,AIDS Intervention MedicalCollegeof Wisconsin, A totalof223PLHIV, mostlyPID, were recruited within25 Russia, canbeLocatedand Out-of-Care PLHIVinSt. Petersburg, One canreachout-of-carePLHIVhiddeninthecommunity At leastone-thirdofPLHIVintheUSarenotmedical As part of a social network intervention trialinSt.As partofasocialnetworkintervention 2 , Anastasia Meylakhs , Anastasia

network connectionswithotherPLHIV. This

Russia isevenlower, including PLHIVwho

venue-based, wereused andotherstrategies

from 2to44members(mean=9.04, 1 , JeffreyKelly 2 , AlexeiYakovlev 1 ,

RUSSIAN FEDERATIONRUSSIAN 2

10th International Conference on 10th International - 33 Thomas Whitfield(presenting) Missed Doses Bisexual Men:Prevalence andPredictorsof adherence patterns intheprior30and90days. adherence patterns were foundtobecurrentlyon Methodology: project. bisexual men(GBM)notinvolvedinademonstration PrEPadherenceinasampleofgayand seekstoinvestigate study foundadherencetobesuboptimal. projectshave stration The present effective, adherenceto Background: 2 1 Jeffrey Parsons medication andplanaheadfortimeswhentheymaynotbe home. medication to exploreeffectivewayshelpPrEPusersremembertaketheir adosewasmissed.occasion that Futureresearchshouldbeconducted likelyhadlittlepotentialforexposureintherare participants inthisstudy week of Truvada tobeeffectiveinthepreventionofHIV, hasbeenshown high relatively volition have Conclusions: eitherthedaybeforeorofamisseddose. mission riskbehavior home withouttheirpills(26%). OnlytwoparticipantsreportedHIVtrans most commonreasongiven, bybeingsomewhereotherthan followed income, race/ethnicity, status. orrelationship Forgetting (48%)wasthe had missedadose(p=.01);nosignificantdifferenceswerefoundfor proportion ofmenwithacollegedegree(63.9%)thanwithout(25.0%) past 90days;themajority(90%)missedsixdosesorfewer. A greater doses orfewer. inthe missedany Nearlyhalf(48%) reportednothaving 30 days. missedadose,Among thosehaving 92%reportedmissing2 Results: Brooklyn College, Brooklyn, NY, USA City UniversityofNew York, NY, USA In total, dosesintheprior missedany 69%reportednothaving Prophylaxis (PrEP)AmongGayand Adherence toPre-Exposure InorderforPrEPintheformofonce-daily Truvada tobe This study indicates that GBM taking PrEP on their own GBMtakingPrEPontheirown that indicates This study In a US representative sampleof1,071GBM,In aUSrepresentative 52(6%) 1

scheduled dosesisnecessary. Ongoingdemon HIV Treatment andPreventionAdherence

adherence. 3dosesa Giventheresearchthat

PrEP. ontheir These menprovideddata 1 , ChristianGrov 2 , H. Rendina Jonathon - 1 - , 34 10th International Conference on 10th International further study. a shorthospital stay. warrant Enhanced or moreprolonged interventions with analysessuggestedthebenefitofthisprogramamongpatients atory HIVcare in outpatient Conclusions: (<7days). with ashorterlengthofhospitalization of hospitalization, withevidenceofabenefitfrommentoringinpersons andlength asignificantinteractionbetweentheintervention ses indicated comes, including theretentionincareand VL change, butpost-hocanaly 0.94). out There alsowerenodifferencesinpre-specifiedsecondary outcome(P= percent oftheparticipantsinbotharmsmetprimary acteristics did not differ between the randomized groups. Twenty-eight mm 67% non-Hispanicblack;65%withenrollmentCD4cellcount<200cells/ analysis.ified intent-to-treat age was42years; 74%male; Themedian Results: months afterdischarge, withmissingvaluessettofailure. discharge) and VL improvement( carevisitswithin30daysandbetween31180after primary outcomewasacompositeofretentionincare(completedHIV primary HIVtransmission. provideddidacticsessionsonavoiding intervention The 5 phonecallsinthe10weeksafterdischarge. The attention-control sessions withavolunteerpeermentorwhilehospitalized, by followed skillsaroundHIVself-care,and behavioral andincluded twoin-person wasdesignedtoincreaseinformation,The intervention motivation, with HIVinfectionorwereoutofcare.and wereeithernewlydiagnosed mentor intervention. Methods: rigorously tested. in HIVcare. Peer mentoring Background: 5 4 3 2 1 Melinda Stanley Rivet Amico K. Thomas Giordano(presenting) Load inHospitalized, Out-of-CarePatients DeBakey VA MedicalCenter, Houston, TX, USA Harris HealthSystem, Houston, TX, USA Northwestern University, Evanston, IL, USA University ofMichigan, Ann Arbor, MI, USA Baylor CollegeofMedicine, Houston, TX, USA 3 ; 11% diagnosed withHIVinfectionwhilehospitalized.; 11%diagnosed Baselinechar We enrolled460participantsin3years;417werethemod We conductedarandomized, controlledclinical trialofapeer Retention inHIVCareandViral Effect ofPeer MentoringtoImprove Although peermentoringdidnotincrease re-engagement Few interventions have been shown toimproveretention beenshown Few have interventions 2 , MichaelKallen 1

Eligible adultswererecruitedwhilehospitalized,

among allhospitalized, out-of-carepersons, explor

is usedinsomesettings, buthasnotbeen 3 , Jackie Wear, 1 ≥ , JeffreyCully 1 log HIV Treatment andPreventionAdherence 10 decline fromenrollment VL) 6 4 , ChristineHartman 1 , JessicaDavila 1 , 5

, - - - - - 39 Methodology: research reportedhere. work. We addressthese “how” and “why” questionsinthequalitative fectively designedandimplementedifweunderstood of impacthasbeenmodest. couldbemoreef SMS-basedinterventions adherence inrandomizedcontrolledtrialsKenya, butthemagnitude support in Africa. withimproved beenassociated SMSremindershave Background: 3 2 1 Melanie Tam Norma Ware (presenting) Initiating ART inRuralSouthwesternUganda tion toreinforceadherenceandimproverates. moral meaningforadultstaking ART. This enhancesthereminderfunc Conclusions: well.” to adherenceandasenseofresponsibility “carers” to “take medicine cause theyfeltcaredabout. This inturninspiredrenewedcommitment being “encouraged” and “strengthened” intheiradherenceeffortsbe cope with ART, theywere butrather “cared about.” reported Interviewees of “help,” theywerenotbeingleftaloneto signifyingtorecipientsthat also promotedadherenceinanotherway. Reminderswereseenasforms “develop thehabit” oftaking day.ART thesametimeevery at Butthey Results: of effect weredevelopedandlinkedtoexplainreminders’ categories tively analyzedforcontentrevealing reminderswork.”“how Conceptual werecodedusing data software,interview Atlas.ti qualitative theninduc use ofSMSreminders, and(c)socialsupportreceived. Transcribed covering: (a)experienceswiththe Wisepill device, (b)acceptabilityand with Wisepill. Participants interviews tookpartinindividualqualitative on adherence, asmeasuredthroughreal-timeelectronicmonitoring assess theeffectsofSMSremindersandSMS-triggeredsocialsupport to developmentstudy da wereenrolledinamixed-methodsintervention

Massachusetts GeneralHospital, Boston, MA, USA Mbarara UniversityofScienceand Technology, Mbarara, UGANDA Harvard MedicalSchool,Harvard Boston, MA, USA . Participants reporteddailySMSremindershelpedthem Adherence SupportAmongAdults Meanings ofSMSRemindersfor 1 , Esther Atukunda , ReceivingSMSadherenceremindershasemotionaland SMS text messaging isapromisingtoolfor SMStextmessaging ART adherence Sixty-three adults initiating Sixty-threeadultsinitiating ART inruralsouthwestUgan 1 , Monique Wyatt , 2 , Angella Musiimenta , Angella 1 , EmilyPisarski 2 , JessicaHaberer how and 1 mechanism ,

why they - - 3 - - - ORAL ABSTRACTS 21 22 41 dures requiredtoprovidePrEP. andcomfortwiththeproce addressbothknowledge that interventions additional patients, couldalsobeimprovedthrough PrEPavailability than PCPs. Though current Conclusions: further education. module,an onlineeducational butonly42%wouldprescribePrEPafter Among providersnotcurrentlywillingtoprescribePrEP, 71%wouldtake toanotherprovider(p<0.01).22% ofHIVPspreferredtoreferpatients asked,or prescribe(81%)PrEPifapatient though48%ofPCPsand for PrEP. Among never-prescribers ofPrEP, mostwoulddiscuss(96%) referredtothem patients currently prescribingPrEPwerewillingtohave than PCPs(mean=22vs. 3patients). 89%ofHIVPsand57%PCPs of HIVPs), amongwhom, HIVPshadprescribedPrEPtomorepatients condoms vs. PrEP. Overall, 48%hadprescribedPrEP(21%ofPCPs;67% risk compensation, viralresistance, PrEPadherenceandtheutilityof Providers supportedPrEPingeneral, butweredividedontheissuesof levelsofcomfortthanHIVPs(p<0.01on 7 items).PCPs hadlower (e.g., discussingsexualorientation/activities, STIscreening), though levelsofcomfortwith8proceduralaspectsprovidingPrEP varying ≥ read theCDCPrEPguidelines(p<0.01)andhaddiscussedwith and 98%ofHIVPs(p<0.01). MoreHIVPs(83%)thanPCPs(36%)had Results: prevalence. ORALand 210HIVPsrecruitedfromthe Methodology: scale-up ofthispreventiontool. barriers topre-exposureprophylaxis(PrEP)provisioniscriticalthe (HIVPs) knowledge, Background: ABSTRACTS3 2 1 Timothy McAuliffe Andrew Petroll (presenting) and HIVProviders CareProviders Sample ofUSPrimary Attitudes, andBarriersAmongaNational 1 patient (89%vs.40%;p<0.01).1 patient Overall, providersreportedhigh, but University ofMinnesota, Minneapolis, MN, USA Boston Children’s MedicalSchool, Hospital/Harvard Boston, MA, USA Medical Collegeof Wisconsin, Milwaukee, WI, USA 86%ofparticipantshadheardPrEP, including 74%ofPCPs Capacity, Experience, Knowledge, HIV Pre-ExposureProphylaxis PrEPfamiliarityandexperienceishigheramongHIVPs care(PCPs)andHIVproviders’ Assessing primary We conductedan online, of171PCPs survey national 1

experience, attitudes, prescribingcapacity, and

PrEP prescribers report capacity tosee PrEP prescribersreportcapacity 1 , LauraBogart

10 UScitieswiththehighestHIV 2 , KeithHorvath 3

10th International Conference on 10th International - 42 southwest Uganda were enrolled in a mixed-methods intervention devel southwest Ugandawereenrolledinamixed-methodsintervention Methodology: examined here. User experiencesandconsequencesof disclosureWisepill-related are concerns aboutriskofHIVdisclosure whileusing Wisepill remain. ofdeviceacceptability;however, generallyhighrates Research shows (ART).is promisingforpromotingadherencetoantiretroviraltherapy Background: 3 2 1 Esther Atukunda Emily Pisarski(presenting) Uganda support overallhealthand ART adherenceforHIV-infected individuals. facilitating closure, someusersintentionallyuse Wisepill todisclose HIVstatus. By Conclusion: decline oradherencesupportbeneeded. network ofindividualstheycouldrelyonforhelpshouldtheirhealth consequences. Instead, someparticipantsfeltdisclosure expanded the few disclosures Wisepill-facilitated theexpectednegative generated abouttheirHIVstatus.conversation orunintentional,Whether deliberate Alternatively, a someparticipantsusedthedeviceasatooltoinitiate “being seen” with timesresultedinundesireddisclosure.Wisepill at its purposewhenquestionedaboutthedevice. Despitesuchefforts, crimination, disclosure usersavoided byhiding Wisepill orlyingabout riskfordisclosurethem at ofHIVstatus. Fearing anddis isolation “asked questions” aboutthedevice, astheseinteractionsmightput Results: riences, andconsequencesofdisclosure forparticipants. theme. weresubsequentlyre-examinedtounderstandfears, Data expe HIVdisclosure revealeddevice-related of codeddata tobeanemergent Transcribed werecodedusing data interview Atlas.ti software. Review acceptability anduseofSMSreminders, and(c)socialsupportreceived. covering:tive interviews (a)experienceswiththe Wisepill device, (b) monitoring with Wisepill. Participants tookpartinindividualqualita SMS-triggered socialsupport, asmeasuredthroughreal-timeelectronic opment study. The aimwastoassesstheeffectsofSMSremindersand Massachusetts GeneralHospital, Boston, MA, USA Mbarara UniversityofScienceand Technology, Mbarara, UGANDA MedicalSchool,Harvard Boston, MA, USA Some participants hesitated to Someparticipantshesitated “be seen” with Wisepill and disclosure, to Wisepill canincreasesocialresourcesavailable HIV Disclosure inRuralSouthwestern Experiences ofWisepill-Facilitated Although beingseenwith Wisepill cantriggerunwanteddis Real-timewirelessadherencemonitoringwith Wisepill Sixty-threeHIV-infected adultsinitiating ART inrural 2 , Angella Musiimenta , Angella HIV Treatment andPreventionAdherence 1 , Monique Wyatt , 2 , JessicaHaberer 1 , Melanie Tam, 3 , Norma Ware, 1 ,

- - 1 - - - 51 10th International Conference on 10th International dress itmayimproveadherenceinLMIC. drop-offs inweekendadherence. toad Screeningand newinterventions binge drinkers. Bingedrinking is apotentiallymodifiable determinant of initiation, treatment small at Conclusions: with smallerdifference. Haitisiteandreportingfair/poorhealthwereassociated while beingat 1.28-6.07). difference withgreater wasassociated Longertimeonstudy pointslargerthaninnon-bingedrinkers(CI95% 3.68percentage age taken onweekdaysandweekendsamongbingedrinkerswasaver p <0.001). Inmultivariableanalysis, thedifferenceinpercentofdoses 92.6% vs89.7%and93.7%inquarters1-4, respectively, all days thanonweekends(median: 96.0%vs94.4%;93.7%91.7%; leastonceinlast30days.drinking at Adherence washigheronweek male, was37 medianage Results: Equations. usingGeneralizedEstimating were evaluated 30 days, self-perceptionofhealth, arm, treatment site)andtimeonstudy and bingedrinking( characteristics (sex, age, CD4, viralload, yearsoncART, substanceuse each participantover4quarters(successive12-weekperiods). Baseline marized inpercentofdosestakenduringweekdaysandweekendsfor Adherence data, measuredbymicroelectronicmonitors, weresum failure. toincreaseadherenceafterfirst-linetreatment therapy observed middle incomecountries(LMIC) Methodology: end adherence, and2)predictorsofthisdifference. We aimedtoevaluate: 1)iftherewasadifferenceinweekdayvs. week among HIV-infected individualsiscrucial todesigntailoredinterventions. (cART)Therapy efficacy. Background: 6 5 4 3 2 1 Ann Collier Sandra Cardoso Raquel deBoni(presenting) Middle-Income Countries University ofPennsylvania, Philadelphia, PA, USA University of Washington, Seattle, WA, USA Port auPrince, HAITI etdeRecherches, deLaboratoire Institut National Centres Gheskio, Asociacion CivilImpactaSaludyEducacion, Lima, PERU Public Health, Boston, MA, USA in Center forBiostatistics AIDS Research(CBAR), Schoolof Harvard Cruz,Fundação Oswaldo RiodeJaneiro, BRAZIL Data for255(99%)participantswereanalyzed:Data 49.8%were Adherence inanRCTFromLow-/ Binge DrinkingDecreasesWeekend 5 , RobertGross Adherence is the cornerstone to Combination Adherence isthecornerstonetoCombination Antiretroviral Adherence wasworseonweekends. This differencewas ACTG 5234wasarandomizedtrialconductedin8low/ 1 , Grinsztejn Beatriz ≥ 5 alcoholic beverages onasingleoccasion)inlast 5 alcoholicbeverages

Understanding different patterns ofadherence Understanding differentpatterns 6

years. entry,At study 22.3%reportedbinge

but increasedovertimeandwaslargerfor 1 , LuZheng

which evaluated partner-basedwhich evaluated directly 1 , Alberto LaRosa HIV Treatment andPreventionAdherence 2 , SusanRosenkranz 3 , SamuelPierre 2 , XinSun - 4 - , - - 2 , - 57 in amobiletestingunitlocated Methodology: in RiodeJaneiro. testingstrategies throughinnovative cade amongMSMnewlydiagnosed cascade forthispopulation. aimedtoassesstheHIVcarecas This study affected. disproportionately Background: 4 3 2 1 Valdilea Veloso Lemos Katia Rodolfo Castro(presenting) white andyoungMSMshouldbeprioritized. prompt ART arecriticallyneeded. initiation targetingnon- Interventions tocareand toincreaselinkage strategies that cascade ofcareindicates policy andthetest-and-treat care coverage adoptedinBrazil, theMSM were abletoaccessahighrisk Conclusions: predictors ofretention, useof ART andviralsuppression. 2.481[1.054;5.838]) wasobserved. significant There werenostatistically tocareamongMSMolderthan30year-oldhigher linkage (RR[CI95%]= withaHIVdiagnosis.1.918[1.253;2.936]) wereriskfactorsassociated A (RR[CI95%] =1.632[0.956;2.785])andapriorHIV-testing (RR[CI95%]= non-white (RR[CI95%]=1.788[1.157;2.761]), apreviousSTD having were on ART, and50(38.17%)werevirologicallysuppressed. Being linked toHIVcare, 90(68.7%)wereretainedinHIVcare, 80(61.07%) (16.52%) wereHIV-infected. As Results: drug useandpriorHIVtesting. according toage, self-declared skin-color, education, ofSTD, history usinggeneralizedlinearmodels(GLM) wereestimated cascade-stages withHIV.those diagnosed risks(RR)ofindividualsinthe The relative CD4, (ART) from viralloadandantiretroviraltherapy longitudinaldata 12-month-after-HIV-diagnosis-censored cohortwasestablishedusing Secretaria deEstadoSaúdedoRioJaneiro, BRAZIL Latin America andtheCaribbean, Buenos Aires, ARGENTINA Lesbian,International Gay, Bisexual, Trans andIntersex for Association Grupo Arco- Íris, RiodeJaneiro, BRAZIL Cruz,Fundação Oswaldo RiodeJaneiro, BRAZIL From Jan-2013toJan-2014, 793MSMweretested, 131 Rio deJaneiro, Brazil The MSMHIVCareCascadein 1 , JoséGrangeiro Using out of health-care settings testing strategies we Using outofhealth-caresettingstestingstrategies Brazil has a concentrated HIVepidemicandMSM are Brazil hasaconcentrated 1 Data from793MSMtestedforHIVinaLGBTNGOand Data , Grinsztejn Beatriz

Yet, ontheHIVcare isavailable nodata 2 1 , BetoJesus , MarceloRibeiro-Alves

in agayfriendlyvenuewereanalysed. A MSM population. Despitetheuniversal of January 2015,of January 95(72.52%)were 1 3 , DenisePires 1 , MonicaDerrico 4 ,

1 , - ORAL ABSTRACTS 23 24 68 be an appropriate response to the changing nature ofHIVmedicalcare. responsetothechangingnature be anappropriate vulnerable populations. Personalized measuresofretentionincare may withviralloadsuppressionin in carewasmorestronglyassociated care weresuppressedontheir Conclusion: riskofbeingunsuppressed(p<0.05). aelevated housed wereat suppressed. whouseddrugsorwereunstably Non-retainedpatients Caucasian, andofhomosexualtransmissionriskweremorelikelytobe notretainedincare,Among patients thosewhowereolderthan45, ofviralloadsuppression. sensitivity(21.0%)asanindicator but low p <0.01). incarehadhighspecificity(82.2%) Continuousengagement retained(85.0%vs.load suppressionwashigheramongpatients 70.4%, suppression while6,863(79.3%) Results: ORALlogistic regression. measuresofvalidityand suppression wasexaminedusingstatistical Care Program. betweenretentionincareandviralload The relationship intheNew 173facilitiesparticipating review at York Qualityof State adult PLWH characteristicswasderivedthroughchart withvarying between thefirstandlastvisitofadjacentquarters. Asampleof8658 each 6-monthperiodofthe2-year Methodology: ABSTRACTS2013. within establishedHIVprogramsinNew York during2012and State suppression andcontinuousretentionasmeasuredbyclinical visits of retentionincare. betweenviralload We therelationship evaluated who pression amongpatients Background: 1 Daniel Feller (presenting) New York DepartmentofHealth, State Albany, NY, USA Of 8,658eligiblepatients, 7,093(81.9%)achievedviralload The Paradox ofRetention A large proportion of patients notcontinually retainedin A largeproportionofpatients Recent studies demonstrate varying likelihoodsofsup varying Recentstudiesdemonstrate Retention in care was defined as having hadavisitin Retention incarewasdefinedashaving 1 , Bruce Agins ,

do notmeetthecurrentformaldefinitions

final viralloadtest. Continuousretention

were retainedincare. ofviral The rate

review period with at least60days review periodwithat 1

10th International Conference on 10th International - 74 logistic regressionmodel. refills, medical claims, wereanalyzedvia demographics andpatient tember 31, 2014, wascollected. including De-identifieddata prescription 39% ofallU.S. 1, retailpharmaciesbetweenJanuary 2012, andSep from Btreatment. leveldata chronic hepatitis electronicpatient National excluding useforHIVtreatment, Methodology: tices. exploresthechangingcharacteristicsofUSPrEPusers. This study for pre-exposure Background: 1 Piontkowsky David Staci Bush(presenting) in theUS2014 percentages of people initiating PrEPareunder25. ofpeopleinitiating percentages 2014, whilethenumberofnewfemalestartshasremainedstatic. Small to beshiftingwithnewstartsincreasingconsiderablyamongmalesin ence. of The population appears TVD forPrEPusersintheUSnationally starting TVD forPrEPin2014 Conclusion: Median proportiondayscoveredwas78.2%(95%CI76.9-79.5%). 95% CI89.1–92.7%)thanthosein2013(69.6%, 95%CI66.9–72.2%). uals prescribed TVD in2014hadsignificantlyhigheradherence(90.9%, was 7.5%(95%CI6.6-8.4);females17.0%15.2-18.8). Individ ± 11.3)thanfemales(36.712.5). The proportionofmalesunder25 11.7 yearswith10.5%beingunder25old. Maleswereolder(38.8 male newstartsincreasedfrom53.7%to87.4%. was38.2± Meanage number offemaleshasdeclined slightly(177to153). The proportion of males perquarterhasincreasedsignificantly(205to1064), whilethe from 382in3Q2012to12173Q2014. The numberofnewstartsfor were included inthis Results: Gilead Sciences, Foster City, CA, USA A totalof5,272uniqueindividualswhostarted TVD forPrEP Pre-Exposure ProphylaxisUtilization Significant Uptakeof Truvada for There hasbeenasharpincreaseinthenumberofpeople TDF/FTC (TVD) was approved inJuly2012bytheUSFDA TDF/FTC (TVD)wasapproved An algorithmwasusedtoidentify TVD forPrEPuseby

prophylaxis (PrEP) in combination withsafersexprac prophylaxis (PrEP)incombination 1 , RobertinoMera

analysis. increasedby319% NewPrEPstartshave HIV Treatment andPreventionAdherence 1 , LeslieNg

with acorrespondingincreaseinadher

post-exposure prophylaxis, andoff-label 1 1 , Magnuson David 1 ,

- - - - 87 10th International Conference on 10th International virologic outcomes. should assesstheimpactofSMSandreal-timeadherencemonitoringon armsshouldbeexplored.and deliveredamongstudy Largerstudies months offollow-up. Differencesintypesofadherencesupportneeded adherence, althoughsignificant Conclusions: threemonths. undetectable (<400copies/ml)at in the Triggered SMSarmandControl. All butoneHIVRNAlevelswere at sixmonths.significance weresimilar Adherenceand>48-hourlapses (IRR 0.7, p=0.003)intheScheduledSMSarm. Differencesreached werelessfrequent was 9.0%higher(p=0.04)and>48-hourlapses and 4(2-16)intheControl, respectively. ComparedtoControl, adherence 95.8%) and8(2-10)inthe Triggered SMSarm, and92.0%(78.2-95.2%) (89.9-98.5%) and4(1-9)intheScheduledSMSarm, 89.8%(77.7- were94.2% Median (IQR)adherenceandnumberof>48-hourlapses of participantsweretakingoncedailytenofovir/emtricitabine/efavirenz. was 31years, andmedian Results: in dosingeventswerecomparedbyPoisson regression. >48-hourlapses equations; compared bylineargeneralizedestimating threeandninemonths.mined at Percent dosestakeneachmonthwas Adherence wasmonitoredinreal-time(Wisepill). HIVRNAwasdeter • CONTROL • • randomized (1:1:1): Methodology: adherence support. a pilotrandomizedcontrolledtrialcomparingmultipletypesofSMS been have results todate Background: 2 1 Nicholas Musinguzi Jessica Haberer(presenting) A PilotRandomizedControlledTrial Mbarara UniversityofScienceand Technology, Mbarara, UGANDA Massachusetts GeneralHospital, Boston, MA, USA added afterthreemonths TRIGGERED SMS– after threemonths SMS tosocialsupporters(ifnodosingeventsfor>48hours)added then triggeredSMS(byreal-timedetectionofmisseddosingevents); SCHEDULED SMS– Median follow-up inthisanalysiswas7.9months,Median follow-up medianage Antiretroviral TherapyAdherence: Antiretroviral toImprove SMS Interventions –NoSMS Cellular technology mayimproveadherence;however, Cellulartechnology Scheduled SMSremindersearlyin ART mayincrease Sixty-three individuals initiating Sixty-three individualsinitiating ART inUgandawere 2 , Bangsberg David starting at enrollment;SMStosocialsupporters starting at (dailyforonemonth, weeklyfortwomonths),

mixed. We findingsfrom presentpreliminary

enrollment CD4countwas322cells/ml;97% 1

differences didnotoccuruntilsix , Angella Musiimenta , Angella HIV Treatment andPreventionAdherence 1 2 , Esther Atukunda ,

- 2 , 104 H. JonathonRendina(presenting) Nationally RepresentativeSample Perceptions ResultsFroma ofProviders: by DemographicFactors, Sexual Risk, and uptake, particularlyperceptionsofPrEPstigmafromone’s networkand examinevariousbarrierstoPrEP intentions tobeginPrEPandfewthat beennolarge,have studiesofGBMfocusedon representative nationally examinedwillingnesstotakePrEP.smaller studieshave However, there beenconducted projects have Background: 3 2 1 Ana Ventuneac initiation. highlighting thecomplexroleperceptionsaboutprovidersplayinPrEP withPrEPintentions,provider stigmawerebothpositivelyassociated ically, aproviderwhoknewmenwereMSMandconcernsabout having begin PrEP, emphasizingtheneedforprogramsimprovingaccess. Iron intentionto socioeconomic status, greater insexualrisk)have engaging HIV epidemicismost Conclusions: result, andsocialstigmaregardingPrEPwerenotassociated. country, densityofhomeregion, population income, recentSTI-positive withintentionstostartPrEP.ciated Healthinsurancestatus, regionofthe fewer healthconsequencesofPrEP(p=.02)wereindependentlyasso = .01), incondomlessanalsex(p engaged having White p participant wasGBM(p (p younger age health consequences, andproviderstigma. Inamultivariablemodel, months. The barriersscalereducedtothreefactors–socialstigma, 16.2% intendedto;among Results: predictorsofPrEPuptakeintentions. behavioral multivariable logisticregressionexaminingstructural, demographic, and included amodifiedmeasureofperceivedPrEPbarriers. We conducteda tions inthenationally Methodology: providers. Hunter College, New York, NY, USA Brooklyn College, Brooklyn, NY, USA Studiesand Center forHIVEducational Training, New York, NY, USA

= .08), (p lessthancollegeeducation Morethanhalf(56.5%)werewillingtotakePrEP, thoughonly Demographically andbehaviorally,Demographically groupsinwhichthe Several largePrEPefficacy trialsanddemonstration 1

We 800HIV-negative GBMaboutPrEPinten surveyed , JeffreyParsons = .005), careproviderwhoknewthe aprimary having Gay andBisexual MenareDriven Intentions toInitiatePrEPAmong

concentrated (e.g.,concentrated younger, menofcolor, lower representative representative

= .04), p Blackrace(versusLatino

those, 58.0%intendedtodosowithinthree

with gay/bisexualmen(GBM)andseveral 3 1 , ChristianGrov One Thousand Strong One Thousand

= .001), beingsingle(p

= .003), perceiving 2 , ThomasWhitfield

panel, which = .04and -

- - 1 , ORAL ABSTRACTS 25 26 109

to engagement in HIV care and treatment adherence. inHIVcareandtreatment to engagement promise,shows including Conclusions: 95% CI: 1.18-1.27;RR 74% to90.5%onEiCandfrom18.9%40.9% VLS (RR RR and from21.8%to44.3%on VLS (RR CI:1.65-1.90); withunstablehousing, from63.8%to90.6%onEiC to 53.2%on VLS (RR with poormentalhealth, from68.5%to90.3%onEiCand30.1% respectively. Outcomesalsosignificantlyimprovedamongsubgroups 1.28-1.33) andfrom30.3%to54.4%(RR EiC and VLS increasedfrom69.6%to90.7%(RR mental health(30%). Among CCPclients overall, theproportionswith needs: unstablehousing(23%), Results: equations. (CIs)usinggeneralizedestimating confidence intervals risks(RRs)and those outcomespre-versuspost-enrollmentrelative testinthesecondhalfofyear).mL onlatest We for thencalculated ≥ We incare(EiC, assessedengagement >1yearbeforeCCPenrollment.through March2013anddiagnosed rollment outcomesfor5,941clients enrolledfromDecember2009 records, weexaminedbaseline Methodology: ORALaddress barrierstocareandtreatment. (CCP) utilizesaclient-centered, to teamapproach multidisciplinary The New York CityRyan White Part Program A HIVCareCoordination and aredifficulttoeffectivelyaddresswithinanHIV clinical caresetting. can posesignificantbarriers Background: ABSTRACTS3 2 1 Sarah GorrellKulkarni Stephanie Chamberlin(presenting) at Baseline Health, UnstableHousing, andSubstanceUse Care CoordinationClientsWithPoor Mental 1 ineachhalf-year)andviralloadsuppression(VLS)(VL VLS Centers forDiseaseControlandPrevention, Atlanta, GA, USA CUNY SchoolofPublicHealth, New York, NY, USA NY, USA New York CityDepartmentofHealthandMentalHygiene, New York, =2.03, 95%CI: 1.83-2.25), andwithrecentharddruguse, from A substantialproportionofCCPclients unmet demonstrated Client-centered, HIVcarecoordination multidisciplinary Poor mentalhealth, housinginstability, andsubstanceuse Using program data and surveillance-based laboratory laboratory andsurveillance-based Usingprogramdata Viral LoadSuppressionAmongHIV CareEngagementand Improved EiC 2 , McKayleeRobertson VLS = 1.32, 95%CI:1.28-1.36;RR = 2.17, 95%CI: 1.90-2.48).

among personswithkeypsychosocialbarriers

to achievingoptimalHIVcareoutcomes,

characteristics andpre-post-en recent harddruguse(16%)orpoor 1 EiC , Irvine Mary ≥ = 1.42, 95%CI: 1.36-1.48; 2 tests VLS = 1.80, 95%CI: 1.73-1.87), 3 , DenisNash ≥ EiC 90 daysapart, with 1 = 1.30, 95%CI: , RebekkahRobbins VLS =1.77, 95% 2 ≤ 200 copies/ EiC = 1.22, 10th International Conference on 10th International

- 1 , 114 Methodology: Methodology: a preferencefororalversusLAIPrEP. adherence,lower thoughitispresentlyunclear whetherindividualshave protection,greater particularlyamonggroupswhoarelikelytohave projects,suboptimal indemonstration thusLAIPrEPmayprovideeven a long-actinginjectable(LAI). Adherence toonce-daily Truvada hasbeen of HIVintheforms Background: 2 1 Thomas Whitfield Jeffrey Parsons (presenting) US SampleofGayandBisexual Men Injectable PrEPinaNationallyRepresentative availability ofLAIPrEPmayincreaseuptakebiomedicalprevention. availability perceive itspotentialhealthconsequencessimilarly, suggestingthe PrEP. GBMnotonlypreferLAIPrEPbutalso These resultssuggestthat LAI PrEPwasmorestronglypreferredthandailyorintermittentoral it, oforalPrEP. willingnesstoLAIPrEPwascomparablethat Infact, sample ofGBMwaslargely Conclusions: respectively. (3.1of4) for bothdailyandLAI-PrEP, rating average p on healthandthepotentialsideeffects, whicheachreceivedthesame taking PrEP, thetwomostsalientwerepotentiallong-lastingeffects 22.4%, 14.0%, and63.6%, respectively. Asked aboutthebarriersto between daily, intermittent, andLAIPrEP, participantpreferenceswere effective, whileonly14.2%preferreddailyoralPrEP. Asked tochoose PrEP andanother10.0%saidtheywouldpreferwhicheverwasmore choice betweendailyandLAIPrEP, nearlyhalf(46.6%)preferredLAI proportion (53.4%)expressedwillingnesstotakeLAIPrEP. Giventhe than half(56.5%)expressed Results: and preferencesfororalLAI-PrEP. gay andbisexualmen(GBM) Center for HIV Educational Studiesand Center forHIVEducational Training, New York, NY, USA Hunter College, New York, NY, USA A majorityofGBM(84%)hadneverheardLAIPrEP. More for OralVersus Long-Acting Familiarity WithandPreferences Somewhat unsurprisingly,Somewhat representative thisnationally PrEP has been shown tobeefficaciousinthe prevention PrEP hasbeenshown We recruited a nationally representative sampleof857 We representative recruitedanationally 2 , ChristianGrov

once-daily Truvada and, inemergingresearch, as HIV Treatment andPreventionAdherence

unaware ofLAIPrEP,unaware thoughoncetoldabout

willingness totakedailyPrEPandasimilar 1 , H. Rendina Jonathon

2 asked aboutbothwillingnesstotake 2

, = .94, p

= .20,

116 10th International Conference on 10th International is tailoredtosubstanceusers. andcarethat treatment ments –including toinformHIV theIGT–mayprovidenovelinformation neurocognitive functioningusingbrief, mobile(e.g., onatablet)assess effectsofdruguse.sensitize thebraintonegative The assessmentof cits donotdirectlyimpact Conclusions: (AOR =0.80, p reduced theoddsofnon-adherenceondayswhenclub drugswereused of IGTperformanceonnon-adherence, thoughbetterperformance non-adherence;marijuanadidnot.medication There wasnomaineffect 3.15, drinking(AOR=2.54, p=0.005)andheavy p intercept aswellage, race, andeducation. Bothclub druguse(AOR= ofperformanceinmultilevelmodelsadjusted forthe as anindicator RMSEA =0.02, CFI=.99, SRMR=.04. slopewasutilized The quadratic slopeforIGT and quadratic Results: each substance. IGT performanceandexaminedtheinteractionofwith club drug, marijuana, drinkinguseaswellindividual-level andheavy non-adherencebydaily multilevel modelingtopredictdailymedication Gambling ence aswellthecomputerizedIowa Task (IGT). We utilized adher ofsubstanceuseandmedication (TLFB)interview follow-back non-adherenceandadministereda14-daytimeline and HIVmedication bisexual men(GBM)whoreportedrecentcrystal Methodology: substance useandneurocognitivefunctioning. theinteractionof andlookingat been conductedutilizingday-leveldata neurocognitive functioningintheirroleonadherence, lessresearchhas to sexpartners. substanceuseand Though researchhaslookedat HIV-positive individualsaswellto Background: 3 2 1 Jeffrey Parsons H. JonathonRendina(presenting) Gay andBisexual Men Medication AdherenceAmongHIV-Positive Association BetweenSubstanceUseand Hunter College, New York, NY, USA Oregon HealthandScienceUniversity, Portland, OR, USA Studiesand Center forHIVEducational Training, New York, NY, USA A latent growth curve modelwas utilizedtoextractanintercept curve growth A latent Overall these findings suggest that decision-makingdefi Overallthesefindingssuggestthat Medication adherenceiscriticaltothehealthof Medication Functioning intheDay-Level The RoleofNeurocognitive We enrolleddiverse sampleof167HIV-positive gayand

3 = 0.005).

medication adherence but rather mayfurther adherencebutrather medication

performance andhadstrongfit, 1

, SarahFeldstein Ewing the reductionintransmissionrisk HIV Treatment andPreventionAdherence

methamphetamine use

< 0.001)predicted χ 2 , 2 (6) =6.47,

- - - 118 prevention. AFC andRANDconvened26individualsrepresentinggov around toolkit tosupportlocaljurisdictions’engagement ARV-based developed andfacilitated Description: ers. technological contextsandmeaningfulinvolvementofdiversestakehold ment, oflocalpolitical, requiresconsideration economic, socioculturaland ofantiretroviral-based tation Introduction: 2 1 Jessica Terlikowski (presenting) Strategies Prevention Implementation ofAntiretroviral strategies intheirlocalcontexts. strategies of their communitiesaroundtheimplementation ARV-based prevention jurisdictioncanusethescenarioplanningexercisestoengage in any communitystakeholders onlinesothat toolkit willbemadeavailable lessons learnedfrom Recommendations: challenges. difficult waytoapproach tovarioustimeframes;and4)creative dating to consider ARV-based andaccommo preventionoptions)adaptable ning processtobe jurisdictions.implement itintheirown Participants foundscenarioplan oftheprocessandexpressedcommitment to engendered ownership feedback andrecommendations Lessons Learned: implementation. policies,lens anddeterminetheirown for programsandpathways these citiestoaddress ARV-based withalocal preventionstrategies providesanevidence-informedmethodfor train-the-trainer approach challenges. onopportunitiesandmitigate tocapitalize strategies This opportunities andchallengesparticulartotheirjurisdictions;4)explore develop futurescenariosfocusingon ARV-based prevention;2)discuss analyzing political, economic, sociocultural, andtechnologicalfactorsto the highestHIVburdento: Pathways processof 1)learntheMapping from13UScitieswith ernmental andcommunity-basedorganizations RAND Europe, Cambridge, England, UK AIDS Foundation ofChicago, IL, USA The AIDS Foundation (AFC)andRANDEurope ofChicago Communities toEnableSuccessful All ScienceisLocal:Engaging HIV preventionscienceisdynamic. Successfulimplemen : 1) engaging andusefulwaytomobilizecommunities 1)engaging Affording participants’theopportunitytooffer

AFC and RAND will integrate toolkitrevisionsand AFC andRANDwillintegrate participants’ local implementation efforts.participants’ localimplementation The

an interactivescenarioplanningprocessand

(ARV) prevention, including PrEPandtreat

for thetoolkitandworkshopexercises 1 , JimPickett 1 , Cochrane Gavin 2 ------ORAL ABSTRACTS 27 28 132

patient caremayincreasetheprovisionof patient ART adherencesupport. support. providersmoretimefor wouldallow Structuralchangesthat receiveappropriate theirnon-adherentpatients assistance toensurethat facilitiesmayneed care andthosewhodonotpracticeinRWHAP-funded tonon-adherentpatients. services Providerswhodonotprovideprimary adherence assessmentbut Conclusions: 1.22, p<0.01). (aPR enough timetoprovideallneededcareestablishedHIVpatients facility (aPR1.34, p=0.03), orusuallyhaving andreportingalways p =0.02), practicinginaRyan White HIV/AIDSProgram(RWHAP)-funded nurse practitioner(aPR1.33, p<0.01), care(aPR1.45, providingprimary leasttwo withprovidingat sociated ART supportactivitieswerebeinga two ofthesethreeservices. Providercharacteristicsindependentlyas forsupportiveservices,non-adherent patients least and70%providedat 60% offeredadviceabouttoolstoincreaseadherence, 54%referred 64%). Almost allproviders Results: leasttwo (aPR)forprovidingat prevalence ratios ART supportactivities. model toidentifysignificant(p<0.05)predictorsandtheiradjusted p<0.05inamultivariable withtheoutcomeat variables associated ORAL ofthisoutcomewithprovidercharacteristics.associations We included to mostorallpatients. We usedtheRao-Scottchi-squaretesttoassess least twoofthree HIV providerswhoperformedat ART supportactivities HIV careprovidersintheUnited Methodology: byHIVcareproviders. oftheseservices delivery ABSTRACTS (ART).adherence toantiretroviraltherapy However, about littleisknown forclinicalrecommendations Background: 2 1 Linda Beer WestBrady John Weiser (presenting) intheUnitedStates Care Providers University of Michigan Survey ResearchCenter,University ofMichiganSurvey Ann Arbor, MI, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA In all, of (adjustedresponserate 1231providersparticipated 1 2 , GarrettGremel, Altarum.org, ChrisDuke, Altarum Institute, Most providers report following guidelines forregular Most providersreportfollowing IAPAC recentlyupdated andseveralfederalagencies Adherence Support Services byHIV Adherence SupportServices Therapy ofAntiretroviral Delivery During 2013-2014, aprobabilitysampleof wesurveyed

(96%) discussed adherence at every visit, every (96%) discussedadherenceat 1

providers lessfrequentlyreportoffering , JacekSkarbinski

providers tosupportsustained, high

States. of We thepercentage estimated 1 , JohnBrooks 1 ,

10th International Conference on 10th International - 161 HIV careovera90-dayenrollmentperiod. to We data usedsurveillance areprovidedassistance inre-linkingto toservices andagreed located areeligibleforreferraltotheLINCSprogram.diagnosis Patients whoare visit in>6months)orwhodidnotlinktocarewithin90daysofHIV Description: HIV viralloadsuppressionisunclear. who areoutofcare. whoarere-linkedtocareachieve Whether patients toHIV-infected patients programprovidesshort-termnavigation gation Introduction: 1 Susan Scheer Darpun Sachdev Francisco’s LINCSNavigationProgram Out-of-Care Patients WithHIV: ResultsofSan the completionofintervention. of viralsuppression12monthsafter tients toHIVcaredoubledtherate Recommendation: re-linked; p=0.007). closure (51%ofthosewhowerere-linkedand23%not LINCS services, however, 43%weresuppressed3-12monthsaftercase werevirallysuppressedduringthecourseof 17% ofallenrolledpatients was3 months (IQR:from enrollmenttore-linkage 3-4months.)Only weresuccessfullyre-linkedtocare.enrolled patients The mediantime only 23%weresuppressedintheyearpriortoreferral. A totalof74% leastoncepriortoLINCSenrollment;however,were virallysuppressedat 25% wereBlack, and21%wereHispanic. Eightypercentofpatients male (88%). was41years(SD=11years), Meanage 46%were White, andenrolled.(37%) werelocated were The majorityofenrolledpatients ated), 8(2%)refusedservices, and116 125(40%)couldnotbelocated (21%) wereineligible(in-careelsewhere, deceased, moved, orincarcer Lessons Learned: Patients withoutaviralloadwereconsiderednotsuppressed. 3-12 monthsaftercaseclosure referredin2012and2013. forpatients LINCSenrollmentand compare HIVRNAviralsuppression(VL<200)at SanFrancisco DepartmentofPublicHealth, SanFrancisco, CA, USA Patients who were lost to follow-up fromHIVcare(no Patients whowerelosttofollow-up SanFrancisco DepartmentofPublicHealth’s LINCSnavi 1 , StephanieCohen to SuccessfulRe-Engagementof Short-Term NavigationcanLead 1 , SharonPipkin whowerereferredtoLINCS,Among 315patients 66 Short-term navigation services that re-linkedpa that services Short-termnavigation HIV Treatment andPreventionAdherence 1 1 , Erin Antunez(pre senting) 1 ,

- - - 170 10th International Conference on 10th International adherence. incareaswellmedication engagement of arestillneededtopromote ARV treatment, interventions behavioral toenhancesupport. andgroupdynamics delivery Despitetheefficacy are feasibleandacceptabletoHIV-positive youthbutneedtoconsider emotional andhealthchallengestheyface. Group-basedinterventions tothebehavioral,youth mustaddressavarietyoftopicsrelated Conclusions: betweenparticipants. challenging groupdynamics textand raised concernsregardingthelengthofsomescriptedfacilitator the overallsenseofsupportgainedfromgroupsessions. Participants opportunities.medical providerquestion/answer Participants alsoliked identified ashelpfulwere: disclosure, serostatus HIV/AIDSeducation, and significant genderdifferenceswerefound. The M =3.83, SD=.48vs. femalesM=3.66, SD=.51, p=.004), but (M=3.79;SD.51males theyfeltcomfortableparticipating and that males M=3.81, SD=.48vs. femalesM=3.51, SD=.84, p=.000), .000), thetopicswererelevanttotheirlives(M=3.75, that SD=.57; = .33;malesM3.83, SD=.42vs. femalesM=3.63, SD=.49, p= Across sessions, theylearnedalot(M=3.79, youthreportedthat SD randomized to ACCEPT, rangedfrom67%to100%. overallattendance Results: 4 (stronglyagree), andopen-endedquestions. forms usinga4-pointLikertscale, to rangingfrom1(stronglydisagree) trolled trialinfourcities. Acceptability ismeasuredviasessionevaluation HIV-positive peer. througharandomizedcon ACCEPT isbeingevaluated by a mentalhealthprofessionalandan and groupsessionsco-facilitated on promisingpilotdata, ofindividual deliveredthroughacombination Methods: for onesuchintervention. examines youthacceptabilitydata adherence. aswellmedication proved engagement This presentation inmedicalcare.likely tobeengaged shouldpromoteim Interventions Background: 3 2 1 Diana Lemos(presenting) Diagnosed WithHIV Engagement inCareforYouth Newly

National InstituteofChildHealthandHumanDevelopment,National University ofMichigan, Ann Arbor, MI, USA Stoger HospitalofCookCounty, Chicago, IL, USA Bethesda, MD, USA Of the 57 participants (males = 45; females = 12; ages 16-24) Ofthe57participants(males=45;females12;ages ACCEPT isagender-specific intervention, behavioral based Gender-specific toassistnewlydiagnosed interventions Youth withHIVareamongthoseleast newlydiagnosed Behavioral Intervention toPromote Behavioral Intervention Project Accept:Acceptabilityofa 1 , SybilHo HIV Treatment andPreventionAdherence sek 1 , Harper Gary

topics mostfrequently 2 , SoniaLee

3 - - 171 Methodology: Methodology: adherence building(iTAB) intervention. inarandomizedcontrolledtrialofanindividualized textingfor ticipated electronically-monitored ARV adherenceamongHIV/MApersonswhopar (i.e.,between engagement prompts) and responsiveness to text message to antiretroviral MA) arehighlycomorbid, withpooradherence andMAuseisassociated Background: 1 David Moore(presenting) Chelsea Sanders Jessica Montoya Positive MethamphetamineUsers Adherence Building(iTAB) AmongHIV- may improve ARV adherenceinthecontextofactivesubstanceuse. forcareamongthosewhoarenotengaged, triggeredescalations have who arenot.engagement, optimizetreatment that and Interventions andthose between personswhoareeffectivelyadheringtomedications fected substance reminder texts, tobepredictiveof appears ARV adherenceamongHIV-in Conclusions: for 23%ofthevarianceinper-protocol analyses(p level,engagement andtheinteractionbetweenthesefactorsaccounted multivariable >.05). A level(#responses/#oftextprompts)(p norinengagement rates Results: assessingmoodandMAuse. text messages sonalized reminder texts,ARV medication andbothgroupsreceived daily adherenceoutcome.primary Participants intheiTAB groupreceivedper ofthetargetdoestime)over30dayswas usedasthe two-hour window and theproportionofcorrectlytakendoses(i.e., dosestakenwithina± EventMonitoring System (MEMS) tion wastrackedusingtheMedication (CTRL;n=19per intervention domized to iTAB (n = 35 per protocol) and 25 to an active comparison University ofCalifornia, SanDiego, CA, USA The treatment groupsdidnotdifferinmeanMEMSadherence The treatment Engagement, inthecontextofpersonalizedmedication HIV infectionandmethamphetamineusedisorders(HIV/

of IndividualizedTexting for Engagement isKeytoEffectiveness Fifty HIV-positive recentMA-usingparticipantswereran (ARV) therapy. assessed the association The present study 1 1

, Alexandra Rooney , Alexandra , ColinDepp users and may be a useful proxy for differentiating users andmaybeausefulproxyfordifferentiating

model including arm(iTAB treatment vs. CTRL), 1 1 , J. Hampton Atkinson

protocol).single “sentinel”medica AARV 1 , BenGouaux 1 , Anya Umlauf , Anya 1 ,

= .52).

1 ’s ’s ,

- - - - - ORAL ABSTRACTS 29 30 174

outcomes. potential notonlytoreduceHIVrisk, butalsotoimprovementalhealth areavailable.centers wheresuchcomprehensiveservices PrEPhasthe the past. withincommunityhealth PrEPprogramsmaybebestsituated in seen theneedforsuchservices for individualswhomaynothave careandinsurance tobothprimary asgateways programs canserve Conclusions: <.05), perceivedstress(p<.01), andsexualcompulsivity(p<.05). mental health, including reductionsinanxiety(p<.01), depression (p PrEP. significantimpactofPrEPuseon Longitudinalanalysesindicate assistanceprogram.medication All weresuccessfullylinkedtosustained enrollmentprogramand23%weresuccessfully enrolledina facilitated 68% oftheseobtainedaccesstoinsurancethroughreferralsa thehealthcenter.newly linkedtocareat Over31%wereuninsured; center. Ofthese, careand100%were 29%hadnopreviousprimary for sustainedPrEPuse. thehealth Almost 90%chosetocontinuePrEPat completion,At study transitionplans tocreate staffworkedwithpatients (92% >700fmol), andonly6%ofparticipants(n=11)discontinuedPrEP. Results: thehealthcenter.tion projecttocontinuedPrEPcareat ORALtheir experienceinthetrial, andontheirtransitionfromthedemonstra tobeenrolledandacceptPrEP(01/14-03/15).patients We focusonboth health center(R01AA022067). This analysisincludes thefirst200 withacommunity-based projectconductedincollaboration stration Methodology: positively impactthehealthofformerparticipants. ABSTRACTS and participation projectcouldextendbeyondstudy a demonstration individuals. examinedtheextenttowhicheffectivenessin This study forhigh-risk tions remainaboutitspotentialasasustainedintervention Background: 2 Callen-LordeCommunityHealthCenter, New York, NY, USA 1 HunterCollege, New York, NY, USA Catalanotti Anthony Sarit Golub(presenting) Insurance Status, andMentalHealth highlevelsofadherence demonstrated Analysis ofDBSdata PrEP demonstration projects and implementation projectsandimplementation PrEPdemonstration While PrEPisapromisingHIVpreventionstrategy, ques Data are drawn fromSPARK, aredrawn Data anNYC-basedPrEPDemon Synergistic Effects on Primary Care,Synergistic EffectsonPrimary Evidence thatPrEPcan “Do More”: 2 , KailipBoonrai 1 , Anita Radix , Anita 1 , NoraDouglas 2 , Amy Hilley , Amy 2 2 ,

10th International Conference on 10th International - - - 175 population ofadultson population ART innetworkofclinic sitesinZambia. amonga extent towhichmissedvisitsaredistributedorconcentrated missed visitshasnotbeenwelldescribed. We the soughttoevaluate visits, thedifferentialcontributionofindividualstooverallburden ments. studiesdocumentahighprevalenceofmissed Although many depends onhigh Background: 3 2 1 Muntanga Mapani Nancy Czaicki(presenting) TherapyinZambia Antiretroviral HIV-Infected Patients AfterInitiationof may benefitfromretentionsupport. efficient, whereasoverthelongerterm, alargerproportionofpatients of ART mayneedtotargetasmallgroupbeoptimallyeffectiveand of missedvisits. toincreaseretentioninthefirstsix months Interventions small witharelatively lation Conclusions: months-1 year, 87.5%for1-2 years, and95.8%for2-3years. of thoseon ART missed 0-6monthshave months. bytimeon whenstratified A similartrendappears ART: 23.8% ART initiation ing oneormorepharmacy visitsincreasedsubstantiallywithtimesince pharmacy visitsduringthistimeperiod. miss The proportionofpatients accounted for50%ofmissedpharmacy visits, while34.7%missedno 394), mediantimeon ART 345days(IQR150-638)), 16.5%ofpatients (IQR 30-42), median Results: initiation. since ART usingaLorenzcurve.patients bytime These findingswerealsostratified proportionof thecumulative fractionofmissedvisitsagainst cumulative ic medicalrecordsystemusedinroutineclinical care. We plottedthe dates, andotherclinical wereobtainedthroughtheelectron information 1, 2012andDecember31, Methodology: University ofCalifornia, SanFrancisco, CA, USA Centre forInfectiousDiseaseResearchZambia, Lusaka, ZAMBIA University ofCalifornia, Berkeley, CA, USA Overall, (38%male, among105,579patients 35 medianage : 46.6% at 3months, 46.6%at 6months, 66.2%at 12 and83.7%at Missed visitsarenotequallydistributedintheclinic popu The public health impact of antiretroviral therapy in The publichealthimpactofantiretroviraltherapy Africa We examinedadultswhoinitiated ART betweenJanuary Missed Pharmacy Visits Among Quantifying Variability in

adherence to scheduled medication pick-upappoint adherence toscheduledmedication 2 , Nancy Padian

enrollment CD4count254cells/mm HIV Treatment andPreventionAdherence

2014. Pharmacy visitdates, appointment

fraction of patients contributingthemajority fraction ofpatients 1 , CharlesHolmes 1 , ElvinGeng ≥ 1 visitversus65.8%for6 3 2 , IzukanjiSikazwe 3 (IQR132- 2 , - - - - 176 10th International Conference on 10th International failed thefirstintervention. patients who likely reflecting thedifficultyoflocating rates lower but at (60%). ahighrate tients at patients The nextlevelofcontactdidreengage of care. Telephone contactwasaneffectiveintervention, pa reengaging Conclusions: visit, thevisit. 33%(2)scheduledwith17%(1)attending thevisit.(16) attending Six(6.5%)received aphonecall, letter, andhome contacted byphoneandaletterwassent, 33%(23)scheduledwith23% thevisit.scheduled with60%(9)attending 69(75%)wereunabletobe Fifteen (16%)werecontactedbyaphonecallandofthose93%(14) 72% male. They hadamedianCD4countof327(range1to1,516). of41(range22to72),age 78% African American, 8%Hispanic, and fallen outofcare. whohadfallenoutofcareamean The patients died, 13(6.7%)wereincarcerated, andtheremaining92(47.2%)had retained incare. 77(39.5%)hadtransferredtheircare, 13(6.7%)had Results: made. mailed. failedandastimeallowed, Ifbothinterventions ahomevisitwas phone toscheduleanappointment. Ifthiswasunsuccessful, aletterwas communication. Patients whohadfallenoutofcarewerecontactedby care, deceased, usingrecordreviewandpersonal orincarcerated identified. asfallenoutofcare, werecategorized Patients transferred and didnotmeettheHRSAdefinitionofretentionincare2014were Methodology: whohadfallenoutofcare. patients re-engage purpose ofthisprojectwastoseeifoutreachbyasocialworkercould Background: 1 Bean Madelyne Ann in Care toRe-EngagePatientsIntervention WithHIV Medical UniversityofSouthCarolina, Charleston, SC, USA outofourclinicA totalof195patients ofovera1,000werenot Many of the patients identifiedhadnotactuallyfallenout ofthepatients Many Retentionincareisalargeproblemourpopulation. The Patients who had attended ourclinic Patients whohadattended inthepastfiveyears Social Worker isanEffective Personal OutreachbyaTrained 1 , LindaScott 1 , Lauren Richey(presenting) HIV Treatment andPreventionAdherence 1

- 177 in southwestUgandausingreal-timeelectronicadherencemonitors. isalongitudinal, study Methodology: ethical andpracticalimplications. participation,research participantsgainthroughstudy anditspotential adherence.therapy hasbeenpaidtosocialsupportthat Littleattention resourcesfromone’smaterial Background: 3 2 1 Nir Eyal Jeffrey Campbell Among HIVPatients inSouthwestUganda potential complications in longitudinal study design. inlongitudinalstudy potential complications ethical challengeslikedependence. shouldconsiderthese Investigators assessments, andconfoundobservational adherence behavior orcreate potential complications. Socialsupportmayinfluenceparticipants’ and emotionalneeds. benefitsforparticipants but also This creates adherence, participantscan Conclusions: was notintended. andencouragement. attention participation Socialsupportfromstudy due toaperceptionofreal-timeadherencemonitoringassource munity, andfeeling ‘hope’ forthefuture. Emotionalsupportwaspartly included feeling ‘cared for,’ asenseofbelongingtotheresearchcom advice fromresearchstaffandotherparticipants). Emotionalsupport not intendedtobe)andmedical/adherencesupport(typically, impromptu economic support(e.g. transportcosts, forstudy-related compensation mental andemotional—wereidentified. Instrumentalsupportincluded participants andresearch Results: participation. participants gainedfromstudy ofsupportthat ly developedfromthesethemestodescribethenature through research” usingNVIVO10. wereiterative Conceptualcategories to wereinductivelycodedforthemesrelated interviews “social support staff, affectsadherence. participation study and3)waysthat Transcribed inUARTO,and dislikesofparticipation 2)supportreceivedfromstudy ceptions ofresearchparticipation. Participants wereaskedabout1)likes Twenty ofper UARTO study participantswereenrolledinaqualitative Mbarara UniversityofScienceand Technology, Mbarara, UGANDA Massachusetts GeneralHospital, Boston, MA, USA MedicalSchool,Harvard Boston, MA, USA 1 , Angella Musiimenta , Angella Most participantsdescribedgainingsocialsupportfromother Through involvement in a longitudinal cohort study ofHIV Through involvementinalongitudinalcohortstudy Social support, ofpsychologicaland definedasdelivery The Uganda AIDS Rural Treatment Outcomes(UARTO) Observational TrialObservational Participation Social SupportThrough 1 , Bridget Burns(presenting)

observational cohort study of cohortstudy ARTobservational adherence

staff. Two maintypesofsupport—instru

gain social support that fulfillsinstrumental gain socialsupportthat 3

, JessicaHaberer social network, antiretroviral facilitates 2 2 , SylviaNatukinda 3 - ,

- - - ORAL ABSTRACTS 31 32 179

legacy fromstudieswithdifferentinstruments. andcombining data data the VAS scale(r these twomeasuresof Conclusions: were0.89,these correlations 0.81, 0.86, and0.87, respectively. When outliersduetoinversionofthe VAS scalewereexcluded (n=15), group,international r=0.49inthehigh-riskgroup, andr=0.71overall. wasr=0.81inthecriminaljusticegroup,Correlation r=0.39 inthe (n=79);and1domestichigh-risk29).(n =441);1international were fourSTTRconveniencesamplesof ART users: 2criminaljustice number ofmisseddoses(“dosesperday” wasnon-significant). There one ormoredoses, VAS as96.8%minus2.9%timesthe wasestimated used ontheremaining359participants. Among participantsmissing all measures, VAS was100%. was Otherwisetheregressionequation the thirty daysago VAS wassetto100%. If “doses missed” waszerofor VAS. When thelastmisseddoseon ACTG wasreportedasmorethan Results: Retain) consortiumstudieswithbothmeasures. the equation’s STTR(Seek, goodness-of-fitinfourseparate Test, Treat, the predictorsweremultiple14-day ACTG sub-questions. We evaluated sites. The outcomewasthe30-day VAS of percentage ART takenand developed inaclinical carecohort Methodology: Visual Analog Scale(VAS). measures arethe AIDS Clinical Trials Group(ACTG)questionnaireandthe scales.between validated Two commonlyusedvalidated ART adherence toconvert equation measures isdifficultwithoutaco-calibration usedifferent fromseveral studiesthat self-reported adherencedata clinical successassessedin Background: 12 11 10 9 ORAL8 7 6 5 4 3 2 ABSTRACTS1 Richard Kronmal Vu Quan Frederick Altice Wendee Wechsberg Robin Nance and STTRConsortium Clinical Systems(CNICS)ResearchNetwork Adherence intheCFAR NetworkofIntegrated University of Alabama, Birmingham, AL, USA University,Brown Providence, RI, USA Johns HopkinsUniversity, Baltimore, MD, USA Texas ChristianUniversity, Fort Worth, TX, USA University ofCalifornia, SanFrancisco, CA, USA University ofCalifornia, SanDiego, CA, USA Yale University, NewHaven, CT, USA New York, NY, USA Montefiore MedicalCenter/AlbertEinsteinCollegeofMedicine, Friends ResearchInstitute, Baltimore, MD, USA RTI International, Research Triangle Park, NC, USA University ofNorthCarolina, Hill, Chapel NC, USA University of Washington, Seattle, WA, USA 10 We developedathree-phasedecisionruletoconvert ACTG to , KennethMayer 1 , A simple decision rule allowed us to co-calibrate between ustoco-calibrate A simpledecisionruleallowed Antiretroviral adherenceisanimportantdeterminantof Heidi Crane(presenting) Self-Reported MeasuresofART Co-Calibration ofTwo Validated, A robust linear regression co-calibration equation was equation A robustlinearregressionco-calibration 6 2 , ChrisMathews 1 = 0.76), changesininstrumentswithoutlossof allowing 3 , MichaelGordon

adherence byconvertingthe to ACTG estimates 11 , JosephEron

many HIVstudies.many Harmonizingantiretroviral 7 , Christopoulos Katerina

(N =1,045)representingsixU.S. 4 , ChinazoCunningham 1 2 , CarolGolin , MichaelMugavero 2 ,

8 , KevinKnight 5 , 12

10th International Conference on 10th International

9 , 182 susceptible tothismechanism. adherence andtoidentifyifparticularclusters ofHIVsymptomsare by whichHIV-related symptomsinfluenceantiretroviralmedication depressionasapotentialmechanism wastoevaluate pose ofthisstudy remainuncertain.underlying mechanismsofthisrelationship The pur adherence,as oneofthemainpredictorspoormedication yetthe with adherence. beenconsidered HIV-related physicalsymptomshave HIV/AIDS (PLWHA). Despiteitscriticalimportance, PLWHA many struggle with been associated Background: 2 1 Raymond Ownby Moka Yoo (presenting) Medications Adherence toAntiretroviral depression to improve medication adherence. depression toimprovemedication ofsymptoms the importanceofearlyrecognitionandevaluation between HIV-related Conclusions: significant(p=0.04). statistically ed symptomsonadherence, bydepression, asmediated however, was toadherence.not directlyrelated The indirecteffectofgeneralHIV-relat adherence(p=0.017).medication GeneralHIV-related symptomswere levelsof tolower and higherlevelsofdepressivesymptomswererelated levels ofdepressivesymptoms(p<0.001andp=0.003respectively), tohigher general HIV-related symptomsandGIwererelated HIV-related symptoms, depression, adherence. andmedication Both toms. among modelingwasusedtoexplorerelations Structuralequation symptoms: generalHIV-related symptomsandgastrointestinal(GI) symp 47 years(SD=8.69). twoclusters Bifactormodelshowed ofHIV-related American (61%)or Results: wereincludedmemory ascovariates. (p <0.10), andfluidcognitiveabilities, crystallized andlong-termverbal withadherence weresignificantlyassociated variablesthat Demographic EventMonitoringSystem;MEMS). adherence(Medication medication in the AIDS Clinical Trial Group’s Baseline Adherence Questionnaire), and included HIV-related symptoms(HIVSymptomIndex), depression(CESD a largermulti-visit Methodology: Nova SoutheasternUniversity, Ft. Lauderdale, FL, USA University,Emory Atlanta, GA, USA Study participantsweremostlymen(71%)and Study African Findings show the effect of depression on the association Findings theeffectofdepression ontheassociation show Low levels of adherence to antiretroviral medications have have levelsofadherencetoantiretroviralmedications Low 124PLWHA whocompletedabaselinequestionnairefrom HIV-Related PhysicalSymptomson Depressive SymptomsMediate 2

intervention study wereevaluated. study variables Study intervention white/non-Hispanic (35.5%). was age The average

symptoms and medication adherenceandhighlight symptoms andmedication

detrimental healthoutcomesinpersonslivingwith HIV Treatment andPreventionAdherence 1 , McCoy Katryna 1 , Drenna Waldrop-Valverde, 1 - , - - 183 10th International Conference on 10th International scenarios. inated, guidanceforcomplexprescribing particularlyiftheyincorporate effective trainingsanddecision-supporttoolsaredevelopeddissem PrEP provision. DiffusionofPrEPinto generalistpracticescouldoccurif Conclusions: When uncertain, preferences. providersgenerally deferredtopatient whileusingPrEP.PrEP; or(3)disregardmonitoringrecommendations (e.g. butrequest behaviors methamphetamineabuse);(2)reportlow-risk non-adherence andmedication conditions predictiveofriskybehaviors whether toprescribe(orrefill)forpersonswho: psychosocial (1)have major areasofuncertaintywithdecision-making. Dilemmasincluded (PlanB).ventive medications However, bothphysiciangroupshighlighted prescribing experience(e.g. seeone, doone), analogoustootherpre withbrieftrainings,attained clear-cut prescribingprotocols, andminimal in becomingproficientwithPrEP. Theybelievedcompetency couldbe andexpressedinterest preventive medicinetoexistwithintheirpurview ity infection. Although inexperiencedwithPrEP, generalistsconsidered individual orsocietalharms, HIVremainsahigh-morbid andbeliefsthat ing PrEP, givenpositiveearlyprescribing experiences, limitedevidenceof time, however, LGBT-specialists becomecomfortablerecommend have experiences. initialskepticismregardingPrEP. Providersindicated Over dar”), whereasLGBT-specialists andprescribing haddetailedknowledge white. allonthera generalistswereunfamiliarwithPrEP(“notat Many Results: inductive methodology. attitudes, prescribingexperiencesanddecision-making. Analyses utilized cialists”; n=12). topicsregardingPrEPincluded Interview knowledge, the careoflesbian, gay, bisexual, (“LGBT-spe and transgenderpatients (“generalists”; n=19)andacommunityhealthcenterspecializingin anacademicmedicalcenter wereconductedwithPCPsat interviews Methods: andexperienceswithprescribingPrEP. towards PCP attitudes pre-exposure prophylaxis(PrEP). However, assessed fewstudieshave riskforHIVacquisitionandcouldbepivotalinimplementing sons at Background: 4 3 2 1 John Wong Douglas Krakower(presenting) CareProviders Primary Care:AQualitativeStudyWith Primary Tufts MedicalCenter, Boston, MA, USA University,Brown Providence, RI, USA MedicalSchool,Harvard Boston, MA, USA Beth IsrealDeaconessMedicalCenter, Boston, MA, USA Participants’ was39;45%werefemale, medianage 77%were DuringSeptember2013to August 2014, in-depthqualitative 4 , KevinMaloney Boston-areaLGBThealthspecialistsareearlyadoptersof Primary careproviders(PCPs)arelikelytoencounterper Primary Prophylaxis IntoSpecialistand Diffusion 0fHIVPre-Exposure 1 , KennethMayer 1 , Norma Ware, HIV Treatment andPreventionAdherence 2 2 , Ira Wilson , 3 ,

------184 Black and Latino MSMand Black andLatino TG intheBronx, NYusingacommuni forHIV-negative andinfected intervention media-based linkage-to-care accesstocare.with HIVtohave Therefore, wesoughttodevelopasocial (e.g. PrEPand Introduction: 4 3 2 1 Rivera Sage Viraj Patel (presenting) Transgender (TG)IndividualsinNewYork City Men WhoHaveSex WithMen(MSM)and for Based Linkage-to-CareIntervention with widereachtomoreeffectivelylinkandretainMSM TG tocare. diverse stakeholdersfrom Recommendations: prevent drop-offsor ‘missed opportunities’forengagement. monitoring oftechnicalaspectsonlinecomponentsisneededto uncovering novelbarriersandfacilitators. Lastly, wefoundcontinuous by peers andtheirnetworksstrengthenedthedesignofEngage-NYC (e.g., generalhealth-related). ongoingfeedbackviathe Incorporating moreonlineusersto engaged Lessons Learned: via multiplesocialmediaplatforms. work-flows). beingpilottested isnow navigator Engage-NYC and patient components(e.g.,intervention outreachmessages, graphics, webpage, ited feedbackfromtheironlineandofflinenetworks)tofurtherrefine ongoingfeedbackfrompeers(whosolic andincorporated information visits, numberofcontacts, made. andappointments We thenusedthis We vianumberofclick-through measuredengagement rates, webpage then displayedovertwo24-hourperiodsonthreesocialmediasites. navigator.and waystocontactapatient were The outreachmessages wouldlink,messages aboutclinical whichprovidedinformation services online.nated We alsodevelopedaprojectwebsite, towhichtheonline tobedissemi addressingidentifiedbarriersandfacilitators messages (IMB) modelasananalyticframeworkPeers usedfindingstodevelop usingtheInformation-Motivation-Behavioral of careengagement ducted focusgroupswithMSM/TGtoexplorebarriersandfacilitators providers andstaff, andasocialmediamarketingfirm. We thencon and formedan Description: research(CBPR)approach. ty-based participatory Disperse Interactive, New York, NY, USA The LGBTCommunityCenter, New York, NY, USA Bronx CommunityHealthNetwork, Bronx, NY, USA Albert EinsteinCollegeofMedicine, New York, NY, USA 3 , Al Berrios , Al To develop ‘Engage-NYC,’ werecruitedMSMpeerleaders

Addressing HIV disparities with biobehavioral interventions interventions Addressing HIVdisparitieswithbiobehavioral

treatment-as-prevention) require individuals at riskand requireindividualsat treatment-as-prevention) interdisciplinary teamincludinginterdisciplinary thepeerleaders, clinical Developing a Novel Social-Media Developing aNovel “Kiki WithYour Doctor?!?” We found that certain messages (e.g.,We certainmessages foundthat PrEP-related) Integrate a Integrate usingCBPRand ‘bottom-up’ approach 4 1 , RobertBeil

the outset and incorporate noveltechnologies the outsetandincorporate

come in for appointments thanothers come inforappointments 1 , EricMachicote

2 , OniBlackstock - - - - 1 , ORAL ABSTRACTS 33 34 188

designs. in trialcommunitiesandtakeaccountoftheserealitiesfuture adeeperunderstandingofthecircumstanceswomen researches have Conclusion: equals. participantswith warmth,trial staffshouldtreat honestrespect, andas toshareexperiencesanddispelrumours;4.chosen aspeereducators to improveadherenceduringtrials;3. participants shouldbe appropriate used applicators, andadherenceresultsgiventoparticipantsinrealtime shouldbereturnedtosites,applicators testsusedtoidentify dye-stain 2. awarmingsensation; volume shouldbereducedandgelshave all trials, suggestions: participantsmadethefollowing 1. microbicidegel critical. When askedtodesignaspectsoffuturehypotheticalmicrobicide pants reportedtheydidn’tnecessarilyunderstandwhyadherencewas and groupdiscussionscouldhelpimproveadherencebecausepartici trials compareresultsfromrandomizedgroupsusingsimplediagrams male involvementfromthebeginning. abouthow Improvingeducation important roleininfluencinggeladherence, thustrialsshouldintegrate Results: (Durbann=19;Mwanza26). participated and MDP301(PRO2000gel)participants. Forty-five trialparticipants South Africa andMwanza, Tanzania withformer VOICE (1%tenofovirgel) discussion workshops(3-5hourseach)wereconductedinDurban, trials toimproveadherenceandreporting. Eightfocusgroup an opportunitytodesignaspectsoffuturehypotheticalmicrobicide ORAL activities,ipants infocusgroupdiscussionsandparticipatory including Methods: use andadherencereportingforfuturemicrobicidetrials. insights offormertrialparticipantscanbeutilizedtohelpimprovegel microbicidetrialsworldwide. inlate-stage participated women have The reported andactualuseamongtrialparticipants. Tens ofthousands inal microbicidetrials, alargediscrepancy showing withdata between ABSTRACTSBackground: 3 2 1 Saidi Kapiga Lori Miller(presenting) Adherence of FormerTrial Participants onImproving Mwanza Intervention Mwanza Intervention Trials Unit, Mwanza, TANZANIA South African MedicalResearchCouncil, Cape Town, SOUTH AFRICA London SchoolofHygieneand Tropical Medicine, London, England, UK Former an malepartnershave participantsemphasizedthat microbicidegeltrialpartic formervaginal engaged This study 3 Adherence andadherencereportingmaybeimproved if , GitaRamjee Poor adherencecontinuestobeamajorchallenge in vag Microbicide GelTrials? Opinions Low AdherenceinVaginal 1 , ShelleyLees 2 , RichardHayes 1 , ReneeStreet 1 2 , NeethaMorar 10th International Conference on 10th International - 2 , - - 189 Methodology: inRwanda. transmission rates prophylaxis. We theimpactofthispolicy evaluate onmother-to-child HIV receiving forinfant ART healthand6weeksofnevirapine fortheirown ofthe18-monthbreastfeedingperiodforthosenotalready to cessation (ART) tiretroviral therapy forpregnantwomenfrom14weeksgestation rates. Rwandaadopted “Option B” inNovember2010, consisting ofan transmission the effectivenessoftheseprotocolsinreducingnational (Human Immunodeficiency Virus)HIVprograms, about butlittleisknown guidelines forpreventionofmother-to-child transmission(PMTCT)of Background: 1 Monique Abimpaye(presenting) An InterruptedTime SeriesAnalysis uted tothedecline intransmission. of improved adherenceandearlierinitiation ART, contrib couldalsohave programsaswellotherstrategies,care andtreatment including infected mothertoinfantsinRwanda. The scale-upofPMTCTand ART fromHIV withadecreasein18-monthtransmissionrates associated Conclusion: the 18-monthtransmissionrate. [-1.64, -0.25])andthetrend(-0.059/100, 95%CI: [-0.112, -0.007])in guidelines, wefoundareductioninboththelevel(-0.94/100, 95%CI: 0.04/100, 95%CI: [0.00012, 0.08]). Following thechangeinPMTCT increasedthroughouttheperiodpriortoMay2012(baseline trend age Results: May 2012(18monthsafterthePMTCTguidelinechange). beforeandafter compared thelevelandtrendofHIVtransmissionrates 18monthsper100childrenand ofpositiveHIVtestsat analyzed therate al HIVtrackingsystem(TRACNET)from August 2010toJuly2014. We reportedonPMTCToutcomestoRwanda’s(72%) offacilitiesthat nation included population Our study HIV-exposed 356/489 childrenattending ed timeseriesanalysistoassesstheimpactofguidelinechange. Rwanda BiomedicalCenter, Kigali, RWANDA The trendofmother-to-child 18monthsof HIVtransmissionat Implementation of Implementation WHO PMTCTguidelineOptionBwas In2010, the World (WHO)revised HealthOrganization We aquasi-experimentaldesignandinterrupt employed Child HIVTransmission inRwanda: Impact ofOptionBonMother-to- HIV Treatment andPreventionAdherence 1

- - - - 193 10th International Conference on 10th International mental healthneeds. be aneffective, approach toaddressingHIVpatients’ resource-efficient bly becauseofhighbaselineadherenceandviralsuppression. MBCmay increased depression-freedaysbutdidnotimpactHIVoutcomes, possi achieved clinically Conclusion: 6or12months. at adherencewereapparent appointment arms inantiretroviraladherence, virologicsuppression, HIVsymptoms, or 57) moredepression-freedaysover12months. Nodifferencesbetween of29(95%CI: armparticipantsexperiencedanaverage Intervention 1, -6%]). By12monthsthearmshadcomparablementalhealthoutcomes. [RD] 13%[1%, 25%]), (RD-18%[-30%, waslower andsuicidalideation -1.7]), probabilityofdepressionremissionwashigher(riskdifference tousualcare(meandifference-3.7[95%CI:participants relative -5.6, 6 months, amongintervention HRSDdepressiveseveritywaslower adherence (mean87%)andHRSDdepressiveseverity20). At suppressed (68%)andhadhighbaselineself-reportedantiretroviral male (71%), Blacknon-Hispanic(62%), (73%), unemployed andvirally and155tousualcare.intervention A majorityofparticipantswere Results: Depression (HRSD). Scalefor severity wasmeasuredquarterlywiththeHamiltonRating sured monthlyfor12monthsviatelephone-basedpillcounts. Depressive but receivednorecommendations. Antiretroviral adherencewasmea usual care, approach clinicians depressiontreatment any couldfollow clinicians. HIVprimary-care totreating recommendations treatment In arm, madestandardizedevidence-based depressioncaremanagers depressive disorder. IntheMeasurement-Based Care(MBC)intervention antiretroviral adherenceamongHIV-infected USadultswithmajor whether evidence-based Methodology: can improveHIV-related outcomes. Prior studiesoffer Background: 4 3 2 1 Elizabeth Turner James Raper Thielman Nathan Brian Pence (presenting) Randomized ControlledTrial Outcomes: ResultsFromtheSlamDunc Warren-Vance CommunityHealthCenter, Henderson, NC, USA University of Alabama, Birmingham, AL, USA Duke University, Durham, NC, USA University ofNorthCarolina, Hill, Chapel NC, USA From 2010-2013, 149participantswererandomizedto In the largest trial of its kind among HIV-infected adults, MBC 3 , James Willig , Depression isamajorbarriertoHIVcareandoutcomes. The 4-siteSLAMDUNCrandomizedcontrolledtrialtested Treatment onHIVandDepression The EffectofAntidepressant 2 , EvelynQuinlivan 2 , Amy Heine , Amy

conflicting evidence on whether depression treatment conflicting evidenceonwhetherdepressiontreatment significant depression improvements at 6 months and significant depression improvements

antidepressant management wouldimprove antidepressant management 1 , BradleyGaynes 3 , KristenShirey 1 , MichaelMugavero 1 HIV Treatment andPreventionAdherence 2 , MichelleOgle 2 , Julie Adams , 3 , TeenaMcGuinness 2 4 , ,

- 3 , - 199 cents, youngadults, andadults(14-20, 21-29, Methodology: outcomes ofthosewhoremainedincare. on to olderadultsinitiated ART inNigeria, andtodeterminevirologic pare theriskofinconsistentHIVcareinadolescentsandyoungadults adherence tocareand Background: 2 1 Kenneth Freedberg Ifeyinwa Onwuatuelo Abdulkabir Adegoke Aimalohi Ahonkhai(presenting) Adults inNigeria needed tooptimizehealthduringthisvulnerableperiod. 1year.had substantialviremiaat Youth-friendly modelsofHIVcareare Even amongthosewithconsistentcare, 50%oftheyoungestpatients increased riskforinconsistentHIV Conclusions: adolescents (48%)andyoungadults(32%)than(26%), p=0.003. adults. Among thosewithconsistentcare, viremiawasmorecommonin and YA (OR1.41, riskofinconsistentcarethan p=0.001)hadagreater adjusting forsexandbaselineCD4, adolescents(OR1.90, p=0.001) of YA, and57%ofadultshadinconsistentcare(p=0.003). Inanalysis 1,523), (p<0.001). After thefirstyearon ART, 71%ofadolescents, 62% in youngadults(n=893)and189/uL[IQR: 86-322]inadults(n= 251/uL [IQR: 153-408]in Results: remained incare. 12monthsamongthosewho of viremia(HIVRNA>1,000copies/mL)at sion toassesstheoddsofinconsistentcareand ANOVA tocomparerates consecutive visitswas>3months. We logisticregres usedmultivariate visits was with patients had monthly ART pick-upand3-monthlyclinical visits. We defined initiated ART auniversityclinic. between1/2009and12/2011at Patients AIDS Prevention Initiative inNigeria,AIDS PreventionInitiative Abuja, NIGERIA Massachusetts GeneralHospital, Boston, MA, USA The cohortincluded 2,494patients. MedianbaselineCD4was ≤ 3 months;and consistent In aNigeriancohort, adolescentsandyoungadultswereat Youth riskforpoor withchronicmedicalconditionsareat We of adoles conductedaretrospective cohortstudy Among AdolescentsandYoung Age Matters:InconsistentHIVCare 1 1 , SusanRegan 2 , ElenaLosina

clinical outcomes. Ourobjectivesweretocom care if the time between any twoconsecutive careifthetimebetweenany

adolescents (n=80), 241/uL[IQR: 127-378] inconsistent care

1 care withclinic absences>3months. 1 , BolanleBanigbe 1 , IngridBassett , ProsperOkonkwo if the time between any two ifthetimebetweenany

and >29years)who 1 , 2

, Juliet Adeola , 2 ,

2 - , -

- ORAL ABSTRACTS 35 36 201

system. helpedguideclients that highly trustedrelationships throughthehealth ranged fromtheprovisionofsimplereminderstodevelopment with HIV. For previously “out ofcare” patients, thebenefitsofnavigation incare.patients This was Conclusions: assistance. These clients ordidnotperceiveaneedfor wereoftenself-managing return tocare. A finalsubsetdidnotrespondwelltotheinterventions. themto motivated ily benefitedfromremindersorbriefinteractionsthat thehealthcaresystem,needed onlylimitedhelptonavigate andprimar infrequent contact. These clients incare, werepre-disposedtoengage with compassion, trust, andreliability. A secondsubsetdesiredonly These clients deliveredservices respondedbestwhennavigators previously beenoutofcare. Onesubsetpreferredfrequentcontact. well-defined needsamong whohad clients withestablisheddiagnoses forHIVcare.ses andsetexpectations Bycontrast, therewereless well-defined needs. helpedthemcopewithnewdiagno Navigators for personalizedattention. Results: work analysisapproach. audio-recorded, theframe andanalyzedfollowing transcribedverbatim =40;68%men,(mean age 63% African American). were All interviews HIV-related healthcaresystems professionals orpeerstohelpnavigate withclientsin-depth interviews enrolled ORALMethodology: metclients’ theseservices needs. tounderstandhow study navigator-typethrough patient services. We conductedaqualitative focusedonlinking,sen interventions andretainingpatients re-engaging toimproveHIVcarecontinuumoutcomes.interventions Mostofthecho and Access toCareInitiative. receivedfundingtoimplement Sixstates ABSTRACTSSpecial Projectsof Background: 1 Sophia Zamudio-Haas Kimberly Koester(presenting) Available” LikeThat are BetterOffHavingServices to CareInitiativeInterventions: “People University ofCalifornia, SanFrancisco, CA, USA Intervention impactdifferedbyclients’ anddesire Intervention HIVhistory Overall, helpedtolinkandre-engage theinterventions In 2011, theHealthResourcesandServices Administration From 2014, January-December weconducted75 SPNS SystemsLinkageandAccess Client Perspectives ontheHRSA/

National Significance launched the Systems Linkage SignificancelaunchedtheSystemsLinkage National 1 ,Steward Wayne

particularly true for people newly diagnosed particularly trueforpeoplenewlydiagnosed

Newly diagnosed clientsNewly diagnosed hadconsistent, 1 , ShannonFuller 1

, JanetMyers in interventions that used that in interventions 1 , Andre Maiorana , Andre 1 10th International Conference on 10th International - 1 , - - - 204 Methodology: thequestion. answer adherence.medication However, longitudinalstudiesareneededto suggest disclosure toHIVpositiveadolescents improvesHIV ofstatus Background: 3 2 1 Gabriel Anabwani Jennifer Chapman Harriet Okatch(presenting) Study Adolescents inBotswana:ALongitudinal the hypothesizeddesirableimpactonadherence. disclosure,This suggeststhat asperformedinthissetting, doesnothave disclosure. Longtermafterdisclosure, ofdecline therates increased. smallimprovementinadherencewhichwasdecliningin avery priorto Conclusions: Post-disclosure, medianadherencedeclined by1.2%perquarter. 88.5-99.5),age. p=0.04whichremainedsignificantafteradjustingfor during thedisclosure timefrom97.3%(IQR82.4–99.5)to97.9% tically significant, but clinically minimal, increaseinadherenceoccurred Pre-disclosure, median adherence declined by 0.4% per quarter. A statis disclosure 12.2years(IQR11.6-12.9), (medianage 50%female). 14.6years(IQR13.2-16.6).age 74(24.7%)adolescentshadincident Results: models wereadjustedforage. closure periods. duringadolescence, Sinceadherenceworsenswithage andwhetheradherencechangedduringthepre-post-dis interval models, weexploredwhetheradherencechangedduringthedisclosure disclosure occurred. Usingsegmentedgeneralizedlinearmixedeffects visits andthedisclosure timewasdefinedasthequarterduringwhich System (MEMS)caps. disclosure Status quarterlystudy wasassessedat EventMonitoring usingMedication 10-19)inBotswana adolescents (age Gaborone, BOTSWANA Children’sBotswana-Baylor ClinicalCentreofExcellence, University ofPennsylvania, Philadelphia, PA, USA Children’s HospitalofPhiladelphia, PA, USA At baseline, thedisclosure prevalencewas64.7%(median Disclosure toyoungadolescentsresulted ofHIVstatus Qualitative and cross sectional quantitative studies andcrosssectionalquantitative Qualitative Over24months, adherencewasmonitoredin300 Adherence inHIV-Infected The ImpactofDisclosure on 3 , RobertGross 1 , Tafireyi Marukutira HIV Treatment andPreventionAdherence 1 , RachelHammond 2 , ElizabethLowenthal 3 , Ontibile Tshume , 1 , Morales Knashawn 2 3 ,

- 2 , - 205 10th International Conference on 10th International forindividualhealthoutcomesandHIVprevention. implications meaningful impactinreducingindividualandcommunityviralloadwith Services. ofsuchprogramsmayhave Morewidespreadimplementation program withEnhancedPharmacyenrollment inaMailedMedications significantlyimprovedvirologiccontrol following findings indicate Conclusions: enrollment, up. follow 103(66%)werevirallysuppressedat (p <0.001). with asuppressed VL increasedsignificantly, from73%to 88% overall (n=590), follow-up at data theproportion laboratory with available insurance,Private baseline. and73%virallysuppressedat For persons Results: follow-up, rangingfrom6weekstooneyearafterprogramenrollment. baseline(closest valuesat valuepriortoenrollment)and laboratory analysis, wecomparedviralload(VL)suppression(<200c/mL)using HIV/AIDSClinicalsiteinacademically affiliated Alabama. Usingpaired an 2015at to theprogrambetweenNovember2011andJanuary Methodology: and EnhancedPharmacy program. Services enrollmentinCurantHealth,in viralloadfollowing aMailedMedications aimed toassess ART changes persistenceandadherenceviaobserved theindividualandsystemslevel.access barriersat Accordingly, we medication enhanced pharmacy programmingmayalleviate services withhome-deliveredand refillautomation ART, with mailedmedications thesystemlevel.persistence at leveladherencesupport With patient ART adherence, fewprogramsaimtoaddressthesechallengesin ART While client-level existtoaddressindividualbarriers interventions include issues, transportation ruralresidence, distance, andstigma. theindividualleveland uninterrupted receiptarewelldocumentedat Background: 1 Michael Mugavero Will Rutland(presenting) Outcomes? AffectBiologic Enhanced Pharmacy Services in Alabama:DoMailedMedicationsWith University of Alabama, Birmingham, AL, USA Mean age was47years, Meanage with23%Female, 58%Black, 57% Of the 157 patients whowerenotsuppressed(VL Ofthe157patients Despite a high rate ofbaselineviralsuppression, Despiteahighrate these Challenges to antiretroviral therapy (ART) Challengestoantiretroviraltherapy acquisitionand For thisanalysis, weincluded (N=652)referred patients for Persons LivingWithHIV/AIDS PrescriptionDelivery Antiretroviral 1 , RanjithKasanagottu 1 , AshutoshTamhane HIV Treatment andPreventionAdherence 1 , JamesRaper 1 ,

1 , Anne Zinski , Anne ≥ 200) at 200) at 1 206 6 5 4 3 2 1 Heidi Crane(presenting) Elvin Geng H Kim Mimiaga Matthew Kenneth Mayer Daniel Drozd Joseph Merrill Patients inCareAcrosstheUnitedStates Time inaNationallyDistributedCohortof Therapy(ART)Antiretroviral AdherenceOver even withoutcompletecessation. focused ondecreasingseveritymayimprove strategies ART adherence class andtheseverityoftheiruse. Giventheseresults, harmreduction highlights theimportanceofexaminingadherencebyindividualdrug differacrossdrugclasses.over timeandtheseassociations This Conclusion: (0.13-0.31/point, p<0.001). findings weresimilaralthoughtheimpactofseverityusewasgreater point). included Inmixedmodelsthat substanceuse, time-updated ofopioidandmarijuanause(0.09-0.12%/ ble (0.20-0.23%/point)that alcohol, methamphetamine, dou andcocaine/crackwasapproximately poorer adherenceovertime(p<0.05). However, theimpactofbaseline withsignificantly of useforalldrugsandalcoholwereassociated adherence. withlower panic ethnicitywereassociated Baselineseverity (marijuana) to15(methamphetamines). Female sex, Blackrace, andHis ments. Among currentusers, medianseverityscoresrangedfrom7 Results: substanceuseseverity.dated viral load, duration. andfollow-up Sensitivity analysesincluded time-up adherence adjustedforage, race/ethnicity, sex, site, baselineCD4and betweenbaselinealcoholandsubstanceuse longitudinal ciations measured adherence. We usedmixedeffectsmodelstoexamineasso was definedby AUDIT-C score(0-12points). Avisualanaloguescale of usewasdefinedby ASSISTscore(0-39points)andalcoholseverity crack, methamphetamines/crystal, illicitopioids, andmarijuana), severity DIT-C) and ART adherence(30-day VAS). For eachdrugclass (cocaine/ tablet-based assessmentsincluding druguse(ASSIST), alcoholuse(AU Methodology: bydrugclasswould vary andseverityofuse. ofsubstanceusewithadherence longitudinalassociations esized that and didnotexaminedruguseseverityorpolysubstanceuse. We hypoth however,adherence isknown; studiesweresmall, many cross-sectional, Background: 7 University of Alabama, Birmingham, AL, USA University ofCalifornia, SanDiego, CA, USA MedicalSchool,Harvard Boston, MA, USA Johns HopkinsUniversity, Baltimore, MD, USA University of Washington, Seattle, WA, USA University ofCalifornia, SanFrancisco, CA, USA University ofNorthCarolina, Hill, Chapel NC, USA 1 , SoniaNapravnik whocompleted25,234assess There were8,672patients 7 , Paul Crane Severity of substance use is associated withadherence Severityofsubstanceuseisassociated 1 , GeetanjaliChander betweensubstanceuseandpoor An association ART 1 , RobinNance 3 CNICS patients incarefrom6sitescompleted CNICS patients , JaneSimoni and SubstanceUseSeverity Association BetweenAlcohol 3 , James Willig , 1 , MariKitahata 6 , JosephEron 1 1 1 , JDelaney , ChrisMathews 5 , GreerBurkholder 2 , McCaul Mary 1 6 , MichaelSaag , Christopoulos Katerina 1 , RobFredericksen 4 , MichaelMugavero 2 , HeidiHutton 5 , KarenCropsey 5 ,

1 ,

2 7 , ,

5 - , 5 , -

- - - - - ORAL ABSTRACTS 37 38 210

clinical practice. setting ofsampling, andpotentialbarriers tomorewidespreadusein her/himself.collection bythepatient Furtherstudiesmightexaminethe willingness andconfidenceforonce-offbutnotregularDBSsample resource-limited settings. exposuretoproceduresincreased Repeated measurement areacceptableto Conclusions: or bloodsamples. andfutureuseoftheirhair reported concernsaboutlong-termstorage a healthworkercometotheirhomedoFS. visit any at Nopatients Throughout allvisits, regular clinic lastvisit. visitscomparedto63%and3%respectivelyat FSand43%togivehairat participants reportedwillingnesstohave lastvisit.do FSthemselvescomparedto47%at At firstvisit, 87%of least reported feelingat confident”“somewhat (ona5-pointscale)to lastvisit. homecomparedto53%at at At firstvisit, 10%ofparticipants first visit, 10%ofparticipantsreportedwillingnesstodoFSthemselves reported pain, 94%indicated “a little” to “some” (ona5-pointscale). At Of 148collections, 47%had Results: tion venues, ofsamples. andfate concerns including pain, potentialtocollectsamplesthemselves, collec ORAL five monthly at clinic visits. Methodology: tenofovir andemtricitibine. health clinic whohadrecentlycommencedoncedaily ART containing and hairsamplesamong30HIV-positive individualsinaSouth African HIV clinics. We examinedthefeasibilityandacceptabilityofmonthlyDBS may provideconvenient, ABSTRACTSBackground: 2 1 Robert Remien LopezRios Javier Reuben Robbins(presenting) Treatment AdherenceinSouthAfrica ARV BiomarkersasObjectiveMeasuresof University of Cape University ofCape Town, SOUTH AFRICA Columbia University, New York, NY, USA Twenty-eight participantscompleted5visits;24. DBS andhairsamplecollectionfor ART adherence Drug metabolitelevelsindriedbloodspot(DBS)andhair 1 A nursecollected hair andfinger-stick (FS)DBSsamples Hair- andDriedBloodSpot-Derived Feasibility andAcceptabilityof 1 , ClaudeMellins ≥ 90% of participants reported willingness to have 90% ofparticipantsreportedwillingnesstohave

objective measuresof ART adherenceforbusy

Participants reported on their experiences and

no reportedpainfromFS;ofthosewith 1

, HettaGouse most patients andmaybefeasiblein most patients 1 , JohnJoska 2 , YoliswaMtingeni 2 , Patricia, Warne 1 2 , , 10th International Conference on 10th International

- 214 Methodology: Methodology: withahighHIVprevalence(8.8-16.4%).population examined barriersto ART adherenceamongHIV-positive transwomen, a asprevention).HIV transmission(treatment study This qualitative Background: 2 1 Venkatesan Chakrapani Divya Ravi(presenting) Qualitative Investigation Identified Trans Women inIndia:A Adherence AmongHijra-/Thirunangai- mental healthsupportservices. improving sensitivitytrainingamongproviders, andincreasingaccessto tailored adherencestrategies, providingacomprehensive ART education, women amongtranscommunities, assistingtranswomeninadopting multi-faceted interventions: promotingacceptanceofHIV-positive trans Conclusions: regularly.medication transparticipants fromcollectingtheir frequent visits)–demotivated ART time, lackofprivacy/confidentiality, and ART stock-outs(necessitating – proceduraldelays, covertdiscrimination, counseling inadequate treatment, and ART. experiences ingovernment Negative ART centers and fearofharmfulinteractionsbetweenalcohol, femalehormonal depositions onstomachandbackofneckfromlong-term ART adherence were fearofseriousandvisibleside-effectssuchascharacteristicfat – e.g., takingextraprecautionstohideantiretrovirals. Otherbarriers This non-disclosure participants becomestaxing forstudy ofHIVstatus was revealedtoothertranswomenpeers, partners, or familymembers. and financialsupportamongHIV-positive transwomeniftheirstatus A keybarrierwasthefearofrejectionandlosssocial, emotional, social-structural,adherence at healthcaresystem, andindividuallevels. work =44%;begging25%). We identifiedinterlinkedbarriersto ART Results: framework approach. providers =4;communityleaders2). wereanalyzedusingthe Data or ‘transgender’ =50%);andsixIDIswithkey-informants(service India: 16IDIswithHIV-positive transwomen(thirunangai=50%;hijras (IDIs)inChennaiandNewDelhi,conducted 22in-depthinterviews INDIA Centre forSexualityandHealthResearchPolicy, Tamil Nadu, University ofNorthCarolina, Hill, Chapel NC, USA Trans (sex socioeconomicstatus participantswereoflow Promoting ART adherenceamongtranswomenrequires ART adherenceiscriticalforprolonginglifeandpreventing Between December 2014 and January 2015,Between December2014andJanuary we Antiretroviral TreatmentAntiretroviral (ART) Multi-Level Barriersto 2 HIV Treatment andPreventionAdherence 1 , Vijayalakshmi Loganathan , Vijayalakshmi 2 , RubanNelson 2 , 216 10th International Conference on 10th International the efficiency ofthistestingparadigm. persons. Comparisonstoothertestingschemes areneededtoassess infectionsandOOCHIV-positive ofnewlydiagnosed abled identification informedbycarecontinuumoutcomeswasfeasible anden locations inthetwo was observed Conclusions: between HRAsandLRAs. inriskbehaviors in LRAsversusHRAs;nodifferenceswereobserved = 0.007)andfewerblacks(91.0%vs. 94.6%, p=0.008)weretested was51years.age A higherproportionofmales(63.9%vs. 56.9%, p All HIV-positive participantswereblack, 64%weremale, andmedian (n=9)orOOC6);46%13)were incare.new diagnoses HRAs and0-2.8%inLRAs. Among HIV-positive participants, 54%were in LRAs(p=0.57). Testing HIVseropositivityrangedfrom0-9.7%in tested. Overall, 28persons Results: those testedineachareacompared. among testingwasperformedineachareaandparticipant data rapid CTs wereidentified;twelveHRAsandeightLRAs. Community-basedHIV and proportionofpersonsoutcare(OOC)neverincare. Twenty risk areas, -LRAs)themedianforthreeindicators: monitoredviralload, wereeitherabove(higherriskareas,CTs that (lower HRAs)orbelow with HIVprevalence from data Washington,ratory DC Methodology: incare. re-engagement toidentifyHIV-positive or personsneedinglinkage a feasiblestrategy areas,in geographic definedbycarecontinuumparameters, wouldbe continuum outcomes. We soughttodetermineiftargetedHIVtesting new HIVtransmissionsmay Background: 2 1 A. Toni Young Amanda Castel(presenting) Geographic AreasforHIVTesting Community Education Group,Community Education Washington, DC, USA The George Washington University, Washington, DC, USA A totalof1,471persons(870inHRAs;601LRAs)were 2 Although nosignificantdifferenceinHIVseropositivity InhighHIVprevalenceareassuchas Washington, DC, , GeoffreyMaugham We andlabo usedroutinely reportedHIVsurveillance Continuum OutcomestoIdentify Feasibility ofUsingHIVCare ≥ 1%. We algorithmtoidentify developedastatistical

testing areas, identifyingtargetedHIVtesting

(1.9%) testedHIV+;2.1%inHRAvs. 1.7%

be attributed topersonswithpoorHIVcare be attributed 1 , IreneKuo

and identified55censustracts(CTs) 2 , CarolReisen HIV Treatment andPreventionAdherence 1 , MeriamMikre 1 1 ,

- - 223 received care coordination and support services throughtheCompre andsupportservices received carecoordination only, services Eighty-three personsreceivedcarecoordination and85 1, post-releasebetweenJanuary services 2012andDecember31, 2014. Methodology: release. following to provideaccessHIVmedicalcareandmedications programintended individuals enrolledinatransitionalcarecoordination itive individuals. aimstoassessHIVcareoutcomesamong This study inHIVmedicalcareforHIV-poscritical intersectionforre-engagement Background: 1 Safere Diawara Lauren Yerkes Virginia Among FormerlyIncarceratedIndividualsin along the HIV care continuum for formerly incarcerated individuals. along theHIVcarecontinuumforformerlyincarcerated assistance, toimprovinghealthoutcomes offeramoreholisticapproach needs, targetingotherimmediate services suchashousingandfinancial from incarceration. supplementedwithlocal support Carecoordination amongindividualsreleased ute tomoresuccessfulHIVcareengagement Conclusions: retention incareand67.1%forvirologicsuppression. andCHARLI,participants receivingbothcarecoordination to87.1%for were virologicallysuppressed;theseoutcomesincreasedforthe85 only,in carecoordination 67.5%wereretainedinHIVcareand54.2% pants werevirologicallysuppressed. Among the83participantsenrolled were retainedincare12-monthspost-release, and60.7%ofpartici in HIVmedicalcarewithin90dayspost-release. Seventy-sevenpercent Results: was<200copies/mL. 12-month post-releasetimeperiodthat and virologicsuppressionwasmeasuredasthelastviralloadwithin least60daysapart, wereat the 12-monthpost-releasetimeperiodthat (retention) wasbasedontwoormoreofthesemarkersforcarewithin release;continuousengagement prescription within90daysfollowing of aCD4orviralloadlabdraw, HIVmedicalcarevisit, orantiretroviral inHIVmedicalcarewasanalyzedbased on evidence Re-engagement (CHARLI)program. forInmates hensive HIV/AIDSResourcesandLinkages Virginia DepartmentofHealth, Richmond, VA, USA Among 168HIV-infected individuals, 76.8%werere-engaged Findings suggest that care coordination services contrib services Findings carecoordination suggestthat Research suggests that release from incarceration isa releasefromincarceration Researchsuggeststhat 1 Participants (N=168)receivedcarecoordination , Gilmore Kate 1 Services onHIVCareOutcomes Services the ImpactofCareCoordination , Anne Rhodes(presenting) 1 , StevenBailey 1 , MistyJohnson 1 1 ,

- - - - ORAL ABSTRACTS 39 40 241

electronic monitoring in low-resource settings. electronic monitoringinlow-resource objective “real-world” to ARV adherencemeasureandanalternative thepotentialofusingDBS-derivedbiomarkersasan demonstrate inSouth procedures werehighlyacceptabletopatients Africa. Results withDBS the weakcorrelation TFV-DP. We DBS reportelsewherethat in which Wisepill maynotreflectdoseingestion, possiblyexplaining witheithermeasure.not correlated Ourfindingsalsorevealinstances significant, with association Conclusions: the pastmonth. goodadherencewithnomisseddosesin self-reported excellentorvery but haddetectable TFV-DP levels. removed fromtheanalysesthosewhohadnotopened WP device, (r =.361, p=.001), whichstrengthened(r=.556, p<.001)ifwe points). of There wasonlyaweakcorrelation TFV-DP with WP adherence their thetimeofsampling (88data least10weeksat ARV regimenforat SD±424). We restrictedsubsequentanalysestothosewhohadbeenon (SD ±34%). Mean TFV-DP levelwas917fmol/punch(range, 1-2441; Adherence overthepast4 Results: adherence by WisePill inthe4weekspriortosampling. MS. We examinedPearson between correlations TFV-DP levelsand viewed onself-reportedadherence. TFV-DP wasquantifiedbyLC-MS/ were beingmonitoredby DBSsamplesandwereinter Wisepill gave who, thetimeofenrollment, at had ORAL Methodology: drug ingestion. in DBSasaconvenient, objectivemeasureof ARV adherencereflecting ingestion. We exploredusingassaysoftenofovir-diphosphate (TFV-DP) including subjectivityand Background: ABSTRACTS3 2 1 Bruce Levin Michelle Henry Hetta Gouse Patricia Warne (presenting) Africa Measure ofTreatment AdherenceinSouth University of Cape University ofCape Town, SOUTH AFRICA University ofColorado, Denver, CO, USA Columbia University, New York, NY, USA Participants were30yearsold(SD±5.25)and90%women. 1 3 , ClaudeMellins , JohnJoska DBS levelsof TFV-DP onlyaweak, demonstrated but Existing disadvantages ARV adherencemeasureshave 3 In 5monthlyvisits, 29HIV-positive South African adults ARV BiomarkersasanObjective Utility ofDriedBloodSpot-Derived , LopezRios Javier

3 patient/provider burden;nonemeasuresdrug patient/provider , Cheng-ShiunLeu

weeks measuredby 74% Wisepill averaged

Wisepill, andself-reportedadherencewas 1 , RobertRemien 1 , ReubenRobbins 1 With oneexception, participants

, JoseCastillo-Mancilla initiated ARVs containing TFV and containing TFV ARVs initiated 1 1 , YoliswaMtingeni 1 , Peter, Anderson 2 ,

3 , 2 10th International Conference on 10th International

- 244 with transwomen (totalN=30)inSanFranciscowith transwomen focusedontheirknowl Methodology: riskforHIV. at urban transwomen andbarrierstoPrEP acceptabilityamong culturally specificfacilitators their uniquepositionswithinsocioculturalcontexts. examined This study in PrEPresearch, for withMSMwithoutconsideration oftenaggregated in thetrial. Furthermore, areexcluded transwomen orunderrepresented revealedzeroefficacysubanalysis oftheiPrExdata amongtranswomen approach.the firstefficaciousbiomedicalHIVprevention However, a riskofacquiringHIV.ate Pre-exposureprophylaxis(PrEP)represents Background: 1 Jae Sevelius(presenting) Acceptability AmongTransgender Women and uniquegroup. riskamongthishighlyvulnerable disparate prevention effortstomitigate contexts, including medicalsettings, haslimitedtheeffectivenessofHIV of transwomen’s bodiesandsexualitieswithin fraughtsociocultural of PrEPamongurbantranswomen. Ongoingfailuretoconsiderpositions and concernstoinformdissemination several trans-specificfacilitators fromMSMinHIVpreventionstrategies,transwomen emphasizing Conclusions: ofmedicalsettings. avoidance hormones, multiplemedications, managing potentialsideeffects, and safer sex. BarrierstoPrEPuseincluded concernsaboutinteractionswith increase theirHIVrisk, including tonegotiate power sexworkandlow use ofPrEPcouldaddressseveralaspectstranswomen’s livesthat of PrEPwaslow, high. interestwasrelatively Participants notedthat was citedasessentialtoPrEPuptakeandadherence. While knowledge prescribestheirhormones) (particularly thesametrustedproviderthat healthcare settings, abilitytoobtainPrEPfromatrans-friendlyprovider Results: analytic codesusing Atlas.ti. scripts wereanalyzedforcommonthemes;ateamofresearchersapplied edge of, interestin, andconcernsaboutPrEPforHIVprevention. Tran University ofCalifornia, SanFrancisco, CA, USA Due to negative experienceswithhealthcareprovidersand Duetonegative Findings underscore an urgent need to disaggregate Findings underscoreanurgentneedtodisaggregate Transgender disproportion areat women(‘transwomen’) We conducted 3 focusgroupsand9individual interviews Barriers andFacilitators toPrEP “I AmNotaMan”:Trans-Specific HIV Treatment andPreventionAdherence 1 , JoAnneKeatley 1 , Emily Arnold , 1

- - - 259 10th International Conference on 10th International available. now strategies empiricallysupportedadherence-promotion most benefitfromthemany riskforpoorvirologicoutcomes,identify groupsmostat whowould in care. to and engagement efforts to enhance linkage Future work might bode wellforHIVpreventionefforts. Conclusions: conference). with the at forpresentation VL levelsovertime(withresultsavailable changesassociated on identifyingadherenceandsocio-demographic in undetectable VL overthistimeperiod. Furtheranalyseswillfocus over timewithsite-to-sitevariabilitysmallerthantheoverallchange trend asimilar increasingpercentage All oftheindividualsitesshowed crease ofundetectable VL of~3%peryear, in87%2014. culminating in 2001and48%undetectable2002. From 2003on, therewas anin ofundetectable percentage with47%undetectable VL testsheldsteady increased from1997(30%)to2000(47%). Overthenexttwoyears, the (in 1997)to39,5402010). Results: individual clinic overtime. ofundetectable percentage VL tests(<400copies/mL)overallandby values between1997and2014. examinedthe Descriptivestatistics Clinical Network ofIntegrated Methodology: (ART)therapy initiates, initiation. andmodifiedguidelinesfortreatment improved adherence, ofantiretroviral changingsocio-demographics withdecreases inviralload(VL),factors potentiallyassociated suchas izable forclinics acrosstheUnitedStates. Ifconfirmed, wecanexamine than seenpreviously. Itisimportanttoconfirmwhetherthisgeneral ofviralsuppression, suggesthighrates the UnitedStates possiblyhigher Background: 5 4 3 2 1 Chris Mathews Kenneth Mayer Jane Simoni(presenting) With It? United States:What’s AdherenceGottodo University of Alabama, Birmingham, AL, USA University ofCalifornia, SanDiego, CA, USA MedicalSchool,Harvard Boston, MA, USA University,Brown Providence, RI, USA University of Washington, Seattle, WA, USA The numberof VL testsanalyzedperyearrangedfrom9,180 Findings ofdiminishing “clinic VL” intheUnitedStates Recent reports from individual HIV primary careclinicsRecent reportsfromindividualHIVprimary in 4 2 Data derivefromthe29,467participantsinCFARData Nationally DistributedCohortinthe Diminishing “Clinic Viral Load” ina , MichaelMugavero , Frances, Aunon 1 , RobinNance

The percentage ofundetectable The percentage VL tests Systems (CNICS)cohortwithviralload 1 , StevenSafren 5

, MariKitahata Moreover, theyshouldcatalyze HIV Treatment andPreventionAdherence 1 , Ira Wilson , 3 , JDelaney 1 , HeidiCrane 2 ,

1 ,

- - 269 Using tion launchedatoolkit– Description: HIVcare. facilitate persons notincareisapromisingtoolhealthdepartmentscanuseto toidentify data UsingHIVsurveillance along thecontinuumofcare. inHIVcarearecriticalstepstoattain toandre-engagement linkage oftheirinfection.to transmitHIVcomparedpersonsunaware Thus, who areretainedincareandvirallysuppressed94%lesslikely Introduction: 1 Green (presenting) Kathleen and Prevention Health DatatoImprove of HIVSurveillance is essentialtoDtCsuccess. amongsurveillance,collaboration preventionandcareprograms, which Additionally, TA shouldfacilitate sharing. todata munity engagement toCareactivitiesfromcom to beflexibleandshouldaddressallData DtC activities,departments iscriticaltosupportingandguiding TA needs Recommendations: lance, preventionandcareprograms. cases forthefirsttime, surveil thecomingtogetherofstaffacrossHIV Participation inthisprojectfacilitated, inmost program.the surveillance sharing, confidentialityanddata around data morbidity, of andhistory We factors,consider organizational hadto jurisdictionlaws/policies Our TA amongeachhealthdepartment. variedgreatly approach tation. designandimplemen instrategy differentstages wereat Jurisdictions Lessons receive TA. wasrequired tobeeligible to to healthdepartments’HIVsurveillance reporting ofallCD4 T-lymphocyte andHIVviralloadtestsbylaboratories confidentialname-based Mandatory incare.to belinkedorre-engaged toidentifypersonslivingwithHIVnotincarewhoneed data surveillance six toninemonthsofintensivetechnicalassistance(TA) onusingHIV withthetoolkitlaunch,conjunction sevenhealthdepartmentsreceived Centers forDiseaseControlandPrevention, Atlanta, GA, USA

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- - ORAL ABSTRACTS 41 42 274

*Co-Senior Authors coping anddecreaseHIV-associated stigma. to initiate ART. shouldbedesignedtooptimize Futureinterventions tion, upto40%of ART-eligible individualsarelostafter testing, orrefuse for thethresholdforinitiation.VCT withCD4countswellbelow Inaddi Conclusions: 1.02-1.32, p=0.02). = 1.28, 95%CI: 1.04-1.58, p=0.02), (OR=1.16, andfatalism 95%CI: (OR=1.19,strategy 95%CI: 0.99-1.44, p=0.06), fear ofstigma(OR as acoping eligible adults, withuseofdenial initialrefusalisassociated and Soweto 4.0% in Gugulethu). among that analysesshow Univiariate uponlearning treatment their ART eligibility (10.0% “initial refusers” in Soweto, 22.5%inGugulethu). An additional7.0%whoreturnedrefused not returnfortheirCD4+resultswithinsixweeksoftesting(43.3%in all ART-eligible adultswhopresentedfor VCT acrosssites, 32.9%did count was238cells/mm unemployed, and55%hadnotcompletedhighschool. MedianCD4 was 35yearsold, ofwhom63%werewomen. Fifty percentwere Results: ART refusal. with structured questionnairetoassesspsycho-socialfactorsassociated inthepre-ART ofattrition period,assessed rates andusedadetailed inSouth twotownships 2105 at andGugulethu).Africa (Soweto We ART-eligible adultswhopresentedfor VCT betweenJuly, 2014-March, Methodology: South Africa. in testing centers twourban counselingandtesting(VCT)at for voluntary Africa. Ourgoalwastounderstand ART-refusal amongadultspresenting particularly incountrieswhereHIVishyperendemic, suchasSouth alone ofthedisease, isinsufficienttostopthespread availability free generation.” There evidence,is growing however, treatment that (ART),access toantiretroviraltherapy with the goal of ancreating “AIDS- Background: ORAL9 8 7 6 5 4 3 ABSTRACTS2 1 Glenda Gray Garrett M. Fitzmaurice Dominick Leone Ingrid T. Katz(presenting) Prospective Multi-SiteCohortStudy TherapyAvailabilityAntiretroviral –A SOUTH AFRICA South African MedicalResearchCouncil, Western Cape, SchoolofPublicHealth,Harvard Boston, UnitedStates University ofCape Town MedicalSchool, Cape Town, SOUTH AFRICA Boston UniversitySchoolofMedicine, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA University ofthe Witwatersrand, Johannesburg, SOUTH AFRICA MedicalSchool,Harvard Boston, MA, USA Boston, MA, USA Massachusetts GeneralHospital, MedicalSchool, Harvard Brigham and Women’s Hospital, Boston, MA, USA We eachsite. enrolled200participantsat The medianage 4,9 Our data suggest that HIV-positive suggestthat adultsarepresenting Our data Global HIV treatment initiatives have focusedonincreasing have initiatives HIVtreatment Global * We atotalof300HIV-positive, prospectivelysurveyed Africa inanEraofExpanded Treatment RefusalinSouth 1,6 , IngridCourtney 1,3,8 3 , R. David Bangsberg (202.5 in Soweto vs. (202.5inSoweto 265.5inGugulethu). Of 1,2,3 , JananDietrich 7 , Gugu Tshabalala , 2,3 4 ,

, Orrell Catherine Laura M. Bogart 4 ,

3,5 7 10th International Conference on 10th International *, *, ,

- 276 Methodology: (YLWHA). (FACE) inyouthlivingwithHIV/AIDS advancecareplanningintervention spective, longitudinal, ofFAmily-CEntered randomizedcontrolledstudy Background: 3 2 1 Megan Wilkins (presenting) Patricia Garvie Intervention of aRandomizedAdvance CarePlanning Prospective LongitudinalFollow-UpStudy for YLWHA andpotentialpartners, demandingfurtherinvestigation. tiretroviral adherence, and toofewyouthwithUVL, remainsproblematic shouldbefurtherexamined.that for reasonsunknown Suboptimalan betteradherencethan heterosexualyouth,bisexual youthdemonstrated youth andmale YLWHA difficultieswithadherence. hadgreater Gay/ depression scores. The strongestpredictorofadherencewasUVL. Older depression, toadherence, didnotrelate likelyduetorestrictedrangein Conclusion: higher oddsof adherence (OR=0.34, CI month adherence =29);51%self-reportedpast Meanadherencewas76.1%(SD Class C. infected,behaviourally opportunistic infection, of 39%history 29%CDC 72% heterosexual, 26%gay/bisexual, infected, 77%perinatally 21% 17.7years,yses weremeanage 54%male, 95%black, 8%Hispanic, Results: included Analyses linearandlogisticregression. records. wereabstractedfrommedical data HIVhealth-status presented here. conflict examinedaspredictorsofadherence(visualanaloguescale)are baseline depression, anxiety, emotionalfunctioning, anddecisional visits.follow-up Youth withseveredepressionwereexcluded. Youth clinics forscreening, baseline, sessions, 3intervention/control and4 >18a parent/guardian(ifyouth oneoffiveurbanhospital-based yearsat St. JudeChildren’s ResearchHospital, Memphis, TN, USA Children’s National, Washington, DC, USA Children’s and Diagnostic Treatment Center, Ft. Lauderdale, FL, USA N=94 YLWHA included onantiretroviralmedications inanal Contrary toexpectation,Contrary emotionalfunctioning, including adherencewasassessedwithinapro Antiretroviral 3 YLWHA with 20yearsenrolledasadyad 14through age ≥ , Jichuan Wang, Youth WithHIVEnrolledina Predictors ofAdherencein 90% adherence(OR=9.5, CI ≥ 90%; 62%hadundetectableviralload(UVL; >90% HIV Treatment andPreventionAdherence 95 [0.12,0.95], p=.040). Youth with UVLhad 1 , YaoCheng 2 , MaureenLyon 2 , RonaldDallas 95 3 [3.3,27.3], p<0.001). 3 ,

- - - 280 10th International Conference on 10th International modelsonHIVcareandviralsuppression. service housing oftheimpact Results warrant furtherexploration incare.engaged the twogroupsweremoresimilarwhenlimitedtosubsetsofpersons HOPWA clients thanPLWHA ofviralsuppressionbetween overall;rates Conclusions: suppressed. and 50%weresuppressed;amongPLWHA incare, engaged 79%were to care, incare, 63%wereengaged started tohave 60%appeared ART, Ofthe117,618PLWHA overall, 86%hadbeenlinked were suppressed. 71% weresuppressed;amongHOPWA incare, enrolleesengaged 74% incare,96% wereengaged started tohave 91%appeared ART, and Results: incarewhoweresuppressed. engaged NYC PLWHAand 2013 overall, the proportionofpersons andcalculated tosuppressionforNYC HOPWA clients care continuumfromdiagnosis a Thehealthdepartmentcreated last suppressionin2013(per viral VL). tion (viral suppression [ (ART)initia testin2013), (any antiretroviral therapy also indicated and since 2001, andengagement ofHIVdiagnosis) least8daysafterdate at test (any testswereproxiesforcarelinkage HIV-related laboratory [VL]). tests(CD4countandHIVviralload and resultsofHIV-related laboratory dates, toobtain HIVdiagnosis anddates registry NYC HIVsurveillance Methodology: care forhousingprogramclients. (PLWHA). in The HIVcarecontinuumcanbeusedtomonitorengagement personslivingwithHIV/AIDS vices andpromoteHIVcareforlow-income (HOPWA) fundingtoprovideseveralmodelsofhousingandsupportser over $50millionoffederalHousingOpportunitiesforPersons with AIDS Background: 2 1 Wiewel (presenting) Ellen New York City, 2013 Persons LivingWithHIV/AIDSOverall, RDE Systems, Clifton, NJ, USA NY, USA New York CityDepartmentofHealthandMentalHygiene, New York, Ofthe35,168HOPWA enrollees, 100%hadbeenlinkedtocare, Rates ofviralsuppressionweremuchhigheramong Rates The New York City(NYC)healthdepartmentadministers Data on2013NYCHOPWA tothe Data enrolleeswerematched Housing ProgramClientsand The HIVCareContinuumfor ≤ 200 copies/mL] at any point since 2001) and and 2001) since point any at copies/mL] 200 1 , LauraHollod HIV Treatment andPreventionAdherence 1 , Jesse Thomas , 2 , JohnRojas

- - 1 281 adapting such interventions foruseinSub-Saharan suchinterventions adapting Africa, wherethe However, thereisalackofresearch on co-morbid mentaldisorders. can improvebothadherenceandmentalhealthforpeopleon ART with (ART). improveadherencetoantiretroviraltherapy interventions They Introduction: 5 4 3 2 1 Steven Safren Conall O’Cleirigh Primrose Nyamayaro Melanie Abas Living WithHIVinZimbabwe efficacy inpublic ofthisintervention ART facilitiesinZimbabwe. in Sub-Saharan Africa. the isneededtoevaluate Robustevaluation setting acceptable foradherencecounselorstodeliverinalow-resource toimprove ing approach ART adherenceanddepressionisfeasible Recommendations: (SD 3.3). MeanPHQ-9pre-CBIwas13.5(SD2.6), droppingto3.4 follow-up.at defined as tions foradherencebarriersanddepressionproblems. Adherence, and theadditionofculturallycompetentprobestoelicitpossiblesolu fordepression, andonproblem-solvingtherapy visual aidsforeducation original Life-Steps the maindifferences arelanguage, moreemphasison “ Lessons Learned: Patient HealthQuestionnaire, witha3-monthfollow-up. adherence electronicallyusing WisePill, anddepressionusingthe9-item adherence. ofpoor indicators was39years. Meanage We measured alsoclinical CBI in15participants(9female)whohaddepressionand guidewas17/18. rating mean fidelityonatherapist We thentestedthe with10clients practice eachtheirAfter 5daystrainingandsupervised consultation. We trainedlocaladherencecounselors todelivertheCBI. clinic inHarare, Zimbabwe, including methodsandexpert qualitative (CBI)foradherenceinamajor intervention cognitive behavioral ART Description: sion arecommon. prevalence ofHIVishighestandwherementaldisorderssuchasdepres Nzira Itsva” which translates as ‘New Direction’. Compared tothe England, UK London SchoolofHygeineand Tropical Medicine, London, Mount SinaiMedicalSchool, New York, NY, USA Massachusetts GeneralHospital, Boston, MA, USA University ofZimbabwe, Harare, ZIMBABWE Kings CollegeLondon, England, UK ≥ 90% inthepast2weeks, hadimprovedfrom47%to100% theLife-Steps toadapting We approach usedasystematic Evidence from the US shows that cognitive-behavioral cognitive-behavioral that EvidencefromtheUSshows 3

(presenting) and DepressionAmongPeople Treatment Adherence toImprove 3 , KidiaKhameer The culturally-adapted CBIforadherenceiscalled Theculturally-adapted evidence-basedproblem-solv A culturally-adapted 2 , JessicaMagidson 1 , DixonChibanda 4 , KirstyMacpherson 3 , TariroMakadzange 2 , TarisaiBere 1 , Ricardo Araya , 2 ,

- 5 , - - ORAL ABSTRACTS 43 44 282

these keyHIVcarecontinuumcomponentsinLAC. in impactamong personslivingwithHIVandtopositively engagement has thepotentialtoimproveretentioninHIVcareandviralsuppression Conclusions: in careincreasedfrom45%to72%(p<0.0001). copies/mL increasedfrom52%to84%(p<0.0001)andthoseretained 12m pre-MCCtopost-MCC, with theproportionofpatients VL<200 (range:received 17.3medianhoursofMCCservices 0-147.5). From <6months;and73%on ART). incarcerated At 12months, had patients poverty level; 51% 76% male; 85% Black; 26% 25HIVclinicsat (49%Latino, Results: compared using McNemar’s testforpaired data. 12monthswere Differencesinthemainoutcomesat past 12months). 12-month outcomes. in daysapart 90 The mainoutcomeswere VL differencesin imental pre-testpost-testdesignwasusedtoevaluate testdates. usingHIVlaboratory visits wereestimated A quasi-exper withinterquartilerange(IQR).number ofMCChoursisreported Medical werecollected. data sessment, andMCCservice laboratory The median for poorhealthoutcomesweretargetedenrollment. Baselineas ORALto improvehealthoutcomesandreduceriskbehaviors. risk Patients at medical andpsychosocialneeddelivertargetedbriefinterventions Description: the firstyearofMCCprogram. low-income, populations. minoritypatient ispresentedfor Outcomedata Ryan program isfundedat predominantly White HIVclinics serve inthat TheMCC centeredmedicalhomeintoHIVcaredelivery.of thepatient ABSTRACTS principles to improvetheLACHIVcarecontinuumandincorporate 2012 (MCC)programin Health implementedtheMedicalCareCoordination Introduction: 1 Wendy(presenting) Garland Coordination PrograminLosAngelesCounty From theFirstYear oftheMedicalCare Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, Between1/2013-12/2013, wereenrolledMCC patients 1,204 teamstoassess The MCCprogramusesmultidisciplinary Promising results from the first year of MCC suggest that thefirstyearofMCCsuggestthat Promisingresultsfrom TheLos County(LAC)DepartmentofPublic Angeles and Viral Suppression:Results inRetentionCare Improvements ≥ 40 years; 23% STD diagnosis 1 , SonaliKulkarni 1

≤

6 months; 10%6 months; ≤ federal 10th International Conference on 10th International - - 287 spond differentlyondifferentrecallintervals. (IRT) Itemresponsetheory adherence measure. malesandfemalesre how littleisknown However theclinicalused tocapture andaccuracy importantvariation ofthe self-reportedadherence. toevaluate ature Three-day recalliscommonly Background: 6 5 4 3 2 1 Jie Shen Yan Wang MACH14 Study Over Time BetweenMalesandFemales in be applied to create harmonizedadherence measuresovertime. tocreate be applied tocompareself-reportedadherence can The methodsusedinthisstudy adherence betweenmalesandfemales isworthfurtherinvestigation. through threedifferentrecallintervals. ofself-reported The variation adherence latent males andthree-dayrecallforfemalesonevaluating on differentrecallperiods. for The one-daymightbemoreappropriate Conclusion: days recallamongfemales. forthethree-dayrecallamongmalesandone-ortwo- some variation three-day recall. thereis The that model by genderindicates stratified the parameter “difficulty” is much larger for two-day recall than one- or recall ismoredifficultthanone-orthree-dayrecall, andthevarianceof two-day that in thelongitudinaltwo-tieritemfactoranalysisindicates baseline. at all threedifferentrecallintervals The overallestimation Results: into consideration. period.over study The analysisalsotakesthecluster effectamongsites arebeingusedtoassesstheadherencelevel three-day) recallintervals in HIVamong14sitesUnitedStates. Three different(one-, two-and intheMACH14study,exit interview aMulti-site Adherence Collaboration thebaselineand adherenceat in IRT thelatent modelingtoestimate Methodology: to questionsoritems. peopleresponddifferently uses probabilitybasedmodeltodescribehow University of Washington, Seattle, WA, USA University ofPittsburgh, PA, USA Columbia University, New York, NY, USA RAND Corporation, Santa Monica, CA, USA University,Brown Providence, RI, USA University ofCalifornia, Los Angeles, CA, USA There are1,108menand484womeninthesamplewhohave 1 ,Robert Remien

(presenting) isdifferentbetweenmaleandfemale The responsepattern beenusedintheliter A varietyofrecalltimeframeshave We usethenewly developedtwo-tieritemfactoranalysis ence on Different Recall Intervals ence onDifferentRecallIntervals Difference inSelf-ReportedAdher HIV Treatment andPreventionAdherence 1 4 , LiCai , JudithErlen 1 , Ira Wilson , 5 , JaneSimoni 2 GlennWagner , 6 , HonghuLiu 3 ,

1 - - - 289 10th International Conference on 10th International women’s HIVcontinuumofcare. tomoreeffectively addressuniquefactorscontributingto interventions case managers, todeveloptargeted andcommunity-basedservices HIVCC. threaten factors that Findings enhancetheabilityofproviders, en’s andcare;however, HIVtreatment eachgroupstillfacesmultilevel Conclusions: werecitedascarefacilitators. HIV treatment support groupsandmentalhealthservices, ofHIVand and knowledge social groupsandhealthcareproviders, community-basedprograms, stitutions, anddrugalcoholabuseaschallengestocare. Supportive women (N=4)describedunstablehousing, unsupportivehealthcarein forenteringtreatment.frequently citedintervention “Care-Detached” were citedascarefacilitators, withhealthcareproviderinsistenceasa emotional support, andviralsuppressionwithin6monthsoftreatment ers tocare. Supportivehealthcareprovidersandinstitutions, socialand unsupportive healthcareinstitutions, andperceivedHIVstigmaasbarri consistent” tohousing, women(N=7)describedchallengesrelated ascarefacilitators.suppressed viralloadvaluepost-diagnosis “Care-In care providerrelationships, andhighCD4count( healthcare experience, tocare, promptlinkage strongsocialandhealth ≥ majority Black/African American/non-Hispanic (95%)womenwhowere Results: quotespresentuniquethemes. Illustrative andcareengagement. oftreatment typology in a3-groupbehavioral resulted that data analyseslinkingsociobehavioral/biomedical parative Women’s Interagency (WIHS). HIVStudy We performedconstantcom differentCCmilestonespriortoenrollmentin the challenges at Atlanta Methods: factors affectingCCsuccessesandchallenges. obstacles towomen’s HIVcaretoimproveunderstandingofmultilevel to reachHIVcontinuumofcare(CC)outcomes. exploredthe This study Background: 1 Hayley Robinett Julie Zuniga Paula Frew Adherence toHIVTreatment andCare 46 years(75%). “Care-Engaged” women(N=10)describedpositive Emory University,Emory Atlanta, GA, USA Preliminary analyseswithasubsample(N=21)included Preliminary a We with34womenwhoexperienced conductedinterviews 1 , 1 , Gina Wingood , Marcia Holstad influencewom identifieduniquefactors that This study SouthernwomenlivingwithHIVfaceuniquechallenges Women’s Entry, Engagement, and Multilevel Factors Contributingto 1 1 , NikiaBraxton

(presenting) HIV Treatment andPreventionAdherence 1 1 , SarkoSarkodie , IghoOfotokun ≥ 800 cells/mm 1 , 1 ,

3 ) and ------

ORAL ABSTRACTS 45 46 4 quality oflifefurther. An improvementinsocialsupportforPLWA, thereforewill improve their because PLWHA anddiscrimination. arestillexposedtostigmatization mental domainscoresmaysuggestineffectivesocialsupportnetworks, programme. socialandenviron interventions low education Relatively Environmental domainsmayreflectiveoftheeffectivenessplanned programmeinthePhysical,intervention Psychological, Socialand Conclusions: 0.016) differenceinthemeanQOLscoresofpre-testandpost-test. 0.05levelofsignificance.using studentt-testat Thereissignificant(p= chological (p=0.019), Social(p=0.046)andEnvironmental0.032) change intheQOLallfourdomainsi.e. Physical(p=0.008), Psy Hindu (95%). programmethereissignificant intervention After education groupof25-50years,jority ofthem(80%)wereage Male(56.7%)and Results: using SPSS-16 Version software. focus groupdiscussionswerearranged. wasanalyzed The collecteddata POSTERconducted usingthesameinstrumentsamongsubjects. Four Telephone wasprovided. consultation After threemonths, post-testwas programmewasconductedforthreemonths. intervention education instrument baselineQOLofthePLWA wasassessedandthenplanned 2013 involving60PLWA onpre-testrandomly. Using WHO QOL-Brief amongthePLWAthe study on ART BPKIHSfromJuneto at August Methodology: of HealthSciences(BPKIHS), Nepal. of PLWA on ART theanti-retroviralclinic attaining B. at P. Koirala Institute programmeinimprovingtheQOL intervention effectiveness ofeducation ABSTRACTSWHO QualityofLifeBriefScaleinstruments. assessedthe This study PLWA beenconductedinNepalonhow have perceivetheir lifewiththe riseinlongevityofPLWA.with theappreciable Moreover, limitedstudies ofthewell-beingPeopleevaluation Livingwith AIDS (PLWA); especially Background: 1 Ram Mehta AIDS inEasternNepal

B. P. Koirala InstituteofHealthSciences, Dharan, NEPAL Quality ofLifethePeople LivingWith Telephone the toImprove HealthService oftherespondentswas36.70±9.92,The meanage andma

(presenting) Changes in QOL scores in post-test after education ChangesinQOLscorespost-testaftereducation QualityofLife(QOL)isanimportantcomponentinthe A pre-experimentalresearchdesignwasusedtoconduct posters withtheDoublePalm Tree designation. Abstract ReviewCommittee wishtorecognizetheauthorsofhighestscored While 1 we valueall Adherence 2015posterabstractcontributions, IAPAC and the 10th International Conference on 10th International - - - 7 identifying strategies to better engage referredpatients, tobetterengage identifying strategies beginningwith Methods/Practice of NPIproceduresandrestructuringtheintakeprocess. andtransfersfromotherproviders—promptedareview newly diagnosed accordingly.care coordination Increasednumberofnewreferrals—both andneeds;tobeginHIV healthstatus assessment ofnewpatients’ andhealthcareteammembers;toperformathorough between patients toestablisha working relationship which towelcomenewpatients; process aretoprovideapositive, in centeredatmosphere patient Background/Purpose 2 1 Jan Stockton IntoHIVCare Entry part ofthispresentation. andretainHIV-infectedengage personsincareandwillbediscussedas a corecomponentofCQI, to furtherguidedevelopmentofstrategies basic understandingofHIVdiseaseandtreatment. OngoingPDSAcycles, intakeandanincreaseinpatients’ at history ofpatient documentation andphysiciansreportimproved from 30%to21%hasbeenobserved Conclusions/Implications ForPractice on anti-retroviralmedications. mental healthconcerns, whoarerunningshort andtransferringpatients forcasesinvolvingpregnancy,to standardizeschedulingprioritization of theinitialphysicianvisit. Inaddition, a “decision tree” wasdeveloped upcontactuntilcompletion forfollow andremainsavailable education; studiesandmentalhealthscreening;provides line laboratory “HIV 101” andphysicalexams;obtainsbase practice RNperformsintakehistory aboutthemedicalcenterandNPIvisit.information An advanced systemstoreceiveinitialphonecontactsand to providebasic messaging includedinitiatives employing navigators” thanvoice “patient rather appointment withtheInfectiousDiseasephysician.to thefirst CQI the initial/referralphonecontact, throughtheNPIvisit, andcontinuing AIDS Education AIDS Education Training Center, Newark, NJ, USA University ofCincinnati, OH, USA Improvement (CQI)InitiativestoFacilitateImprovement Off toaPositive Start:ContinuousQuality

(presenting) : EffortstoimproveNPIgoalachievementresultedin : The goalsoftheHIVNewPatient Intake(NPI) HIV Treatment andPreventionAdherence 1 , Yolanda Wess : A reductioninmissedvisits 2 , Pamposh Kaul 1

- 11 10th International Conference on 10th International at highestrisk. fisherfolk areneededtoreach delivery outreach forHIVtestingandtreatment fisherfolk to clinic outreachtestingevents. New, flexiblemodelsof largenumbersofhigh-risk issues maybeginwiththefailuretoattract to healthcare), mobility, highpopulation andstigma. to care Linkage due tosystemicclinic barriers(e.g., orinconvenientaccess low relatively Conclusion: surveys. population thanin testing outreacheventsovera6-monthperiod—muchlower and medicalmistrust. outreach eventsfortestingandtreatment), socialsupport, low fatalism, barriers included ofclinics highstigma(leadingtoavoidance and needs forworkduringclinic hoursandoutreachevents. issues (e.g., schedulestoclinic inconvenientferry sites), andcompeting healthcare facilities, mobilityintertwinedwithtransport highpopulation Results: analysismethods. qualitative and wererecorded, transcribed, translated, andcodedusingstandard roles infisherfolkcommunities). wereconductedinLuganda Interviews healthcare providersand6communitymembers(e.g., inadministrative munities in2014. We 10keystakeholders, alsointerviewed including 4 clinic outreacheventsinUgandanLake Victoria lakesideandislandcom (11 women, 15men)within1-2monthsoftheirtestingHIV-positive at cial, structural, andprovider-related barrierstocarewith26fisherfolk Methodology: oftheirserostatus,aware useofantiretroviraltreatment. andlow offisherfolkwhoare percentage low prevalence maybetherelatively 7.3%). (at higher thaninthegeneralpopulation Onereasonfor thehigh and sexworkers), tobe15-40%—much HIVprevalenceisestimated include fishermenandtheirfamilies, peoplewhosupportthefishtrade, Background: 5 4 3 2 1 Rhoda Wanyenze Rose Naigino Laura Bogart(presenting) Qualitative Analysis Boston Children’s Hospital, Boston, MA, USA Makerere UniversitySchoolofPublicHealth, Kampala, UGANDA Mildmay Uganda, Kampala, UGANDA RAND Corporation, Santa Monica, CA, USA Boston Children’s MedicalSchool, Hospital/Harvard Boston, MA, USA Participants citedstructuralbarriers, including few relatively Ugandan FisherfolkCommunities:A Barriers toLinkageHIVCarein Linkage tocareamongfisherfolkischallenging, Linkage primarily 4 InUgandanLake Victoria fisherfolkcommunities(which , BarbaraMukasa We onpsychoso conductedsemi-structured interviews 4

Further, clinic wefound<10%HIVprevalenceat 1 , Glenn Wagner, 3 , EstherKawuma HIV Treatment andPreventionAdherence 2 , William Musoke , William 3 , EmilyMaistrellis Psychosocial 3 ,

5 , - - 13 surgical departmentweretrainedonMogendeviceusefor3days, sites andmonitoring.implementation and MedicalStafffrommaternity theclassical followed programcycleservices ofassessment, planning, andtoreviewprogressregularly.mentation Stepsinestablishingthe Methodology: (performed betweenbirthsto2months)aslongtermstrategy. since 2008, inadditionRwandaismodelingNewbornmalecircumcision were interestedinMMC, tomeetthisdemandadultMMCisprovided circumcise, campaignsthroughcommunitypeople aftersensitization reduce theriskofHIVinfectioninmen. Rwandadoesnottraditionally Background: 2 Karangwa Chaste Lessons Learnt male circumcisionprocedures. are criticaltominimize AE andtoachievebetteroutcomeofNewborn onthejob trainingusinginfantpenismodelsandsupervision adequate Selection ofhealthcareworkerswithsurgicalexperience, extendedand circumcision inMNCHsettingisfeasible. Mogenclamp issimpletouse. Lessons learnedandnext steps: foreskin. experienced AE suchasbleedingand8hadincompleteremovalofthe 41 days. adverseevents(AE), Majority(n/N)didnotexperienceany five welfare clinic visits. was birthweightwas3.3 kilosandage The average the consented at ANC, and59%duringroutinechild 35%afterdelivery Results: for uptakeimprovement. enrolled. andadverseeventswascollectedroutinelyreviewed Data were selected, supplieswereprocured, andclients weresensitized and Rwanda biomedicalCenter, Kigali, RWANDA A totalof85circumcisionswereperformed, 6%ofthese Infant MaleCircumcisioninRwanda: Modeling ImplementationofEarly Medicalmalecircumcision(MMC)hasbeenprovento A steeringcommitteewasestablishedtooverseeimple

(presenting) 1 Integration ofnewbornmale Integration - POSTER ABSTRACTS 47 48 14

uals, providersandcommunityorganizations. isneededtoguideindivid andpreventionroadmap treatment integrated the endofsexualHIVtransmission, acommunity-driven, adaptive, and increasedopportunitiestoconnectwithconsumers.will allow To realize champions, whereevertheyarefound, embracingmultipleapproaches andscaleupofproveninterventions.focused approaches Supporting HIV stakeholderscanprovideexpertiseonwholeperson, consumer to offerthosecommittedendingsexualHIVtransmission. Perinatal Recommendations: and humanconnection. whole person, aroundsexual goals acompellingnarrative andcreating champions forchangewherevertheyappear, forthe anappreciation missed opportunitiesandcorrectiveaction, theimportanceofsupporting infectiontoidentify reviewofevery andinterdisciplinary of systematic prevention activities, embracingmultipleapproaches, theimportance practiceguidance,the benefitsofnormative and oftreatment integration to endingsexualHIVtransmissionare: thecentralroleforHIVtesting, POSTERLessons learned: andprevention.of treatment thecrossroads ofsexualHIVtransmissionwillmostlikelyoccurat nation regionally andlocallytoimplementbestpractices. The successfulelimi available. HIVstakeholdersnationally,This cascadeguidedperinatal asnewresearchandtechnologiesbecame iterated tion paradigmthat andpreven treatment Institutes ofMedicinein1998isanintegrated Description: field hascomealongwaywithhardwonlessonstoshare. ABSTRACTS 50,000newinfectionsyearly.unchanged at HIVprevention The perinatal decreased,have in theU.S. theoverall HIVtransmissionrate remains proposed. incertaindemographics Though sexualHIVtransmissionrates HIVhasbeen perinatal 90% since1991andaframeworktoeliminate cesses intheUnitedStates, declined HIVtransmissionshave perinatal Introduction: 1 Shannon Weber Transmission University ofCalifornia, SanFrancisco, CA, USA to InformPreventionofSexual HIV Lessons LearnedFromPerinatal HIV The Perinatal HIVPreventionCascadefirstproposedbythe publichealthsuc Widely heraldedasoneofthegreatest

(presenting) couldapply HIVpreventionthat Themes fromperinatal The collective successes of perinatal HIVhasmuch The collectivesuccessesofperinatal 1 , RobertGrant 1 10th International Conference on 10th International - - - - ally, onsaferconception, thoughtleaderinterviews familyplanning, transmission, familyplanningandsaferconceptionoptions. Addition to determinemen’s experiencesandbeliefsaboutHIVprevention Methodology: caresetting. reproductivehealthcareintotheprimary integrating determine theirreproductivehealthintentionsandtosupportclinicians women receivingcareat Ward 86HIVClinic. PROMenaimstohelpmen 500HIV-positive sexwith menwhohave theapproximately is aimedat San Francisco GeneralHospital’s (SFGH) Ward 86HIVClinic. PROMen ofBAPACan initiative (Bay Area Perinatal AIDS Center)andbasedat Introduction: 1 Shannon Weber Pro MenInitiative possibility andhope. of fromoneofriskreductionandpermissiontoastory reframe thestory reach HIV-uninfected partnersofHIV-positive menandanopportunityto tion strategy. providesauniqueopportunityto The PROMenapproach andpreven treatment and reproductivehealthgoalsisanintegrated Conclusions: pre-exposure prophylaxis. Forty providerssought54consultations. A totalof13womenwerereferredforHIV-testing andscreeningfor clinicattended foraone-on-onepartnervisitwiththePROMennurse. HIV-negative femalepartnerforacouplevisit. Another sevenwomen Men nurseyielding73totalvisits. Additionally, sevenmenbroughttheir Results: eventwasheld. provider education launched in2013, additionalvideoswereproducedandathree-hour HIVsexualtransmission.and lowering MonthlyPROMensupportgroups andprovidertoolsoncontraception,as patient saferconceptionoptions needs.and consultation These findingsinformedavideoscriptaswell UCSF’s Perinatal HIVHotlinehighlightedclinicians’ National questions HIV transmission, adherenceanddisclosure wereconducted. Callsto HIVE/BAPAC UniversityofCalifornia, SanFrancisco, CA, USA 15 During2014, 44mensoughtaone-on-onevisitwiththePRO SupportingmenlivingwithHIVinachievingtheirsexual PROMen(Positive ReproductiveOutcomesforMen)is DuringthePROMENpilotyear, focusgroupshelped

HIV-Positive MalePartners: The Reaching Women ThroughTheir (presenting) HIV Treatment andPreventionAdherence 1 , Guy Vandenberg, 1 , DeborahCohan 1 - - 18 10th International Conference on 10th International theimpactofproposedinterventions. well asevaluate as inotherpopulations will assessfortheproblemofHIVpillaversion women’sand childreninadditiontotheperinatal cohort. Future research person’s difficulty. Finally,ages,aversion affectswomenofall pill men, manner, underlieeach ofspecificissuesthat exploration whileallowing identify, classify, theproblemearlyandinastandardized andmanage willbecriticaltohelpingpatients.aversion Suchatoolwould ideally thenuancesofpill developmentofanassessmenttooltocapture that longitudinally.and assessinginterventions Specifically, wepropose screening tools, furthercharacterizingthisheterogeneousproblem, Recommendations: visualiation, andcognitiverestructuing. including theory counterconditioning,cognitive behavioral extinction, cognitionsorimages.by negative We basedupon proposeinterventions duetopregnancytioned aversions developed symptomsandaversions components ofpillaversion. We distinguishbetweenclassically condi aversion. todescribethedifferentcausesand We patterns observed women,pregnant andperinatal evidenceofpill shown 17(12%)have adherence inourclinical experience. of140 From ourobservations Lessons Learned: population. inanHIV-infecteddevelopment andexperienceofpillaversion pregnant address therolesofclassical inthe conditioningandcognitivetheory population. toaperinatal Inatheoreticaldiscussionwe interventions therapeutic andapplying standing themultiplecausesofpillaversion literature,pill aversion weproposeaconceptualframeworkforunder Description: behavior.development andreinforcementofpillaversion our pregnantHIV-infected population, weseektobetter understandthe weidentifywithin patterns tobehavioral theory cognitive behavioral andtestingtheoriesinterventions.ing thesebehaviors Byapplying withpillswallowing.toms associated We proposestepsforcharacteriz medical orstructuralcauseaswelltheanxietyandphysicalsymp sion” pillswithnopersistent swallowing andaredefiningitasdifficulty highly activeantiretroviraltherapy. We refertothisproblemas “pill aver pillsasafrequentandsignificantbarriertoadherence swallowing Introduction: 1 Robin Dorman Northwestern University, Chicago, IL, USA Women: toPractice Theory Pill Aversion inHIV-Infected Pregnant Baseduponthistheory, ourexperience, andthepediatric In our perinatal HIV cohort we have observed difficulty observed HIVcohortwehave Inourperinatal

(presenting) Pill aversion is a significant barrier to medication isasignificantbarriertomedication Pillaversion includeAreas offutureinvestigation developing 1 , Lynn, Yee HIV Treatment andPreventionAdherence 1 , SarahSutton 1 - - - - - taking ART. Non-persistencewasdefinedaspurposelynottaking ART for currently collectedbetween6/2009–5/2011from11,844patients data adults receivingmedicalcareintheUnitedStates. We analyzedweighted sampleofHIV-infected amongarepresentative surveillance behavioral Methodology: the UnitedStates, withviralload, andtheirassociation arelacking. in ofnon-persistenceandnon-adherenceamongHIVpatients patterns effectonHIVviralloadthannon-adherence.a greater on data National (ART) withHIVviralloadandmayhave hasbeenfoundtobeassociated Background: 1 Margaret Nyaku States Among HIV-Infected AdultsintheUnited for non-persistence at HIV-clinicalfor non-persistenceat maybebeneficial. appointments suppression. Inadditiontoassessingnon-adherence, routinescreening herent, supportingtheimportanceofmaintaining persistenceforviral were lesslikelytobevirallysuppressedthanthepersistent/non-ad reporting non-persistence. Those whowerenon-persistent/adherent Conclusions: non-persistent/adherent patients. and non-persistence betweenthenon-persistent/non-adherentpatients (18%). There werenosignificantdifferencesamongreportedreasonsfor break” (30%)and “medicine hassideeffectsormakesmefeelbad” for non-persistencewere orneededa “got tiredoftakingmedications 44.8%, 53.6%and69.0%, respectively(p persistent/adherent. ofdurableviralsuppressionwere35.1%, Rates non-persistent/adherent, 10.5%persistent/non-adherentand80.3% Results: for non-persistenceamonggroups. detectable or<200copies/mLduringthepast12months)andreasons used tocomparedurableviralsuppression(definedasallloadsun persistent andadherent(“persistent/adherent”). Chi-squaretestswere adherent”), persistentbutnon-adherent(“persistent/non-adherent”), and sistent/non-adherent”), non-persistentbutadherent(“non-persistent/ intofourgroups:patients non-persistentandnon-adherent(“non-per defined asmissingan ART doseduringthepast3days. We categorized timeinthepast12months. any leasttwodaysat at Non-adherencewas Centers forDiseaseControlandPrevention, Atlanta, GA, USA 22 Overall, 3.5%werenon-persistent/non-adherent, 5.7% Durable viral suppression was low among patients among patients Durableviralsuppressionwaslow Patient-initiated non-persistence to antiretroviral therapy non-persistencetoantiretroviraltherapy Patient-initiated The MedicalMonitoringProjectconductsclinical and 1 , Therapy andViral Suppression Non-Persistence toAntiretroviral Linda Beer

(presenting)

<0.001). Commonreasons 1 , SandraStockwell 1 - - - POSTER ABSTRACTS 49 50 23

improvement and help target resources to populations in greatest need. ingreatest improvement andhelptargetresourcestopopulations fromelectronicmedicalrecords todrivequality technique cananalyzedata risksoffailuretoachievesuppression.elevated This easilyimplemented Conclusion: risk profiles(p<0.01), risksrangingfrom0.7to2.0. withrelative thelikelihoodofsuppressionvariedsignificantlyamong that indicated ofviralloadsuppression(56.2%). rate analysis lowest Confirmatory Patients whoabusedsubstancesandwereunstablyhousedhadthe suppression included age, housing status, druguse, andrace/ethnicity. less likelytoachieveviralloadsuppression. Predictorsofviralload ofviralloadsuppression, rates varying including 5groupssignificantly Results: POSTERta-mining technique. measurement andanalyzedusingclassification treeanalysis, ada were abstractedfrommedicalrecordsforthepurposeofperformance careprogramsinNew from 180establishedHIVprimary York State. Data Methodology: careteamsofproviders. are easilyinterpretablebymultidisciplinary sion approaches. and Resultsareprovidedvisuallyinanintuitiveformat modeling ofdisparitiesinHIVclinical outcomesthantraditionalregres targeted interventions.amoreprecise treeanalysisallows Classification ABSTRACTS ofsuppression toguide rates groupswithlow canidentifypatient data the potentialof ART. viralload Routinemeasurementofpopulation-level areneededtorealize tients remainunsuppressedandthusinterventions HIV/AIDSstrategy.with HIVandisapillaroftheUSNational pa Many (ART)therapy reducestheriskofmorbidityandmortalityforpeopleliving Background: 1 Daniel Feller New York, NY, USA New York DepartmentofHealth, State AIDS Institute, The algorithmclassified cohortinto8groupswith thestudy Disparities inHIVClinicalOutcome Using MachineLearningtoExamine The CaRT groupswith algorithm identifiedseveralpatient

(presenting) Viral loadsuppressionthrougheffectiveantiretroviral We derivedaretrospective sampleof11,419adultPLWH 1 , Bruce Agins , 1

10th International Conference on 10th International - - - 24 to mentalhealth, BZDuseand ART data adherenceandthequalitative relating data Structured questionnaireswereusedtocollectbehavioral received monthlyurinetestsby Assay type: ImmunoChromatography. Methodology: to ART.adherence theprevalenceofBZDuse, estimates study mentalhealthfactorsand of methadonehasbecomeacommonpracticeamongMMTclients. This Background: Samuha,Aavash Kathmandu, NEPAL Bikram Bista Clients FromLalitpurDistrictNepal Methadone MaintenanceTreatment (MMT) Therapy(ART)to Antiretroviral Among doses ofBZDandenhance ART adherenceamongmethadoneclients. absorbingtherapeutic onprescribinglonghalf-lifeslow and investigate co-occurring anxietyorpsychologicalproblemsaswellneedtostudy Conclusion: ART (OR=1.81;p<.05;CI1.01-3.24). (OR =0.43;p<.01;CI0.25-0.72). Only15%(n=3)wereadherentto thecohortswerealsolesslikelytobeadherent that also showed ART needforpsychologicaloremotionalproblems(p =0.005)and treatment for severityratings), sufferedsevereanxietyortension(p<0.0005)and higher showed ASI scores(p=0.04forcompositeand0.005 for regularBZDuse(n=17)85%withoutaprescriptionandalso daily methadonedosewas25mg. 17clients (1female)testedpositive 18% (n=17)hadHCVco-infection. was32years, Medianage Median Results: 2013 toDecember2014. analysis.content andnarrative wasdonefromDecember The study wasmanuallyanalyzedthroughthematic, data andQualitative statistics wasanalyzedviaSPSS13.0usingdescriptiveandinferential data tative BandCweretakenfromclient’shepatitis MMTmedicalcharts. Quanti collected throughresultsoftheurineanalysis, serologicalresultson Among the20cohorts, 10%(n=2)hadHBVco-infectionand Mental HealthFactors andAdherence Study onBenzodiazepine(BZD)use, theneedtoredesignMMTaddress shows The study Using of BZD orally or intravenously tointensifytheeffects UsingofBZDorallyorintravenously

(presenting) A cohort20activeMMTclients (1female)under ART HIV Treatment andPreventionAdherence 1 - 25 10th International Conference on 10th International andtheimpactofPCHCMonHIVclinicaltion patterns outcomes. pharmacist-providercommunica analysis willbeconductedtoevaluate continue toassesschallengesandsuccesseswiththePCHCM. Data Recommendations: HIV-specific betweenpharmacistsand communication clients. betweenpharmacistsandprovidersmoreorganized communication regimens,understanding ofcomplexmedication moremeaningful sites include administration, correctedtimingofmedication improved MTM visit, missedMTMvisits)barriers. Earlysuccessescitedbyproject pharmacies)andenrollment(delayinscheduling or unwillingtoswitch pending. Currentreportedchallengesinclude recruitment(clients unable initial MTMvisit, beencompletedand51are ofwhich63(55%)have recruitment. initiated have Overall, werescheduledforthe 114 patients Lessons Learned: frommedicalandpharmacygathered recordabstraction. es toprojectimplementation. collectionincludes Data clinical outcomes individual andallsitemeetingstodiscussearlychallengessuccess ongoing projectoversight, andanalysis. management data This includes ic-pharmacy sites, developedanddeliveredsitetraining, andisproviding As partofimplementation, theprojectteamhasidentifiedpartner clin provider, pharmacist, continuethroughout theprojectperiod. andpatient betweenthe andcollaboration monitoringofcommunication services; forMedication (MTM) pharmacists inpreparation Management Therapy withpartnered Clinical providerssharecompletemedicalhistory will enroll1,000HIV-infected clients, emphasizingminorityenrollment. Description: to ART, therebyimprovingHIVclinical outcomes. Model (PCHCM)projectaimstoincreaseretentionincareandadherence pharmacists andHIVclinical providers, thePatient-Centered HIVCare suppressed. between careandimprovingcommunication Byintegrating yet,therapy; withHIVarevirologically only30%ofthosediagnosed HIV-infected incareandadherentto individualswhoremainengaged Introduction: 6 5 4 3 2 1 Kathy Byrd(presenting) Michael Shankle Kristin Darin Between PharmacistsandProviders Communication Outcomes ThroughImproved Fort Worth,USA TX, University ofNorth Texas System CollegeofPharmacy, Centers forDiseaseControlandPrevention, Atlanta, GA, USA Walgreen Company, Deerfield, IL, USA HealthHIV, Washington, DC, USA University ofNebraskaMedicalCenter, Omaha, NE, USA Chicago, IL, USA Northwestern UniversityFeinberg SchoolofMedicine, HIV CareModeltoOptimize Implementation ofaPatient-Centered 1 The PCHCMproject, whichbeganinSeptember2013, , KimberlyScarsi (ART)Antiretroviral therapy reducesmortalityamong 3 , Ambrose Delpino , Ambrose 2015,As ofJanuary and sevensitesareparticipating To constructbestpractices, theprojectteamwill 5 , Patrick Clay 2 , MichaelDeMayo 4 , Paul, Weidle HIV Treatment andPreventionAdherence 6 , GlenPietrandoni 3 5 , Carmelita Whitfield , ,

3 - , - - 27 the individualsreturnedtocarewithoutpublichealthintervention. movement todifferentprovidersor2) evidence ofcaredueto1)patient help distinguishpotentiallylost-to-carepersonsfromthosewithcurrent Partnerships betweenmedicalprovidersandhealthdepartmentscan oftenenterandexitcareovertime. andpatients isdynamic care status HIV/AIDSStrategy.care isakeycomponentoftheNational However, Background: 2 1 Marlene McNeese Richard Grimes(presenting) Saroochi Agarwal and in-CarePopulations Individuals: AComparisonofLost-to-Care still considerthismeasure. of thephysicalenvironmentandaccesstocare, additionalstudiesmight forawidespreadmetropolitanarea.consideration Giventheimportance including residentialproximitytomajorHIVproviders, animportant limitation,Despite that ouranalysesqueriedmultiplecharacteristics, forfuturestudies. thisfactorshouldbeaconsideration suggesting that asthelengthoftimeoutcareincreases,returning tocaredissipate care status. predictorsof that demonstrated A previousHoustonstudy of potentiallylost-to-carepersonslackadistinguishingpredictorfor Conclusions: 0.973-1.084]). nosignificanteffects. Multivariableanalysisshowed (OR=0.999,diagnosis [CI0.982-1.016]), andproximity(OR=1.027, [CI 0.794-2.242]), ethnicity(OR=1.536, [CI0.834-2.829]), ofHIV duration 0.962-1.001]), sex(OR=0.965, [CI0.589-1.579]), race(OR=1.334, [CI Results: provider clinic andmultivariable logistic regression. usingunivariate mostcurrentresidentialaddresstothenearest and proximityofpatients’ were comparedbyage, sex, race, ethnicity, ofHIVdiagnosis, duration tobeoutofcare(n=138).(n =133)orappeared These populations provider referralshadevidenceofcarewithintheprevioussixmonths systemsdeterminedif searches amongmultiplecareandsurveillance (N=271). intervention (HDHHS)forpossiblere-linkage Record Services medical providerstotheHoustonDepartmentofHealthandHuman Methodology: University of Texas Houston, HealthScienceCenterat TX, USA Houston DepartmentofHealthandHumanServices, Houston, TX, USA Univariate analyses were not significant for age (OR=0.981, analyseswerenotsignificantfor Univariate [CI Potentially Lost-to-Care, HIV-Positive Identify When MedicalProviders Among thissample, providerreferrals resultssuggestthat IdentifyingandlinkingHIV-infected personstomedical Potentially werereferredbyHIV lost-to-carepatients 1 1 , Kellie Watkins,

2 , Biru Yang, 1 , BradleyRaven 1 , Marcia Wolverton, 1 , CamdenHallmark 1 ,

1 , POSTER ABSTRACTS 51 52 28

deciding whether or not to initiate PCPprophylaxis. deciding whetherornottoinitiate intoaccountwhen Providers maybetakingviralsuppressionstatus whodidnotreceiveprophylaxiswerevirallysuppressed.of patients did notreceivePCPprophylaxisdespitecurrentguidelines. The majority Conclusions: 1.63; 95% CI, 1.30–2.05). ethnicity andnumberofCD4<200tests(adjustedprevalenceratio, received PCPprophylaxisafteradjustingforconfoundersincluding race/ not who werevirallysuppressedsignificantlymorelikelytohave pressed, 14%(95%CI, 11–17)didnotreceivePCPprophylaxis. Patients not receivePCPprophylaxisandamongthosewhowerevirallysup Among thosewhowerevirallysuppressed, 28%(95%CI, 23–33)did [CI],(95% confidenceinterval 16–22)didnotreceivePCPprophylaxis. Results: suppression usingmultivariablelogisticregression. betweenPCPprophylaxisprescriptionanddurable viral association by durableviralsuppressionstatus. We alsoassessedtheindependent ofPCPprophylaxisprescriptioninthemedical record documentation POSTER ofHIV-infected withaCD4<200whohad weighted percentage patients collectedbetween6/2009–5/2012,Using MMPdata weassessedthe of HIV-infected adultsreceivingmedicalcare intheUnitedStates. sample andclinical amongarepresentative behavioral surveillance Methodology: byviralsuppressionstatus. and whethertheyvary examinedPCPprophylaxisprescriptionpractices recent studieshave intheseindividuals.suppressed becausePCPincidenceislow Few whoarevirally forpatients PCPprophylaxismaynotbenecessary that T-lymphocyte count<200cells/mm ABSTRACTSrecommend PCPprophylaxisforallHIV-infected personswithaCD4+ jiroveci Background: 1 Jacek Skarbinski Xia Lin(presenting) Patients With Viral SuppressionAmongHIV-Infected Centers forDiseaseControlandPrevention, Atlanta, GA, USA is a life-threatening infection. isalife-threatening guidelines treatment UnitedStates Among HIV-infected adultswithaCD4<200(n=1,655), 19% Pneumonia ProphylaxisAssociated Prescription of Almost oneinfiveHIV-infected withaCD4<200 patients Pneumocystis pneumonia(PCP)causedby The MedicalMonitoringProject(MMP)conducts 1

1 , ShikhaGarg 1 Pneumocystis jiroveci 3 , ChristineMattson (CD4 <200). suggest Recentdata 1 ,

Pneumocystis 10th International Conference on 10th International -

Methodology: of viralsuppressionandthusreducingthenumbernewHIVinfections. incareiskeytoachievinghigherlevels andretaintheirpatients engage experiencedbyHIVcareproviderswhostriveto barriers andfacilitators inHIVcare. andretentionofpatients engagement Understanding the after initialdiagnosis. However, littleresearchhasbeenconductedon andlinkingpeopletoHIVcare on theexpansionofHIVtestingservices inHIVcareandtreatment.cessfully engaged Researchhasfocused Background: 2 1 Damian Denson(presenting) Care WhenEngagingPatientsCare Providers in continuous andconsistentHIVcaretreatment. in theimportanceofprovidersineffectivelyreducinggap illustrate eachpointintheHIVcontinuumofcareand at engagement patient incare.engagement support ongoingeffortstoimprove These data themmayenhancepatient abilitiestonavigate systems andpatients’ holistically, patients standing andtreating whileimprovingsupport Conclusions: ofHIV-positive byotherclinicians.stigmatizing patients appointments,and providerchallengesinmanaging andpersistent policies, insurance-andmedication-related patient difficulties navigating included toneeded supportservices, challengesinconnectingpatients andtrustbetweenproviderspatients.and reputation Keybarriers (ideally inonelocation), theflexibilityof clinic proceduresandproviders, ofabroadrangeprovidersandsupport services the availability provider types. incareincluded engagement ofpatient Keyfacilitators Results: providers ofHIVcareandtreatment. andretentionexperiencedby engagement topatient and facilitators workers.and casemanagers/social exploredbarriers The interviews physicians, nursepractitioners, physician’s assistants, registerednurses, (Atlanta, GA;Baltimore, MD; Washington, DC). included Interviewees providers inthreemajormetropolitanareaswithhighHIVprevalence Atlas Research, Washington, DC, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA 29 Data wereanalyzedforemergingthemesacrossallfacility and Data Our findings suggest that an orientation toward under toward anorientation Ourfindingssuggestthat IntheUS, persons livingwithHIVarenotsuc many Qualitative data werecollectedin2014from30HIVcare data Qualitative Facilitators ExperiencedbyHIV Understanding Barriersand HIV Treatment andPreventionAdherence 1 , JamieHart 2

- - 32 10th International Conference on 10th International migrants, quality. toimprovedata andrecruitingsampledpersons,ods forlocating including out-of-state receiving andnotcare. MMPwillcontinuetostrengthenmeth inference usingCSBSmethodstoinclude HIV-diagnosed personsboth Recommendations: including ofpublichealthimportance. anewpopulation facility-based sampling, while CSBSmethodsyielda similar responserate facility-based MMP, becausetheywerenotreceivingcare. Comparedto CSBS respondents, beeneligibletobeincluded 26%wouldnothave in 46% comparedto51%forfacility-basedMMPinthesameyear. Among 23(33%).interviewed Adjusted foreligibility, was theoverallresponserate migrants, out-of-state 490(72%);amonglocated we we interviewed collection,(91%) residedintheprojectareaconductingdata ofwhom Lessons Learned: jurisdictions ofresidence. withhealthdepartmentsin afterestablishingagreements another state metropolitan areas. We onpersonswhohadmovedto collecteddata and ofHIVinfiveUSstate 1,200 sampledadultslivingwithadiagnosis to locate, recruit, interview, andperformmedicalrecordabstractionson ty-based samplingframes. From July, 2013–June, 2014, weattempted thanfacili registriesrather by samplingfromHIVcasesurveillance include HIV-diagnosed personsbothreceivingandnotcare projectisapilotofnewsamplingmethodforMMP to stration Description: care, mortalityandriskofHIVtransmission. elevated whohave to includeMMP broadenitstargetpopulation personsnotreceivingHIV mission riskbehaviors. The InstituteofMedicinehasrecommendedthat ofHIV-related careutilization,estimates clinical outcomes, andtrans receiving HIVcare. representative areusedtomakenationally MMPdata collectsclinical onpersons veillance systemthat data andbehavioral Introduction: 7 6 5 4 3 2 1 Jeanne Bertolli McKaylee Robertson Chi-Chi Udeagu Thomas Jaenicke Stanley Wei (presenting) Monitoring Project Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, New York, NY, USA New York CityDepartmentofHealthandMentalHygiene, DepartmentofHealth,Mississippi State Jackson, MS, USA Washington DepartmentofHealth, State Olympia, WA, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA andKingCounty,Public HealthSeattle Seattle, WA, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA not ReceivingHIVCareintheMedical Inclusion ofHIV-Diagnosed Persons Sampling(CSBS)demon The Case-Surveillance-Based The MedicalMonitoringProject(MMP)isanHIVsur 1 6 , ChristopherJohnson , Amy Rock-Wohl, Amy 4 , KendraJohnson We 751sampledpersons(63%). located Of these, 681 1 Inmid-2015, of MMPwillbroadenitspopulation , JosephPrejean 1 , JuliaHood 7 , LaurenMessina 5 , LeandroMena 1 HIV Treatment andPreventionAdherence 1 , JacekSkarbinski , MiChen 2 , Alison Hughes , Alison 1 , Tian Tang 1 5 ,

, SusanScheer

3 , 1

1 ,

- - 4 - , - - 35 10 9 8 7 6 5 4 3 2 1 Victoria Mobley Jennifer Keller Heidi Swygard(presenting) Statewide Team modified ARTAS programwascriticaltoimprovingHIVcare coordination. a using disease controlefforts. delivery fieldworkandservice Integrating andretentionefforts enhanced bydistinguishingbetweenlinkage forPLWH andretentionincareservices linkage inNC. Patient trustwas Recommendations: performance expectations. uniformtrainingand meetingsandcallsfacilitated with statewide ed frequent ARTAS refreshers. structure teammanagement A statewide workforce occasionallylimitedeffectivenessoftheteamandnecessitat and procedurestoaddressbrokenappointments. Turnover intheSBC andretentionefforts,linkage developmentofpolicies andencouraged these processes. Field workperformedbySBCscomplementedclinic logistics. andcommunications evaluation CAREWare softwarefacilitated standards, collection, data classification ofoutcomes, monitoringand methodsandprocess in developmentofstandardizedcommunication resulted effortbetweenpublichealthandlocalagencies coordinated trust; the ARTAS-informed thisdifferentiation. facilitated approach A andprovider from diseasecontrolroleswascriticalforgainingpatient incare. andre-engagement of linkage retentionincare Differentiating Lessons Learned: assistance (e.g. systemnavigation, transportation). whileprovidingpatient approach strengths-based casemanagement (ARTAS) trainingofferedbytheCDC, andutilizedan ARTAS-informed care. SBCscompleted Anti-Retroviral Treatment and Access toServices orlosttocare),diagnosed themin tolinkorre-engage andattempting were taskedwithacceptingreferralsforPLWH notincare(newly Description: care forPLWH inNorthCarolina. Counselors, SBC), specificallytrainedtoassistwithincreasingaccess Bridge teamofpublichealthofficers(State usingastatewide navigation andretention goals.is importanttomeetinglinkage We exploredpatient care forpersonslivingwithHIV(PLWH). Improvedsystemcoordination Introduction: Duke University, Durham, NC, USA Hill, Chapel University ofNorthCarolinaat Hill, Chapel NC, USA Services, Raleigh, NC, USA Communicable DiseaseBranch, NCDepartmentofHealthandHuman Hill, Chapel University ofNorthCarolinaat Hill, Chapel NC, USA Duke University, Durham, NC, USA Hill, Chapel University ofNorthCarolinaat Hill, Chapel NC, USA Wake Forest UniversitySchoolofMedicine, Winston Salem, NC, USA University ofNorthCarolina, Hill, Chapel Hill, Chapel NC, USA and HumanServices, Raleigh, NC, USA Communicable DiseaseBranch, NorthCarolinaDepartmentofHealth Hill, Chapel University ofNorthCarolinaat Hill, Chapel NC, USA Modified ARTAS Programanda Connections toHIVCareUsinga Program implementation began in January 2013. beganinJanuary Programimplementation SBCs Many barriers exist to timely linkage and engagement in andengagement barriersexisttotimelylinkage Many 4 , EvelynQuinlivan 8 , ElisaKlein Patient trustwasparamounttoachievingthegoals teamofpublichealthofficersprovided A statewide 9 , MiriramBerger 1 , JacquelynClymore 5 , KristenSullivan 10

6 2 , Arlene Sena , Arlene , Amy Heine , Amy 3 , 7

- POSTER ABSTRACTS 53 54 36

intervention strategies online. strategies intervention andotheradherence Further researchiswarrantedtodevelopSnapshots their identity. Socialmediaisparticularly wellsuitedtophoto-stories. socialmediawithoutdisclosingclinics; tonavigate andhelpingpatients could beaddressedbycomputertutorialsandaccessin tion. andprivacy Barrierssuchaslackofcomputerknowledge concerns about thewayssocialmediacouldenhancereachofinterven social mediaoutweighedthebarriers. Participants wereenthusiastic Discussion andConclusion: computer illiteracy anddisclosure fears. viasocialmedia,notable barrierstoconductingSnapshots including use. Although theywereaminorityofparticipants, afewPWHdidreport decrease stigma, andreachyoungerPWHwhoreporthighcomputer widely, people withoutHIVaboutthevirusandmedicinesto educate people withHIVtoeachother, adherencephoto-stories disseminate through socialmedia. They commendedsocialmedia’s abilitytoconnect byothers’stories their photo-storiesofadherenceandbeingeducated Results: ofthemeanalysis. transcriptsforkeyconceptsusingstrategies interview media versionoftheprojectinsemi-structuredinterviews. We analyzed andassessedthefeasibilityacceptability ofasocial the materials POSTERwith asampleofparticipantswhomade(N=10)andviewed15) HIV andadherenceexperiences. We conductedpostprojectinterviews posters usingphoto-stories, oftheirown andnarratives personalimages Methodology: intervention, andmotivation viasocialmedia. education of ducting Snapshots Adherence (Snapshots), aphoto-storiesadherence use socialmedia. We exploredthefeasibilityandacceptabilityofcon mobile phones, andsocialnetworksites, fewadherenceinterventions numbersofpeoplewithHIV(PWH)reportusingcomputers,growing HIVmessages. waytodelivereducational fective andengaging Although ABSTRACTSBackground: 4 3 2 1 Michelle Teti (presenting) Promote HIVMedicationAdherence? Effectiveness ofaPhoto-StoriesProjectto University ofMissouri, Columbia, Missouri, USA Truman MedicalCenter, KansasCity, MO, USA UMKC SchoolofMedicine, KansasCity, MO, USA The UniversityofMissouri, Columbia, MO, USA Many interviewees wereenthusiasticaboutbothsharing interviewees Many Social MediaEnhancetheReachand Harnessing Technology forHealth:Can Increasingevidencesupportssocialmediaasacostef 16 PWH created medication adherence educational adherenceeducational medication 16 PWHcreated 1 , Gerkovich Mary The pros to conducting Snapshots via The prostoconductingSnapshots 2 , RoseFarnan 3 , NiZhang 10th International Conference on 10th International - - - 4

37 uated whetherthemeanpre-andpost-assessmentscores significantly uated controls. astheirown with learnersserving A paired2-tailedt-testeval design, throughacase-basedlinkedpre-vspost-assessment study ated cases inaninteractive, text-basedformat. effectwasevalu Educational practice. The activitylaunchedonlineon5/13/2014andcomprised2 pre-exposureprophylaxis(PrEP)intoclinical incorporating appropriately riskforHIVacquisitionand with respecttoidentifyingindividualsat (CME)activitycanimproveID/HIVspecialists’andPCPs’skills education Methods: are integraltostemmingHIVtransmission. andbiomedicalpreventionstrategies modification behavior Both patient year, every ed States preventionremainsacriticalpublichealthpriority. Background: 1 Simi Hurst ability to appropriately use PrEP.ability toappropriately teractive grandroundsapproach, resultedinsignificantgainsprovider Conclusions: • • • (P <.05)improvementswereobserved: completion (P<.05;d=1.355). Morespecifically, significant following were between30%and559%higheronthepost-assessmentafterCME CME completion(P<.05;d=1.37). Among PCPs, correctresponses were between20%and493%higheronthepost-assessmentafter ed allpre/postquestions. Among HIV/IDspecialists, correctresponses This analysisincludes 73ID/HIVspecialistsand279PCPswhocomplet Results: effect sizeoftheintervention. werecollectedthrough6/9/2014. Data responses toindividualquestions. Cohen’s the Dwasusedtocalculate differed fromoneanotherandPearson’s measuredchangesin χ2statistic Medscape, LLC, Oxford, NJ, USA specialists: 66%vs92%;PCPs: 53%vs75%) PrEPcareinthecontextofpregnancyProviding appropriate (ID/HIV specialists: 15%vs86%;PCPs: 10%vs64) receivingPrEP(ID/HIV Providing ongoingmonitoringamongpatients (pre- vspost-assessment);PCPs: 29%vs72%) forPrEP(ID/HIVspecialists: ofcandidates Identification 68%vs92% Overall, intheactivity. 7,285healthcareprovidersparticipated whetheranonlinecontinuingmedical evaluated This study Improves ClinicalDecision-Making Improves HIV Prevention:Case-BasedEducation

(presenting) This online, case-basedCMEactivity, modeledafterthein With approximately 50,000newHIVinfectionsintheUnit With approximately HIV Treatment andPreventionAdherence 1 , Capparelli Catherine 1 - - - - - 38 10th International Conference on 10th International toimproveadherence to identifybarriersanddevelopstrategies ART. fined sequenceofCMEmodules, significantlyimprovedphysicianability Conclusions: • • • • curriculum weresignificantlymorelikelyto: inthePL physicianswhoparticipated reveledthat post-assessment data pre- andpost-assessmentquestions. ComparisonbetweenSAand HIVinfectionandcompletedboth the 175physicianswhoactivelytreat cians, inthePLcurriculum. participated have These resultsfocuson Results: SA andpost-assessmentdata. comparisonbetweenthe effectiveness wasmeasuredthroughstatistical all 6CMEmoduleslaunchedsimultaneouslyon6/8/2012. Education needsidentifiedthroughtheSA.on individualeducational TheSAand modules. Eachphysicianwasdirectedtooneormoremodulesbased and1of6interactive,practice gaps CME-certified, multimediaeducation and fostering ART adherence. EachSAquestionwasalignedwith1of3 inassessing physicians’individualpracticegaps to identifyparticipating individual practicegaps. A case-basedself-assessment(SA)wasused programmingbasedon directslearnerstoeducational solution that Methods: assessandencourage appropriately ART adherence. onproviderabilityto (CME)initiative continuing medicaleducation among theirpatients. theimpactofanonline evaluated This study theopportunitytoproactivelyidentifybarriersandfosteradherence have are virologicallysuppressed. Physicianswhocarefortheseindividuals a chroniccondition. However, only~25%ofindividualslivingwithHIV reduced HIV-related morbidityandmortalitytransformedHIVinto Background: 1 Simi Hurst in HIVCare Medscape, LLC, Oxford, NJ, USA (P <.001) strategies,Incorporate suchastextmessages, toimproveadherence (P<.001) empathy encourage judgment(P<.001)and avoid skillsthat Utilize communication (P <.001) abilitytorecalladherence ofpatients’ Recognize thelimitations (P <.001) impactadherence maynegatively Proactively recognizefactorsthat A totalof4,947healthcareproviders, including 2,561physi Personalized Learning(PL)isaneeds-driveneducational A Personalized LearningApproach Maximizing Adherence:

(presenting) This PLcurriculum, whichguidedphysiciansthroughade (ART) dramatically Advances inantiretroviraltherapy have 1 , Katie Anders Katie , HIV Treatment andPreventionAdherence 1 , Capparelli Catherine

- - gy. We of examinedpatterns VL duringandafterpregnancy inthelast20 protects women’s health, andsupportstheU.S. HIV/AIDSStrate National (ART)viral therapy reducestheriskofmother-to-child HIVtransmission, Background: 5 4 3 2 1 Madeline Sutton Ellen Tedaldi Monita Patel March 2014 Pregnancy —UnitedStates, 1996– January require additional interventions tosupport require additionalinterventions ART andadherence. initiation load wasrecommendedforpregnantwomen. Postpartum womenmay even duringthepastdecade, when ART anundetectableviral toattain pression increasedduringpregnancy butwassuboptimalpostpartum, Conclusions: were67%,sponding percentages 74%, and76%(P=.022). and 39%(postpartum)(P=.017);during2005–2014(n84), thecorre with VL suppressionwere35%(pregnancy start), 49%(pregnancy end), postpartum (P=.002). During1996–2004(n=118), thepercentages with pregnancyVL suppressionwere36%at start, 55%end, and41% end, and2.5(IQR: 1.4–3.9)postpartum(P=.002). Similarly, percentages log end (79%), andpostpartum(66%). Regardlessof ART status, median (IQR: 2-7). ART pregnancy prescriptionwasdocumentedat start(56%), 24–34), topregnancy andmediantimefromHIVdiagnosis was4years (other). pregnancy at Medianage was29years(interquartilerange[IQR]: ethnicity, were65%(black), 15%(white), 13%(Hispanic/Latino), and7% Results: assessed byusingKruskal-Wallis andchi-squaretests, respectively. during 1996-2014. were Differencesinmediansandpercentages start, end, and6monthspostpartumamongpregnanciesoccurring with age VL suppression(<200copies/mL), and pregnancyART at status (HOPS), Study HIV Outpatient weexaminedlog Methodology: years, evolved. have duringwhichPMTCTandHIVtreatment 10 Chicago, IL, USA Northwestern UniversityFeinberg SchoolofMedicine, University ofIllinois, Chicago, IL, USA Temple UniversitySchoolofMedicine, Philadelphia, PA, USA Corporation, Vienna,Cerner VA,USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA VLs were2.8(IQR: pregnancy 1.4–3.8)at start, 2.1(IQR: 1.4–2.9) 40 Percentages ofpregnancies(202among140women), byrace/ 3 , RichardNovak

InasampleofHIV-infected pregnantwomen, VL sup HIVplasmaRNAviralload(VL)suppressionwithantiretro (presenting) Using data from9HIVspecialtyclinics Usingdata inthe participating 1 , JohnBrooks Suppression DuringandAfter Trends inHIVViral Load 1 , Carl Armon , 4 , Frank Palella 1 , Buchacz Kate 2 , StevenNesheim 5 , MargaretLampe 1 10

VL (copies/mL), percent

1 ,

- - - - - POSTER ABSTRACTS 55 56

after theystartPrEP. likelihood mayexertonactualchangesinCASamongmenbeforeand and dissonancebetweentemptation therolethat the needtoinvestigate increasingovertime. thispercentage trended toward Findings highlight forCASanddata a majoritybelievedPrEPwouldincreasetemptation cause theirCAStoincreaseandthisdidnotchangeovertime. However, uptake amidstincreasingfamiliarity. Few believedtaking PrEPwould Conclusions: marginally withinparticipantsfromBLto12M(AOR=1.05, p=.07). inCASincreased Perceived toengage influenceofPrEPontemptation inCASdidnotchangeovertime.fluence ofPrEPonlikelihoodtoengage to 12M(AOR=1.34, p=.03). Willingness totake PrEP andperceivedin enrollment month(AOR=1.08, p=.01)andwithinparticipantsfromBL ity increasedsignificantlyacrosstimebothbetweenparticipantsby were 33.3%, 46.3%, 28.4%, and51.9%, respectively. PrEPfamiliar inCAS. toengage increase theirtempation By12M, theseproportions inCAS,their likelihoodtoengage and58.0%believedPrEPwould expressed willingnesstotakePrEP, 25.3%believedPrEPwouldincrease Results: inCAS. engage PrEP, to andperceivedinfluenceofPrEP onlikelihood-andtemptation- in-person visittype(BLvs. 12M)onPrEPfamiliarity, willingnesstotake effect ofbetween-personenrollmentmonth(0through27)andwith between 2011-2014. We conductedmultilevelmodelingexaminingthe POSTER for162HIV-negative highlysexuallyactiveGBMwhoparticipated data Methodology: (CAS). PrEPwillincreaseincondomlessanalsex popular/social mediathat amidstconcernin among gayandbisexualmen(GBM)hasbeenslow HIVtransmission;however, toeliminate is apromisingstrategy uptake Background: 3 ABSTRACTS2 1 Ana Ventuneac Christian Grov and Bisexual Men, 2011-2014 Results FromaLongitudinalStudyofGay and Temptation for- CondomlessAnalSex: Perceived InfluenceofPrEPonEngagingin- New York, NY, USA Studiesand Center forHIV/AIDSEducational Training, City UniversityofNew York, NY, USA Brooklyn College, Brooklyn, NY, USA 43 At BL, 23.5%knewafairamountorlotaboutPrEP, 46.9% highlightstheneedtoidentifybarriersPrEP This study Once-daily Truvada forpre-exposureprophylaxis(PrEP) We analyzedbaseline (BL)and12-month(12M)follow-up 3

, JeffreyParsons (presenting) Willingness toTake PrEP, andthe Changes inFamiliarity and 1 , H. Rendina Jonathon 2

2 , ThomasWhitfield

10th International Conference on 10th International - - 2 , - based adherenceinterventions. a betterunderstandingofuserexperiencesisneededtoinform Wisepill- tobefeasibleinresource-limitedsettings,Wisepill usehasbeenshown anddetectpotentialadherenceproblemsastheyoccur.havior Although as Wisepill, enableresearchersandclinicians toassesspill-takingbe Background: 3 2 1 Esther Atukunda Melanie Tam Southwestern Uganda Therapy(ART)Antiretroviral inRural Use PromoteAdherenceforAdultsTaking combination ofmulti-leveleffects. combination moral meaningsof Wisepill usecan also promoteadherencethrougha take ART asprescribed. Besidesassessingadherence, theemotionaland inusers,watched whichreinforcesasenseofresponsibilitytoothers Conclusion: ART andweretakingtheirpillsasprescribed. theyunderstoodthepurposeof that wanted todemonstrate Wisepill and those disappointing an efforttoavoid “watching.” Finally, participants Second, participantsfeltcaredabout, themtotake motivating ART in they expectedtobecontactedifthedevicewasnotopenedontime. a senseofaccountability;participantsreportedtakingtheirpillsbecause helped topromoteadherence ART inthreeways. First, itstrengthened hadapositivemeaningformostparticipants,watched whoreportedit through Wisepill asasubjectivesenseoffeeling “watched.” Feeling Results: using the Wisepill device. wereformedtorepresenttheexperienceandmeaningof categories Atlas.ti software. Usingthemesidentifiedacrossthedata, conceptual social supportreceived. Transcribed werecodedusing data interview Wisepill device, (b)acceptabilityanduseofSMSreminders, and(c) covering: interviews in individualqualitative (a)experienceswiththe real-time electronicmonitoringwith Wisepill. Participants tookpart and SMS-triggeredsocialsupportonadherence, asmeasuredthrough development study. The aimwastoassesstheeffectsofSMSreminders in amixed-methodsintervention southwestern Ugandaparticipated Methodology: Massachusetts GeneralHospital, Boston, MA, USA Mbarara UniversityofScience& Technology, Mbarara, UGANDA MedicalSchool,Harvard Boston, MA, USA 44 Participants experiencedreal-timeadherencemonitoring The useof apositivefeelingofbeing Wisepill creates

(presenting) Real-time electronicadherencemonitoringdevices, such Sixty-three HIV-infected adultsinitiating ART inrural 2 , Angella Musiimenta , Angella and MoralEffectsofWisepill Feeling Watched: Emotional HIV Treatment andPreventionAdherence 1 , Monique Wyatt , 2 , JessicaHaberer 1 , EmilyPisarski 3 , Norma Ware, 1 ,

- 1

45 10th International Conference on 10th International of HIVviralloadsandresistancetesting. withobjectivemeasurements impactonindividualheath anegative have terruption. isneededtodetermineifthesebarriers Furtherinvestigation in problem duetothepotentialriskofviralresistancewithtreatment andlabs.medication stockoutsarealsoasignificant Medication based, longdistancesandpayingafeetoreceive traveling withpatients Conclusions: males reportedasbeingabarriervs. 56%offemales. similar withtheexceptionofHIVnon-disclosure which38%of status stockouts(31%).and medication Genderdistributionforbarrierswere (56%),labs/ medication clinic distance(42%), clinic waittime(35%), and systemsbarriersincluded (57%), costoftransportation costof (51%),status (36%). andfearofdiscrimination Significanteconomic barriers included confidentialityconcerns(55%), HIVnon-disclosure 74% female, and91%onantiretroviraltherapy. Significantsocial Results: possible barriers. demographics, HIVdisclosure status, and ‘yes’ or to20 ‘no’ answers randomly selectedtoparticipate. collectedincluded Information patient of clinic stafftranslators. clinic Patients attending onthesedayswere wereadministeredverballyinEnglishor 390 surveys Twi withthehelp KATH.from theadultHIVclinic at population patient Oversixweeks, Methodology: Kumasi, Ghanainordertoimproveaccessandretentioncare. adult HIVclinic Komfo at population Anokye Teaching Hospital(KATH) in barriers. The goalofthisprojectwastoidentifybarrierscareforthe a myriadofobstacles including financial, social, andhealthsystems settings suchassub-Saharan continuetoface Africa wherepatients Background: 1 Rebecca Reece Sara Clemens Alpert Medical School at Brown University, Brown Alpert MedicalSchoolat Providence, RI, USA Our study population had an average age of43.6years, age hadanaverage with population Ourstudy HIV CareinKumasi, Ghana Barriers andFacilitators toAccessing The mostsignificantbarriersarefinancialorsystems Retentiontocareposesaprobleminresource-limited We ofasample conductedacross-sectionalsurvey

1 (presenting) 1 , DanielPatino-Calle HIV Treatment andPreventionAdherence 1 , Aadia Rana , Aadia 1 ,

- 46 framework, ScienceInitiative, developedthroughtheNIHImplementation usual caresettings. science usesanimplementation This NIAAAstudy into oftenlanguishforyearsbeforebeingincorporated interventions en-focused, HIV-risk harmreductionintervention. However, efficacious Background: 3 2 1 William Zule Jacqueline Ndirangu Wendee Wechsberg South Africa inUsualCare Focused HIVIntervention Barriers toOperationalizingaWoman- evaluate implementation,evaluate service, outcomes. andpatient pilotstudiesinastepped-wedgedesignto conduct aseriesofiterative to therandomizedphasewillbeaddressidentifiedbarriers, then ed andtestedinusualcaresettings. The objectivefromtheformative efficacy inSouth tobeimplement Africainseveralstudies andisready understanding HIVandtheimportanceof ARV adherence. Ithasshown power,and relationship gender-based violence, violencepreventionbut Conclusions: oftheintervention. effective implementation across stakeholdergroupsandhighlightedpotentialbarrierstothe Overall, identifiedstrongacceptabilityofthe stage thisformative WHC wereidentifiedasmajorreasonsnottoseek treatment.relationships the targetpopulation, substanceuse, communityviolenceandfearin and shamealackofchildcaretransportation. Among thosein ofthosewhocouldbenefitfromtheparticipation WHCincluded stigma few suggestedadaptions. andfull Identifiedbarrierstoimplementation Results: WHC marketingplan. adaptations. We alsousedstakeholderfeedbacktorefineourexisting andsuggestedintervention barriersandfacilitators tial implementation forHIVinordertoidentifypoten women whowerelivingwithorat-risk with governmentalofficials, clinical providers, andsubstance using Methodology: South Africa: healthcarecentersanddrugrehabclinics. forwomenlivingwithHIVintwousualcare settingsin implementation withthe associated to examinepotentialbarriersandfacilitators WHC’s South Africa MedicalResearchCouncil, Cape Town, SOUTH AFRICA RTI International, Pretoria, SOUTH AFRICA RTI International, Research Triangle Park, NC, USA Perceived appropriateness ofthe Perceived with appropriateness WHC reachedsaturation Framework toExamineMultilevel An ImplementationScience 1

The WHC addressesnotonlysubstanceuse, sexrisk, The Women’s HealthCoOp(WHC)isanefficacious, wom Focus wereconducted groupsandin-depthinterviews 2

, BronwynMyers (presenting) 1 , Ricahrd VanDorn, 3 , TaraCarney 3 , BrittniHoward 1 ,

1 , - - - POSTER ABSTRACTS 57 58 48 eration formedicalschoolcurriculumcommittees. eration training, preferablybeginninginmedicalschool, isanimportantconsid order toachievecompliancewiththeCDCrecommendations, formal byoutsideexperienceswithHIVtesting.shaped in suggests that Data HIVcarearesignificantly towards but students’comfortandattitudes Conclusion: were foundbetweenmaleandfemalerespondents. groups. withHIV/AIDS-centerededucation associated Nodifferences ofHIVtestingandcarewasnotsignificantly Medical studentknowledge intheHIV/AIDS-centeredextracurricularprogram arm.who engaged (p =0.0006, OR, withparticipants 1.689)weresignificantlyassociated score(p=0.0208, attitude comfortscore erage OR1.605)andaverage interview, andmedicalschoolyear)higherav medicalschoolattending work withpeoplelivingHIVandexperiencethesexualhistory Results: levels inadditiontoothercovariates. to assessthecontributionofstudents’knowledge, andcomfort attitude POSTER analysesbytheordinallogisticregressionwere conducted Multivariate characteristics.regarding HIV/AIDShealthcareandtheirdemographic withtheirknowledge, associations andcomfortlevels education attitude lars. ANOVA analysiswasusedtoanalyzethemedicalstudents’HIV/AIDS based ontheirlevelofinvolvementinHIV/AIDS-centeredextracurricu arms extracurricular programsandwereassignedtooneofthreestudy inavarietyof participants wereaskedtodocumentparticipation nine US medicalschools.from 1,026medicalstudentsat All survey Methods: inphysiciandevelopment. stage ABSTRACTS duringmedicalschool,drives ourfocusonHIV/AIDSeducation acritical skills tosuccessfullyfillthismandate. onHIVtraining Thelimiteddata physicianswilldeveloptheneeded hasbeengivenonhow information Background: 2 1 Jason Leider Heather Buxton Comfort Jacobi MedicalCenter, Bronx, NY, USA Albert EinsteinCollegeofMedicine, Bronx, NY, USA After adjustingsignificantconfounders(sexualorientation, Using a voluntary 74-questionsurvey,Using avoluntary werecollected data Student Knowledge, Attitudesand HIV/AIDS: AnAssessmentofMedical 2 Medical students are equipped with knowledge ofHIV/AIDS Medical studentsareequippedwithknowledge

Despite the2006CDCrevisedHIVtestingguidelines, little

(presenting) 1 , Aaron Praiss , Aaron 1 , ChristopherPina 1 ,

10th International Conference on 10th International - - - 49 centre) viabulkmessaging. The Portal comprisesacomputerserver are senttoagroupofphonenumbers(toshortcodelinkedhub whoareHIV-positivehealth agents andareontreatment. Messages questions. peopletoaskHIVrelated allow arereceivedby Messages Description: SexwithMen. suchassexworkersorMenwhohave support andservices to reachpeoplewithHIVwhoaremarginalisedandlacksafeaccess resource runforandbypeoplelivingwithHIV. and Itusestextmessages Introduction: 1 Ndumo Phiri the ElectronicEndAIDSPortal Living WithHIVinZambiaThroughtheUseof services includingservices keypopulations. partnerstopromoteuniversalaccessHIVcare and othercooperating at district, ofHealth officials and Ministry levels provincialandnational withHealthcentres; will utilizefindingsthroughlinkages Policy makers andMother-To-Childwith highriskbehaviours Transmission. The project ofmalecircumcision; mobility;vulnerablegroups rates condoms; low andinconsistentuseof of multipleconcurrentsexualpartners;low efforts ofaddressingthekeydriversnewHIVinfections: highrates Recommendations: legal andpolicy environmentinZambia. excluded andmarginalisedinhealth/HIVcareduetounaccommodating beenpersistently to discussaccessHIVservices, have groupsthat included throughthePortal foundaninteractivesafespace and have been have and Genderminoritiessexworkers–keypopulations by gender,ficiaries contactedandsegregated age andlocation. Sexual Lessons Learned: • • • • The End AIDS portaltargets: ofHIVtreatment. the management SMSin ofanonymous experimentstheusage that approach innovative tolocallanguages). (adaptable accessing theservice The Portal isan andprovidesadvicefeedbacktopeople with 4workingstations Literacy Campaign, Lusaka, ZAMBIA AIDS andRights Alliance forSouthern Africa/Treatment Advocacy and Usage of information forpolicy ofinformation Usage advocacy text every tion, care, senttoaminimumof10,000peoplewith andtreatment withclear dissemination onHIVpreven Bulk messaging information workers sexwithmenand High stigmagroupssuchasmenhaving Rural areaspopulations Advice andSupportfor50,000People TreatmentImproving Adherence

The End AIDS Portal isanaccessibleandanonymous End AIDS Portal System(SMS)to uses ShortMessaging (presenting) Health agents have identifiedthenumberofbene have Health agents This innovation complementsZambiagovernment’sThis innovation HIV Treatment andPreventionAdherence 1 - - 50 10th International Conference on 10th International guide effortstoimprovemedicalcareforthisvulnerablegroup. theintersectionofdruguseandpainmayimpactretentioncould how visits amongHIV-positive drug-usingwomen. A betterunderstandingof Conclusion: 95% CI: 0.51-1.17). between painandmissedvisitsamongnon-drugusers(aOR=0.77, (aOR =4.64, 95%CI: 1.50-14.36). There wasnosignificantassociation of paindaysweremorelikelytomiss 23.8%, p=0.005). Among currentdrugusers, thosewithahighnumber to reportahighnumberofpaindaysthannon-drugusers(31.2%vs. number and25.6%ahighnumber. Currentdrugusersweremorelikely ed currentdruguse. For daysinpain, 51.2%reportednone, 24.2%alow 26.1% wereHispanicand67.3%non-HispanicBlack;13.8%report Results: bydruguse. logisticregressionstratifying conducted multivariate methamphetamine, injectiondruguseinthelast3months. orany We dichotomized as (above median). periodwere Missedvisitsduringtheone-yearfollow-up as:with activityandwascategorized none, median)andhigh (below low paincauseddifficulties as numberofdaysinthepreviousmonththat characteristics fromacohortofHIV-positive women. Pain wasmeasured conducted whichobtainedsocio-demographic, andclinical riskbehavior Methodology: betweenpainandmissedvisits,association bydrug use. stratifying group.among thisdemographic Therefore, wesoughttoexaminethe painanddrugusemayinteracttoaffectmissedvisits abouthow known visits, acommonlyusedmeasureofretentionincare. However, littleis withmissed a highnumberofdaysinpainwaspositivelyassociated Background: 3 2 1 Quinlivan EByrd Stella Safo HIV-Positive Women WithDrugUse Tufts UniversitySchoolofMedicine, Springfield, MA, USA University ofNorthCarolina, Hill, Chapel NC, USA Institute forGlobalHealthandInfectiousDiseases, Montefiore MedicalCenter, New York, NY, USA Among 921HIV-positive women, was42.3years; medianage Associated WithMissedVisits Among A HighNumberofDaysinPain is

(presenting) withmissed A highnumberofpaindayswasassociated Ourpriorresearchfoundthat, amongHIV-positive women, From 2010-2013, was alongitudinalmultisiteinitiative 2 ≤ , Thomas Lincoln , Thomas 1 vs. ≥ 1 2. Currentdruguseincluded cocaine, heroin, , Arthur Blank , Arthur 3 , OniBlackstock HIV Treatment andPreventionAdherence ≥ 2 visitsthanthosewithnone 1 , ChinazoCunningham 1

1 ,

- 52 lations, accountingforpossibleselectionbiasinRCTparticipants. RCTfindingstobroader extrapolate clinic popu method toquantitatively HIV careisunknown. Generalizabilityweightsarearecentlyproposed adults. Whether theseresultsgeneralizetodepressedadultsinroutine forHIV-infectedthe efficacy interventions ofdepressionmanagement Background: 4 3 2 1 Bradley Gaynes Michael Mugavero Angela Bengtson Results toRoutineCare may belesspronouncedingeneralHIVcare, inthetrial. thanobserved was moreeffective. The impactofmeasurement-baseddepressioncare pants, suchaswomen, MSM, orthoseon ART, forwhomtheintervention Conclusions: had littleimpact. attenuation,differences influencedthe whilepsychosocialdifferences in CNICS(1.7points;95%CI:-2.1,5.5). andHIVclinical Demographic effect anattenuated indicated The generalizability-weightedestimate HAMD improvement(95%CI:0.9,5.6).vention ledtoa3.3-pointrelative alcohol/drugusethanCNICSpatients.problematic Inthetrial, theinter (ART); panicdisorderor on antiretroviraltherapy andlesslikelytohave American, sexwithmen(MSM);morelikelytobe andmenwhohave Results: ity-weighted results. for Depression(HAMD)score. We comparedtrialresultstogeneralizabil Scale as themeandifferencebetweenarmsin6-monthHamiltonRating and stabilizedbythemarginalodds. effectwasestimated Intervention SLAM DUNC(vsCNICS, conditionalonpredictors, inapooleddataset) astheinverseoddsofbeingin Generalizability weightswerecalculated clusion criteria(likelymajordepression;nobipolar/psychoticdisorders). 8USsites).care at InCNICS, 1,474adultsmetmodifiedSLAMDUNCin HIV-infected adults, inroutine n=190)totheCNICScohort(HIVpatients tousualcareamongdepressed relative intervention pression treatment 6-month outcomesinSLAMDUNC(RCTofameasurement-basedde Methodology: University of Washington, Seattle, WA, USA University of Alabama, Birmingham, AL, USA Duke University, Durham, NC, USA University ofNorthCarolina, Hill, Chapel NC, USA SLAMDUNCparticipantsweremorelikelyfemale, African Infected Adults:GeneralizingTrial DepressionAmongHIV-Improving hadanover-representationThe trialmayhave ofpartici Randomized controlled trials (RCTs) have demonstrated demonstrated Randomizedcontrolledtrials(RCTs)have We fromparticipantswith generalizedeffect estimates 2

3 (presenting) , EvelynQuinlivan 1 , BrianPence 1 , Amy Heine , Amy 1 , JulieO’Donnell 1 , HeidiCrane 4 2 , ,

------POSTER ABSTRACTS 59 60

usefulness ofthePPCSIisrecommended. adherencemethods.electronic medication intothe Furtherinvestigation formsof picture qualityandcontentmaylendinsightintoalternative counts. There isanacceptableinter-rater reliability. of The evaluation Conclusion: of .850(CI=.725-.924). reliability withaCronbachalphaof.850. OverallICCcoefficientreported internal consistency, withaCronbachalphaof.70andhighinter-rater redundancy.was reducedto12byeliminating The PPCSIhasgood (mean =36). Basedonitemanalysis, theoriginal17-iteminstrument 22; 71%)andmale(n=25;81%), between18and56years aged count. These individualswerepredominantly African American (n= Results: wasdevelopedintandemwithinstrument. protocol that POSTER independently completedthePPCSIforeachparticipantusingarating consistency, inter-rater reliability, anditemanalysis. Three raters We toanalyzethePPCSIinternal collectedthesePPCreliabilitysurveys areliabilitypicturepillcountthenextdaywithout assistance.repeated baseline.on takingpicturesoftheirpills/bottlelabelsat They then Methodology: the PPCSI. the pillcount). The purposeofthisabstractistoreportthereliability toconduct visualized) andpicturecontent(criticalelementsnecessary are withinthephotograph picture quality(theeasewithwhichimages ABSTRACTSoped toexaminetwokeydimensionsoftextedpillcountphotographs: Likert scalepicturepillcountscoringinstrument(PPCSI)wasdevel services.camera functionandmultimediamessage A 12-item3-point ence byconductingmonthlypicturepillcounts(PPC)usingasmartphone mHealthintervention,self-management participantsreport ART adher Background: 1 Hourel Natasha Maya Baumann Emory University,Emory Atlanta, GA, USA 53 30 MFHPparticipantscompletedthereliabilitypicturepill The PPCSIisapromisingassessmentoftextedpicturepill IntheMusicforHealthProject(MFHP), HIV anapp-based MFHPparticipantsweregivenone-on-oneinstructions 1 , Pope Howard

Scoring Instrument Reliability ofaPicturePillCount (presenting) 1 1 , JulieZuniga , DerekJobe 1 1 , MarciaHolstad , MarionRice 1 ,

1 10th International Conference on 10th International - - 54 in 2013–2014from1,234HIVcareprovidersfacilitiessampledfor providers whoofferedCRHCtofemalepatients. werecollected Data Methodology: lacking. care provider, describingproviderCRHCpracticesare data butnational infants. Few womenreportdiscussingreproductivehealthwiththeirHIV living withHIV, giventhepotentialfortransmissiontopartnersand recommended asanimportantcomponentofcareprovidedtowomen Background: 1 Jacek Skarbinski Runa Gokhale Survey, 2013 in theUnitedStates—NationalHIVProvider States willreceivetheseservices. States womenlivingwithHIVintheUnited may increasethelikelihoodthat provisionofCRHC toprovideCRHCandtoolsfacilitating ommendations consistently offeringCRHC. byprovidersoftherec Increasedawareness livingwithHIV;reproductive age however, onlyhalfofprovidersreported health, including contraceptionandpregnancy, withallwomen of Conclusions: offering CRHC(aPR: 1.48, CI1.02-2.16). patients, with careremainedindependentlyassociated providingprimary After adjustmentforgender, yearsofHIVcareexperience, andnumberof care,of providersnotdeliveringprimary 33% offeredCRHC(P<.01). careaspartofHIV(83%providers)52%offeredCRHC; primary 64% providedreferralsforpreconceptioncare. Ofprovidersdelivering transmission,perinatal 76%providedcontraceptionasappropriate, and transmission risk, forpreventing 87%discussedantiretroviraltherapy CRHC: 71%assessedreproductiveintentions, 78%explainedperinatal [CI],confidence interval 42–55%)reporteddeliveringallcomponentsof Results: (aPR). adjusted prevalenceratios logistic regressionanalysistoestimate chi-square testsandmultivariate betweenprovidercharacteristicsandofferingCRHC,ciations weused always” or “always” offeringfivecomponentsofCRHC. To assessasso of HIV-infected adultsincare. OfferingCRHCwasdefinedas “almost the MedicalMonitoringProject(MMP), probabilitysurvey anational Centers forDiseaseControlandPrevention, Atlanta, GA, USA Of1,144providerscaringforfemalepatients, 49%(95% Offered toWomen ReceivingHIVCare Reproductive HealthCounseling Currentguidelinesrecommenddiscussingreproductive Comprehensivereproductivehealthcounseling(CRHC)is ofHIVcare We theweightedpercentage estimated

(presenting) 1 HIV Treatment andPreventionAdherence 1 , Bradley Heather 1 , John Weiser, 1 ,

- - 55 10th International Conference on 10th International tocare. inlinkage bridging thegap thereby carebyincreasingHIVscreeninganddiagnosis improve patient tion, andmaintenanceofafiscallytiedprovider incentiveprogramto Conclusions: at P<0.05. significant isstatistically screening that anincreasein ofproviderincentivesbothshow post-implementation -6.4963 andPvalue0. these2differentanalysesofpre-and Lookingat to December, 2014, significanceisalsofoundwithZ-score statistical 0.0002. timepointsofDecember,When comparingthe2separate 2013 tation, significantisfoundwithaZ-score-3.716andP-value statistical ofincentivesto11monthspost-implemen months pre-implementation over11monthswas42%. screeningrate average When comparing6 was40%. screeningrate average After theincentiveperiodbegan, the Results: ofthisfiscalincentiveforHIVscreening.implementation priortoandafterthe andcomparedrates providers inourorganization Methodology: basedon1of3qualitymetricsbeginninginJanuary,salary 2014. for HIV. providerswouldget2.5%to5%oftheir This incentivewasthat DO, PA, NP)foravarietyofmetrics, oneofwhichwasscreeningpatients recentlyimplementedafiscalincentivetoproviders (MD/ organization HIV inthecommunity. our ofHIVdiagnosis As anefforttoincreaserates thusimprovingoverallhealthanddecreasingtransmission of treatment gettingonantiretroviral tocarewhichwillhopefullyresultinpatients age sults oftheirHIVtest. willimprovelink ofHIVdiagnosis Increasingrates because theywerenevertestedforHIVorreceivedthere areundiagnosed, livingwithHIVintheUnitedStates of patients either HIV clinic, barrierstocare. buttherearemany ~20% that Itisestimated County, Texas. Oneofthe25clinic siteswithinourFQHCisadedicated of population caretotheunderserved Travisobstetrical andgynecology providesfamilyandinternal medicine,Center (FQHC)that pediatrics, and Background: 2 1 Deborah Morris-Harris(presenting) Brendan DeMarco Qualified HealthCenter EndeavorataFederallyImprovement Infection Prevention & Management Infection Prevention&Management Associates, Austin, TX, USA CommUnityCare HealthCenters, Austin, TX, USA For the6-monthperiodpriortoincentiveintroduction Incentives: ASuccessfulProcess Fiscal HIV ScreeningandProvider The authorspresentthesuccessfulintroduction, integra CommUnityCareisthelargestFederally QualifiedHealth amongall We monthlyHIVscreeningrates lookedat 1 , MishgaMoinuddin HIV Treatment andPreventionAdherence 1 2 , BrettaCandelaria 1 ,

- - - - one HIV-positive partner on an acknowledged antiretroviral therapy (ART)one HIV-positive antiretroviraltherapy partneronanacknowledged Methodology: load overtime. ofpartner’s knowledge withaccurate wereassociated dynamics viral pression andobjectiveHIVRNAviralloadtests, andwhetherrelationship betweenpartners’perceptionsofviralsup examinedassociations study forHIVpreventionandcare.suppressed hasimportantimplications This Background: 2 1 Lynae Darbes Amy Conroy Couples LivingWithHIV/AIDS(TheDuoProject) Suppression: ALongitudinalStudyonMale satisfaction. viral load, whileaddressingpartner discrepancies incommitmentand arewarrantedtoincreasedisclosureCouple-based interventions of sexual riskdecision-makingandtheprovisionof ART social support. assume theirpartnerswerevirallysuppressedandthismayfactorinto Conclusions: partner’s viralloadovertime. ofa knowledge withaccurate associated 0.89-0.98) werenegatively (aOR =0.83, 95%CI: (aOR=0.93, 0.71-0.96)andsatisfaction 95%CI: = 0.91;95%CI: 0.83-0.99). Within-couple differences incommitment ofpartner’s knowledge of accurate viralloaddecreasedovertime(aOR pressed. We theodds foundasignificantfixedeffectfortimesuchthat partner wassuppressedand20%assumedtheirnotsup partner’s viralload. Ofthosewhowereinaccurate, 80%assumedtheir pressed. oftheir knowledge 60%ofpartnershadaccurate Approximately Results: duration,relationship andcoupleHIVstatus. mixed effectslogisticregressionmodels, controllingforcohabitation, dynamics. forallrelationship scores werecreated We fitmulti-level partner perceptionsandviralloadtests. Couple-levelsumanddifference ofpartners’viralsuppressionusing knowledge accurate used tocapture baseline,at 12months, and24months. A dichotomousvariablewas viral load. HIV-positive toconfirmviralload participantshadblooddrawn commitment, satisfaction, closeness) andperceptionsoftheirpartner’s assessment, (e.g., dynamics participantswereaskedaboutrelationship regimen completedfiveassessmentsoveratwo-yearperiod. Ateach Alpert Medical School of Brown University,Alpert MedicalSchoolofBrown Providence, RI, USA University ofCalifornia, SanFrancisco, CA, USA 56 Among 407menon ART baseline, at 50%werevirallysup

(presenting) 1 When partnerswereincorrect, theyweremorelikelyto ofwhetherapartnerisvirally knowledge Accurate , SamanthaDilworth Male couples (N = 266 couples; 532 men) with at least Malecouples(N=266couples;532men)withat Partner KnowledgeofViral Relationship Dynamicsand 1 , KristiGamarel 1 , Johnson Mallory 2 , TorstenNeilands 1

1 ,

- - - POSTER ABSTRACTS 61 62 59

successful intervention implementation. successful intervention the concernsandchallengestheseindividualsencounteriscriticalto forPLWHadherence interventions inruralcommunities, of knowledge itwillnotalterhairstyleappearance.explain that With highneedfor use.and encourage participantsonhairsamplecollectionand Educate local sitecoordinators. waystokeeptheapp Developcreative ‘fresh’ Recommendations: samples, connectivityissues, variabilityinskillanduseofapp). (e.g., limitedtransportation, privacy concerns, reluctancetoprovidehair usechallenges overcoming participantrecruitmentandphoneapp ofhealthdepartmentpartners;and fullparticipation areas; engaging inrural development;identifyingqualifiedresearchcoordinators of app lenges mustbeaddressed, including solvingthetechnicalcomplexities inruralcommunitiesisfeasible.intervention However, severalchal Lessons Learned: use.app useismonitoredremotelyusingFlurry Real-timeapp Analytics. saging. Text remindersandtriviagamequestionsencourage messaging levels, andprovidemonthlypicture-pillcountsconductedviatextmes POSTER3, 6, and9monthsusingcomputerinterviews, hairsamplesfor ARV drug web linksandapillcountsurvey. Participants baseline, areassessedat affectmedication-taking.deal withissuesthat Itincludes amanualwith PLWH andmotivate help educate with 12songsand11videosthat to pre-loaded.ponent app DJtalkshow isasimulated app The intervention Description: PLWH fiveruralhealth at clinics. forpromotingadherencein app comparedtoaneducational phone app controlled trialtestingtheefficacy smart ofamusic-basedmessaging tested inthisgroup. The MusicforHealth(MFH)Projectisarandomized ABSTRACTSto theirurbancounterparts. Yet been have fewadherenceinterventions suboptimal inruraldwellingpersonslivingwithHIV(PLWH) compared Introduction: 1 Drenna Waldrop-Valverde Marcia Holstad Rural Georgia Promote ART AdherenceSelf-Managementin Emory University,Emory Atlanta, GA, USA a Music-Based-MessagingAppto The MusicforHealthProject:Using MFHparticipantsreceiveasmartphonewiththemulticom Researchsuggestsantiretroviraladherencemaybe

(presenting) Implementation of a technology-based adherence ofatechnology-based Implementation Team developerandutilize withanexperiencedapp 1 1 , IghoOfotokun 1 , EugeneFarber 1 ,

10th International Conference on 10th International - - - 61 ence inasampleof100PuertoRicanslivingwithHIV/AIDS. of thethreedimensionshealthliteracy adher inHIV/AIDSmedication Methodology: adherent toHIV/AIDStreatment. importance ofHIVviralloadandCD4cellcount, andarelesslikelytobe levels ofHIVknowledge, arelesslikelytounderstandthemeaningand Background: 3 2 1 Silvia Rabionet Christine Miranda-Diaz Medication Adherence * participants. (p=.048),communicative andcriticalhealthliteracy thannon-adherent Conclusions: healthliteracycommunicative (p=.048). adherenceand independent-sample t-testwassignificantformedication (p=.000),knowledge ofHAART andcorrectidentification (p=.000). An literacy (p=.001), scoresandCD4cellcountknowledge HIVviralload .000). significantdifferenceswerefoundamonghigherhealth Statically healthliteracy withBEHKA-HIVadequate to besignificantlyrelated (p= measured byBEHKA-HIV. adherencewerefound Self-reportmedication 200 cells/µl. Approximately, healthliteracy 66.3%hadadequate as ± 1,047,525copies, and18%hadCD4cellcountequalorlessthan of diagnosis AIDS duringlifetime, themeanHIVviralloadwas160,255 11.39 ±6.78years, 42%completedhighschooleducation, 47%hada 52.04 ±11.58years, ofHIV/AIDS themeantimesincediagnosis Results: This abstract was possible by grants from the National Institutefor This abstractwaspossiblebygrantsfromtheNational National InstitutesofHealth. National Minority HealthandDisparities(8G12MD007583-27)fromthe Resources (5G12RR003035-27), Instituteon andtheNational Mental Health(5R25MH083617-07), CenterforResearch National Fort Laurderdale, FL, USA University ofPuertoRicoMedicalSciencesCampus, Universidad CentraldelCaribe, SanJuan, PR, USA Universidad CentraldelCaribe, Bayamon, PR, USA Mostparticipants63%weremen(n=63), of themeanage and CriticalHealthLiteracy onHIV Impact ofFunctional, Communicative, On average adherentparticipantshadhigherfunctional, Onaverage HIV/AIDS patients withlimitedhealthliteracy HIV/AIDSpatients hadlower wasusedtoexaminetheimpact A cross-sectionalstudy 3 , RobertHunter-Mellado HIV Treatment andPreventionAdherence

(presenting) 1 ,Figueroa-Cosme Wanda 1

2 ,

- 62 10th International Conference on 10th International forthisprogram. be prioritizedwhenselectingpatients higher-risk maybeat scription medications MRPsandshould ofhaving and adherenceinHIV/AIDSpopulation. Patients withmorethan5pre engagement mayincreasepatient ensure theproperuseofmedications addressing MRPs. Utilizingpharmacists toworkwiththemedicalteam identifyingand effectiveat programcanbe very reconciliation ication care. toimprovepatient use ofEHRtechnology A routinetargetedmed Recommendations: andadherencecounseling. education Pharmacy tocorrectsomeMRPsincluded staffinterventions patient or newdrugrecommendations, suggestions. ordrugdiscontinuation discuss MRPregardingdosechangerecommendations, drugsubstitution medications. Ourpharmacy staffworkedwiththemedicalprovidersto withMRPs,Of thepatients than5 65%(n=81)wereprescribedgreater underuse,cation misuse/overuse, medication andadversedrugreaction. Fifty-seven MRPswereidentified. ThemostcommonMRPsweremedi MRPissuesidentifiedduringourencounter.any providers. Inaddition, weresenttotheproviderregarding notesorflags includesthat over-the-counter andprescriptionsfromother medications listforourproviders medication oneaccurate these issuesbygenerating intheEHR. history incomplete medication The pharmacy teamresolved performed. (n=74)hadaninaccurate/ Sixtypercentofpatients Lessons Learned: tion beforeroutinevisits. reconcilia wouldbenefitfrommedication determine whichHIVpatients MRP. encounterwascollectedandanalyzedto fromthepatient Data current medications, todiscussadherence, reported andtodiscussany andpharmacyhealth record(EHR)data recordswereutilizedtoverify the half-hourprecedingeachpatient’s existingappointment. Electronic Description: setting. care problems(MRPs)withinanHIV/AIDSambulatory medication-related wasimplementedtoidentifyandreduce service reconciliation cation Introduction: 1 Sumeet Deogan Graziose Cheryl Care HIV/AIDSSetting Reconciliation PrograminanAmbulatory AIDS HealthcareFoundation, SafetyHarbor, FL, USA Driven, Student-SupportedMedication Implementation ofaPharmacist- Medication reconciliation encounterswerescheduledin reconciliation Medication A clinical pharmacist-driven, student-supportedmedi 1

(presenting) 124 medication reconciliation encounterswere reconciliation 124medication Pharmacistscanassistprovidersinthemeaningful 1 , LauraFields HIV Treatment andPreventionAdherence 1 , Isabella Villegas , 1 ,

- - - - - 63 health workers were posted to primary healthcarecentresinorderto health workerswerepostedtoprimary PMTCT modulesincluding HIVcounselingandtesting. These trained attendants ofNigeriausingmodified State TBAs weretrainedinLagos Methodology: reports between2004and2010inNigeria. infections by90%frombaseline. However, focusesonPMTCT thisstudy of HIV(eMTCT)toreduceMTCTlessthan5%andpediatric MothertoChild world inpursuingthegoalofeliminating Transmission tojointhe inthecountry There isneedforimprovingPMTCTservice pregnant womenwhorequire ARV topreventMTCTreceivingthedrugs. of4.1%andonly12% clinic (ANCS)thereisprevalencerate survey burden ofMothertoChild Transmission ofHIV(MTCT). Inantenatal Purpose ofStudy: 1 Tunde Ogunjobi of MTCTwillbereduced. ficacious ARVprophylaxisinNigeria.and30%oftheworldglobalburden accesstomoreef pregnant womenandbreastfeedinginfantswillhave more tothepreventionofMTCT. least90%ofallHIV-positive By2020at Conclusions: in 2010. infants receiving ARV prophylaxisincreasedfrom516in2004to14,573 also increasedfrom645in2004to26,1332010. Also HIVexposed 2004. NumbersofHIV-positive pregnantwomenreceivingprophylaxis women werecounseledandtestedin2010comparedto18,554 907,387pregnant women whoaccesstheservices. that Reportsshowed ofResults: Summary to 718in2010. were alsocreated. wasincreasedfrom67 SitesofferingPMTCTservices topublichealthcarecentreswitheffectivecoordination decentralization increase pregnantwomen´saccesstoPMTCT. Integration, and linkages A MoreHealthFoundation Inc., Lagos, NIGERIA Lagos StateasaCaseStudy The ReviewofPMTCTinNigeria; healthcarewillcontribute The strengtheningofprimary Nurses, communityhealthworkersandtraditionalbirth

(presenting) Nigeriacontributesupto30%ofthetotalglobal There areincreasesinthenumbersofpregnant 1 , Oguntoye Olawale 1 - POSTER ABSTRACTS 63 64 65 sonal meaningswhichmaybeobstacles toeffective self-management. andacceptanceofHIVstatus.adaptation Ourinstrument assessesper arelessimportantfor knowledge ARV adherencethanispsychological Conclusions: withadherence. werenotassociated knowledge withadherence(r=.25,positively associated p=.02). Otherareasof = .27, about p=.008);whilescoresonknowledge were ARV treatment .84). withnon-adherence(r Scalescoresweresignificantlyassociated with HIV(e.g., anger, fear, shame)hadhighinternalconsistency (alpha HIV-related science. meaningsofliving A scalerepresentingnegative toquestionsabout answers ARV treatment, butnototherdimensionsof ordrugresistance.of viralreplication withaccurate NFCcorrelated HIV diseaseandtreatment. Inparticular, understanding fewhadaccurate Results: instrument withaconveniencesampleof100peoplelivingHIV. and “need forcognition” (NFC). After cognitiveinterviews, wepilotedthe meanings, bothpositiveandnegative, plusself-reportof ARV adherence structured assessmentofscientificunderstanding, andofthesepersonal POSTER associations.or negative We ataxonomyofresponsesinto translated means Imadeamistake.” Taking positive alsocouldhave medications “lifeworld” meaningssuchas “it’s nothingtobeashamedof” or “it asked, forexample, HIVis, toexplainwhat peopleoftenrespondedwith wereoftennotmechanistic.models ofHIVdiseaseandtreatment When diversepeoplelivingwithHIV.with demographically Their conceptual Methodology: often mostsalient. are chronic diseaserealmsofmeaningotherthanbiologicalexplanation andprovidermodels.between patient However, forpeoplelivingwith ABSTRACTSpeople’s mechanisticunderstanding, andemphasizesdifferences models ofdisease. modelstypicallyexplores Researchinexplanatory explanatory enhanced byconcordancebetweenphysicianandpatient Background: 3 2 1 Laura Kogelman (presenting) Michael Laws Brown University,Brown Providence, RI, USA Tufts MedicalCenter, Boston, MA, USA UniversitySchoolofPublicHealth,Brown Providence, RI, USA Mostrespondentshadlimitedunderstandingofthescience Adherence Domains ofMeaningandARV In this preliminary study, Inthispreliminary healthbeliefsandscientific Many maintain that adherencetomedicaladviceis maintainthat Many Formatively, we conductedsemi-structuredinterviews 2 , Ira Wilson , 3 1

, YoojinLee 1 , William Rogers , William 2 , Aadia Rana , Aadia 10th International Conference on 10th International - 3 , 66 clinical care, whichmayleadtovirologicalfailureand/ordrugresistance. economic, in andattrition contributetosub-optimaladherencerates and care.with HIVintheiraccesstotreatment These barriers, largely developingcountries,many multiplebarrierspersistforpeopleliving Background: 3 2 1 Proscovia Nabunya Vilma Ilic Uganda Randomized ControlledTrial inSouthern FindingsFroma Settings: Preliminary adherence amongHIV-positive adolescentsinlimited-resourcesettings. to to ourunderstandingoftheeconomicbarriersandfacilitators ART nology, adherencedata, providingreal-timeandaccurate cancontribute adherence overtime, and betteroverallhealthoutcomes. Wisepill Tech improved will show intervention dence-based economicempowerment Conclusions: adherencelevelsofparticipantsareconducted. average inreal-time,medication technology. usingcellularsatellite Analyses on participants receivea monitorsparticipantintakeof Wisepill devicethat prescribed ART, between10-16years, areenrolledinthestudy. Study HIV-positive adolescentsfrom39healthcare centersinsouthernUganda, group willreceiveonlythebolsteredstandardofcare. A totalof702 counseling sessionsontheimportanceofadheringto ART. The other bolstered standardofcareforyouthlivingwithHIV, whichincludes in thesameregion(Ssewamalaetal., of 2008-2014)andapackage withprovensuccessamongacomparabledemographic intervention ized controlledtrial. Onegroupwillreceiveaneconomicempowerment participants willbecomparedinthis5-yearlongitudinalcluster random Uganda (PI: Ssewamala;NICHD1R01HD074949-01). Two groupsof ence, whichmeasures ART adherenceamongadolescentsinsouthern Methodology: using WisepillTechnology. monitoring ART adherenceamongHIV-positive adolescentsinreal-time ART indevelopingcountries. fromUgandainvolves Onesuchstudy causes, amongpeopleprescribed adherencerates andeffectsoflow andtracking-basedstudiestounderstandthefactors,intervention-based In lightofthesecompoundingissues, developedboth researchershave University ofChicago, IL, USA Masaka, UGANDA CenterforChildHealthand International Asset Development, Columbia University, New York, NY, USA 1 , Fred Ssewamala Adherence toART inLimited-Resource The RoleofTechnology inTracking We thegroupreceivingevi hypothesizethat Despite the provision of antiretroviral therapy (ART) Despitetheprovisionofantiretroviraltherapy in We fromanongoingstudy, examinedata Suubi+Adher 3

HIV Treatment andPreventionAdherence 1 , Apollo Kivumbi(presenting) 2 ,

- - - 70 10th International Conference on 10th International transmission. to prevent aboutstrategies areconsistentwithcurrentknowledge laws todetermineifcriminalization withlegislators and cancollaborate (http://www.cdc.gov/hiv/prevention/programs/pwp/resources.html) health department andresourcematerials requirements fromtheirstate Recommendations: rights andresponsibilities. self-disclosurepatient andpartnernotification,patients’ andaffirmtheir arebetterequippedtofulfilltheirlegalobligations,these laws encourage forintentionalHIVexposure.criminalization Providerswhounderstand Lessons Learned: mightprovokelegalaction. that wouldrevealbehaviors ality that persons deferHIVtestingor ART ofconfidenti useiftheyfearviolations protecttheconfidentialityofHIV-related information.that However, some maynotdeterriskbehaviors. theselaws that (3) laws have All states liability. and oftheselaws personsareunaware many that Studiesshow vention methods(e.g., ART criminal andcondoms)asadefenseagainst to reduceHIVtransmission. Few useofevidence-basedpre allow laws (ART)therapy andpre-exposureprophylaxis(PrEP)wererecommended transmission risk(spitting, biting). Mostwerepassedbeforeantiretroviral high transmissionrisk(sex, andno/negligible bloodandtissuedonation) others toHIV. pose that cancriminalizebehaviors Mostoftheselaws exposing resultinknowingly that impose criminalchargesforbehaviors HIV. (2) As of2011, may hadenactedHIV-specific that 33states laws andproviderstonotifypersonsexposed patients obligate that laws disclosure ofHIVinfection. have (1)Severalstates “duty-to-inform” Description: andpartners. consequencesforpatients minimizenegative ods that with benefitsandrisksofHIVdisclosure disclosure andencourage meth healthcareprovidersbecomefamiliar recommendsthat organizations Introduction: 1 David Purcell Gema Dumitru for HealthcareProviders the UnitedStates–EssentialConsiderations Centers forDiseaseControlandPrevention, Atlanta, GA, USA Prevention WithPersons WithHIVin The LegalLandscapeofHIV influence This guidelinehighlightsthreelegalissuesthat A 2014guidelinefromCDC, HRSA, NIH, IAPAC andother

1 (presenting) , J. StanLehman Most states have laws aboutHIVdisclosure laws have or Moststates Providerscanlearnmoreabouttherelevantlegal 1 1 , Jakhmola Priya HIV Treatment andPreventionAdherence 1 , Irwin Kathleen 1 , - - - 71 they wereHIV-infected, aged Hispanic foreign-borninmetropolitanBoston. Individualswereeligibleif Methodology: population. in HIVcare. We barriers toretentioninHIVcareforthis evaluated in Hispanics, regardingfactorsinfluencingtheirretention littleisknown Background: 4 3 2 1 Hortensia Amaro Julie Levison(presenting) Hispanics inMetropolitanBoston individual, healthsystem, andcommunity. thelevelof at These barrierssuggesttheneedforinterventions stigma, culturalnorms, andlogisticalconstraintsinaccessingHIVcare. experienced significantbarrierstoretentionincarelinkedHIV-related Conclusions: retention incare. Trust andrespectintheHIVprovideraswellfamilysupportfacilitated (e.g. costsandinconvenientclinic transportation orhours). location (e.g. episodesofsubstanceabuseorseveredepression)andstructural werementalhealth-related barriers tokeepingHIVcareappointments masculinity (machismo)ascontributingtoHIV-related stigma. Otherkey HIV status. Menwhoreportedsexwithmencitedstrictculturalbeliefsin as asignificantbarriertoretentioninHIVcarebyinhibitingdisclosure of HIV-related stigmaintheHispaniccommunitywasfrequentlyreported care, definedabove, orhadmissed Results: record. guidelines). We alsomeasuredmissedroutineHIVvisitsfromthemedical consistentwithnational (thelatter 12 monthspriortotheinterview or medicalrecordreviewindicating at attendance tured interviews. RetentioninHIVcarewasdefinedasself-reported assessed barrierstoHIVcareandhealthbeliefsthroughsemi-struc Latin American Spanish-speakingcountries. Bilingualresearchstaff Cambridge Health Alliance, Cambridge, MA, USA University ofSouthernCalifornia, Los Angeles, CA, USA Boston Children’s Hospital, Boston, MA, USA Massachusetts GeneralHospital, Boston, MA, USA Half(48%, N=15)ofthecohorteitherwasnotretainedinHIV Care forHIV-Infected Foreign-Born A QualitativeStudyonRetentioninHIV HIV-infected foreign-bornHispanicsinthis sample While foreign-borncompriseone-halfoftheHIVincidence from31HIV-infectedWe data collectedqualitative ≥ 1 routinevisitwithanHIVproviderinthepast6months 3 , Margarita Alegria , 1 , LauraBogart ≥ 18 years, andborninPuertoRicoorother 4 ≥ ≥ , StevenSafren 1 HIVmedicalvisitinthepastyear. 1 HIV visit every 6monthsinthe 1 HIVvisitevery 2 , ImanKhan 1 1 ,

POSTER ABSTRACTS 65 66 72

and remindsofthechallengesinherentinlivingwithHIV. cess andaddressingmentalhealthaskeybarriersfor TasP inthisregion, Conclusions: (AOR=3.28). predicted previouslystoppingtreatment dictors ofdepression. LivingthethirddecadewithHIValsosignificantly and livingthethirddecadewithHIV(AOR=2.19)weresignificantpre ofdepression.reported ahistory (AOR=2.02) Notcurrently ontreatment 1.92), andnotbeingfemale(AOR=.39). 43.3%(n=78)ofparticipants (AOR =7.03), beingyoungerthan35years(AOR=2.24), single(AOR= 10ormoreyearsofeducation significantly sociallydeterminedbyhaving had CD4countsabove500cellsμL–1. was Beingcurrentlyontreatment hadundetectableviralloadsand56.2%(n=100) currently ontreatment 23.8% hadpreviouslystoppedtreatment. 47.1%(n=89)ofthose andofwhom cohort only61%(n=194)werecurrentlyonHIVtreatment (73.1%),more yearsofeducation andwasworking(77.6%). Inthis heterosexual (72.5%), married(60.4%), hadchildren(63.7%), 10or Results: POSTERratio. logistic regressionswereperformedback-stepbymaximizinglikelihood andmental healthoutcomes,predictors ofHIVtreatment multivariable HIV, werebornandcurrentlylivedinthe Asia Pacific. To assessthe sampling.snowball Participants hadtobeliving10ormoreyears with viamodified inanonlinesurvey viduals from21countriesparticipated Methodology: people livinglongerwithHIVinthe Asia-Pacific region. andmentalhealthoutcomesof research presentstheHIVtreatment challenges of TasP andsuggestwaysforward, thiscommunity-based ABSTRACTS accessandadherenceforviralsuppression.treatment To underscorethe Background: 1 Prabowo Harry Martin Choo for Treatment asPrevention(TasP) With HIVintheAsiaPacific Region:Lessons THAILAND Asia Pacific Networkof People LivingwithHIV(APN+), Bangkok, Participants 18–75. wereaged The majoritywasmale(65.5%), Outcomes ofPeople LivingLonger HIV Treatment andMentalHealth

ac highlightstheneedforequitabletreatment The study Effective treatment asprevention(TasP) Effectivetreatment hingeson (presenting) BetweenNovember2013andFebruary 2014, 360indi 1 1 , ShibaPhurailatpam 1 , OmarSyarif 1 ,

10th International Conference on 10th International - - - 73 Nepal, Pakistan, Philippinesand Vietnam. Semi-structuredquestionnaires used toenroll7,843PLHIVfrom56sitesinBangladesh, Indonesia, Lao, Methodology: withadherenceto associated determinates ART amongPLHIVs. of HIVcarein Asia andthePacific region. examinesdifferent Thispaper communities, forimprovement toadvocate andtousethisinformation Peoplethat LivingwithHIV(PLHIV)faceaspartofdifferentrisk-based wasdesignedwithanobjectiveofunderstandingissues This study determinant ofvirologicsuppressionandshouldbecarefullymonitored. Background: 1 Sushil Koirala Asian Countries in overallHIVcare. adherencesupportmeasures andincorporating initiation or totreatment poor adherence. HIVprogramshouldalsofocusonpreparingaPLHIVpri toaddressissueswith ofacountry specificapopulation outlier behavior had highadherencelevels. There isaneedofbetterunderstanding Conclusions: the spousewasHIV-positive thenself-reportedadherencewaspoor. migrant workersreportedforNepalandthePhilippines. InIndonesiaif factor forhigherlikelihoodofpooradherencewasbeinginternational nificant inallcountriesforbetteradherenceexcept Pakistan. Common weregoodadherers. oftreatment ation Socialsupportfactors weresig poor adherence. People livingwithHIVinBangladesh, initi despitelate with ment withthehealthcareprofessionalweresignificantlyassociated children, ARV regimenchange, on duration ARVs, andmissingappoint smoking andalcoholuse, on duration ARVs, ofspouseand HIVstatus Results: logisticregressionmodel. ate andthesignificantvariableswereincludedthe association inmultivari 95% asacut-offpoint. logisticregressionwasusedtoassess Univariate with were usedtomeasureself-reportedantiretroviralintakebehavior Bangkok, THAILAND Asia Pacific Networkof People LivingwithHIV(APN+), Severalofthefactors, suchashealthstatus, useofillicitdrugs, to ART AmongPLHIVinSevenSouth Factors AssociatedWithAdherence Respondents in the study that werelinkedtocareand that Respondentsinthestudy (ART)Adherence toantiretroviraltherapy isaprincipal samplingtechniquewas A modifiedtargetedsnowball

(presenting) HIV Treatment andPreventionAdherence 1

- - - - - 75 10th International Conference on 10th International suppression. individuals withandwithoutHIVviral PCA andMPRfailedtodiscriminate arestartedon if patients ART early. Adherence with ART, asmeasuredby longed periodofcare. Betteradherencemaybeachievedandsustained resource-limited communitiesinsub-Saharan Africa, evenoverapro Conclusion: 0.67), makingadherencebyPCAapoorpredictorofviralsuppression. good adherence. was0.61;95%(CI0.56- The areaundertheROCcurve with an initialhaemoglobinlevelabove9g/dlarestronglyassociated mance score, noevidenceofopportunisticinfectionandhaving having and theirHIVviralload. Beingwidowed, ahighKarnofskyPerfor having whoknewboththeirCD4cellcount their CD4cellcountandpatients was nodifferenceinadherencebetweenparticipantswhoknewonly adherence overtime, despitethehighleveloverfiveyears. There was 97.4%andtheMPR96.9%. trendin There wasadownward Results: where suppressionisnotpresent. withHIVviralsuppressionandthose betweenpatients to discriminate canbeused determine ifadherenceasmeasuredbytheseestimates of follow-up.wereusedto Characteristiccurves ReceiverOperating and HIVviralload of lessthan95%, (MPR)oflessthan 95%, possessionratio medication wellvariousfactorspredictedpillcountadherence(PCA) to assesshow (ART)home-based antiretroviraltherapy inruralUgandawereanalyzed Methodology: viralogic responseinsuchsettingsareneeded. topredictingHIV approaches resource limitedsettingsandalternative HIVcareprovidersin monitoring ofHIVviralloadisnotyetmetbymany Background: 1 Herbert Kiyingi Care PrograminRuralUganda University ofCaliforniaBerkeley, CA, USA The meangroupadherenceover54monthsmeasuredbyPCA Suppression inaHome-BasedAIDS Adherence Fails toPredictHIVViral Highlevelsofadherencewith ART canbeachievedinrural The for World recommendation HealthOrganization Data foracohortof1,158HIV-infected receiving Data patients

(presenting) ≥ 50 copies per mL at 12monthsand54 50 copiespermLat 1 , Arthur Reingold , Arthur HIV Treatment andPreventionAdherence 1 - - 76 sites and653, arereported. 5517providingonlyPMTCTservices services, Careandtreatment Comprehensive fullpackage 2013 VCT tation, successfully. scaleupandmonitoringoftheHIV/AIDSservices been instrumentaltomakeitpossibleforeffectiveplanning, implemen and children, respectively. Participation ofdifferenthealthpartnershas levels. Since2003uptoMay2014, PLHIVson ART are133,574adults varioushealthsystem at improvingthequalityofhealthcareservices at technologiesaimed TRACnet systemwhichisanewformofinformation programtosupportpeoplelivingwithHIV/AIDSthe ambitious national Background: 1 R Mpundu Louise Kayiranga An ExampleofTRACnetSystem inRwanda: of QualityHealthCareServices system strengthening. improvements andthereforeabasisfor realandsustainablehealth feedback toimplementersandinformeddecisionsprogressivequality accurate, timelyreporting, dissemination, analysisandinformation data new healthcareinitiatives. SettingharmonizedstandardsforH.S. tools, andscaleupof stakeholders areessentialtoenableimplementation andguidedinvolvementofdifferenthealthpartners Decentralization andprogrammanagement.results baseddecisionsforefficientpatient system helpedtoimproveprogramplanning, reporting, monitoringand inthe captured allhealthsystemlevels.Data and accessedat TRACnet beenincreasinglytransmitted have programmeindicators services Conclusion: epidemic anddiseasesacrossthecountry. program modulesinthe reporting, monitoring andresponseofpotential committed tofurtherexpandthe TRACnet systemwithnewotherhealth withitspartnersis August 2014.GovernmentofRwandaincollaboration ing andtestingpreventionofmothertochildtransmissionsince were revisedandincluded counsel ART andnewvoluntary indicators ART drugstoincluding; module2013, earlyinfantdiagnosis indicators on initiated onpatients andmaintainedonlykeyindicators captured Expansion: if needed. intervention monitordrugsandtakequick neededreportsandgraphs; generate care systemlevelstoroutinelykeepaneyeonkeyprogramindicators; theprimary, at program supervisors health andtertiary secondary reporting, feedbackanddecisionstaking: Usingthe TRACnet data, access tothe forvaluableprogramplanning,TRACnet data monitoring, program staff, policy makers, the healthpartnersandfundershave services. Healthcareproviders, fromcentrallevel programmanagers onHIV transmitkeyselectedprogramdata All H.Cacrossthecountry arehardtoreach. that time evenfromtheremotestareasofcountry inreal which contributetoeffectivetransmissionandtrackingofdata bytelephone/internet data services and reportingofHIVintegrated Description: Rwanda BiomedicalCenter, Lusaka, RWANDA 1 Programs MonitoringandSustainable Electronic Systems for Effective Health The TRACnet systemexpandedfromasinglemodulethat Since the implementation ofthe Since theimplementation TRACnet system, keyHIV The levelmonitoring TRACnet systemenablesnational Since 2003, theGovernmentofRwandaembarkedonan

(presenting) 1 , ERemera 1 , CMaliza 1 , LNiyitegeka 1 - , -

POSTER ABSTRACTS 67 68 77

address psychologicaldistressareparticularlyneeded. chosocial aspectsofadolescentHIVcare. toidentifyand Interventions Conclusion: respectively. (OR =1.63;CI: 1.08–2.46), and VAS (OR=1.79;CI: 1.19–2.69) for missedpills(OR=1.75;CI: 1.04–2.95), medicalregimen following oddsofnon-adherence with greater chological distresswasassociated characteristicsandpsychosocialresources,socio-demographic psy Results: using avisualanaloguescale(VAS). adherence past 3days;adherencetomedicalregimenandself-rated POSTERvisits. Adherence wasassessedusingaself-reportonmissedpillsinthe pala, Ugandawasconducted. ALHIV wererecruited duringroutineclinic centerinKam alarge HIVtreatment 53% female)seekingHIVcareat Methodology: adherence.and ART betweenpsychologicaldistress therelationship mediate resources that psychological distressand ART adherence, highlightingpsychosocial in sub-Saharan Africa. between examinestherelationship The paper between psychologicaldistressand ART adherenceamongadolescents mortality. However, exploredtherelationship onlyafewstudieshave ABSTRACTSsuppression, drugresistance, andincreasedriskfor AIDS morbidityand (ART),non-adherence toanti-retroviraltherapy leadingtopoorvirologic living withHIV(ALHIV)worldwide, with andhasbeenassociated Background: 2 1 Harper Gary Massy Mutumba(presenting) Ugandan AdolescentsLivingWithHIV Makerere UniversityCollegeofHealthSciences, Kampala, UGANDA University ofMichigan, Ann Arbor, MI, USA Inlogisticregressionanalysesadjustingforrespondents’ to Anti-Retroviral TherapyAmong to Anti-Retroviral Psychological DistressandAdherence 1 Study findingsunderscoretheneedtostrengthenpsy Study , RachelSnow Psychologicaldistressiscommonamongadolescent of464 A cross-sectionalsurvey 12–19; ALHIV (aged 1 , KenResnicow 1 , Victor Musiime , Victor 1 , JoseBauermeister 2 , JamesLepkowski 1 10th International Conference on 10th International - - 1 , - 78 ence support,riskof reducetheirpatients’ that andotherinterventions early andregularHIVcare, (ART), earlyantiretroviraltreatment adher guideline includes forclinicians recommendations many topromote about HIVpreventionwithpersonsintheUnitedStates. The issuedcomprehensive,organizations evidence-basedrecommendations tion ofProviders AIDS Care(IAPAC), andfourothernongovernmental (HRSA), Institutes ofHealth(NIH), theNational theInternational Associa and Prevention(CDC), theHealthResourcesandServices Administration Introduction: 2 1 Susan Robilotto Kathleen Irwin(presenting) Clinicians intheUnitedStates A Tour ofImplementationResourcesfor prevent newHIVinfections. quality care, willhelp aswell-informedpracticeleadersthat andserve better equippedtoimplementthesenewrecommendations, offerhigh Recommendations: tions withnonclinical providers. building, expandingthescopeofclinical services, andnewcollabora settings.private-sector education, Mostfocusonpatient clinician skill clinicians inpublic-and implementthesenewrecommendations Lessons Learned: adherence. promote regularHIVcareandhighexamples ofstaffingmodelsthat ART andretentionsupportfromnonclinical linkage to engage providers, and for retentionandadherencesupport, andcontracts sampleagreements adherence measuresusingelectronicmedicalrecords, methodstobill materials, clinician talking points, toolstotrackretentionincareand ART andproviderfactsheets,patient brochures, posters, andaudiovisual prompt andregularHIVcarehigh ART adherence. These include resourcesforclinicians freeorlow-cost encourage many that inated Description: transmitting HIVtoothers. Health Resources and Services Health ResourcesandServices Administration, Rockville, MD, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA Prevention WithPersons WithHIV: New RecommendationsforHIV CDC, HRSA, IAPAC, dissem have andother organizations InDecember2014, theU.S. CentersforDiseaseControl 2 , AmritaTailor We widerangeofresourcescanhelp believethat Clinicianswhoarefamiliarwiththeseresources HIV Treatment andPreventionAdherence 1 1 , CharlesCollins , Jakhmola Priya 1 , LauraMcElroy 1 , GemaDumitru 1 , 1

- - - - 79 10th International Conference on 10th International to othermedicalandsocialservices. ners; screeningforHIV, syphilis, gonorrhea, andreferrals andhepatitis; ofmorepart methods to speednotification explore new partner services Recommendations: strengthsandweaknessesofvariousmethods. needed toelucidate outcomes,improve partnerservices are butmore trainingandevaluation orfindpartners.to communicate to beenshown Somemethodshave HIV andSTD, particularlythosewhousewebandmobileapplications more effective, efficient, acceptable, andcost-effectiveforpersonswith Lessons Learned: methods tocomplementtraditionalstrategies. advisedHDstoconsidernovelpartnerservices federal guidelineshave tion aboutpre-exposureprophylaxisforHIV-uninfected persons. Recent who findpartnersthroughelectronicmedia, informa andtodisseminate reach usersofnewtechnologies, including MSM, youth, andpersons networks. withHIVandSTDtestingprovidersto collaborated HDshave tocontactinfectedpersons,smart-device apps partners, andtheirsocial STD. SomeHDsuseweb-sites, rooms, chat texts, socialmedia, and clinics, andHIVclinics ofpersonswithHIVor toexpediteinterviewing specialistsinhigh-volumeHIVtestingsites,partner services STD transmission. Newstaffingmodelspost(orassign “on-call” duty)HD highriskfor with acuteHIVinfectionorSTDco-infectionwhoareat ofpatients HDstoexpediteinterviewing allow now data surveillance infectious, HIVandSTD ormatching acuteHIVinfectionandintegrating Description: partners. serve toself-notifypartners, abouteffectivestrategies patients ordirectly assistance,obtain healthdepartment(HD)partnernotification inform transmission. However, healthcareprovidersdonotadvisepatients many partners ofpossibleHIVandSTDexposure, iscriticalforreducing Introduction: 1 Jakhmola Priya Kathleen Irwin HIV andSTDPartner intheU.S. Services Centers forDiseaseControlandPrevention, Atlanta, GA, USA Adapting EmergingTechnologies for Breaking ChainsofTransmission: In many states, Inmany electronicreportingofcaseshighly Partner services, theprocessofidentifyingandnotifying 1

, SamDooley (presenting) New electronic technologies have the potentialtobe Newelectronictechnologieshave HDsandHIVSTDtestingprovidersshould 1 1 , Frank Strona HIV Treatment andPreventionAdherence 1 , RachelKachur 1 ,

- - eligibility, offeredfromeachprovider. andservices We obtainedHIVcase resources, provider-hours, onavailable andcollectedinformation patient Methods: mode oftravel, in Atlanta. areaswithrespecttoHIVcases(demand),and identifyunderserved by (supply) atooltocomprehensivelyquantifyaccessservices applied mode, totravel by factorsrelated suchaspoverty. We developedand single measure. Characteristicsinfluencingchoiceofprovidermayvary proximityandprovider-relatedconsider bothspatial characteristicsina Background: 1 Patrick Sullivan Sharoda Dasgupta Care inAtlanta, Georgia availability, andclinical andimprovingHIVcareengagement outcomes. needsandservice betweenpatient be usefulinbridgingmismatches Conclusion: areas. underserved car, and52.5%, bypublictransportation, iftraveling ofHIVcaseslivein areasofhighpoverty.with many 1.8%,Approximately by iftraveling and east bypublictransportation,Atlanta iftraveling whichcoincided portation. areaswereidentifiedinurbansouth Underserved modes,both travel bypublictrans overallscoresiftraveling withlower Results: mode. for eachtravel quintiles) andhighHIVcasecount(highesttwoquintiles), wereidentified code, areas, two supply(lowest andunderserved low definedashaving car andbypublictransportation. foreachzip Scoreswerecalculated fortwomodesoftravel: wasconceptualizedseparately of services by services, andwhetherRyan wereaccepted.White CAREpatients Supply distance, providerhours, numberofavailable ofancillary availability weight ofeachvariable. Characteristicsusedinthemodelinclude: travel (1) whichcharacteristicsareimportantindefiningaccess, and(2)the inadiscretechoicemodeltoestimate onHIVcareengagement dataset counts byzipcodefrom AIDSVu.org. We fromanexisting useddata Emory University,Emory Atlanta, GA, USA 80 Supplywashigherinurbanversussuburban/ruralareasfor We careprovidersfrommultiple compiledmajor HIVprimary Conceptualizing access spatially and by travel modemay andbytravel Conceptualizingaccessspatially MostexistingmeasuresofaccesstoHIVcaredonot

a Novel MeasureofAccesstoHIV a Novel Development andApplicationof (presenting) 1 , MichaelKramer 1 1 , EliRosenberg 1 , TravisSanchez 1 , - POSTER ABSTRACTS 69 70 81 and should be directed especially at young and uneducated patients. young anduneducated and shouldbedirectedespeciallyat couldhelppreventvirologicfailure improving medicalvisitattendance fromLima,failure inaMSMpopulation Peru. aimedat Interventions Conclusions: with VF (p=.020and.002, respectively). wereindependentlyassociated andlackofhighschooleducation age VF (p=.003, .001, and.013forMV, AA, and VC, respectively). Younger betweenallthreeretentionparametersand cally significantassociations (18.3%) experienced VF. statisti logisticregressionshowed Multivariate period.study Forty criteria. didnot meet study Oftheremaining246, 45 Results: POSTER andclinicalsocio-demographic factors. betweentheseparametersand association VF inthecontextofbaseline attended. the Multivariablelogisticregressionwasusedtoevaluate adherence (AA), i.e. ofscheduledvisitsthepatient thepercentage i.e. numberofmissedvisitsperyearand3)appointment theaverage leastonevisit, at attended ters inwhichpatients 2)missedvisits(MV), MMV weredefined: 1)visitconstancy (VC), i.e. oftrimes thepercentage least6monthspost-HAARToccurring at initiation. Three measuresof a community-basedclinic inLima. VF wasdefinedasviralload>400 ed HAART IMPACTA, betweenNovember2010andDecember2012at Methodology: ABSTRACTS startingHAART acommunitybasedclinicMSM patients at inLima, Peru. betweenmissedmedicalvisits(MMV)andvirologicfailure(VF)in relation MSM populations. wastodeterminethe The purposeofthisstudy outcomes, onretentionincareofLatin yetthereisscantdata American Background: 1 Michele Sciaudone in aCommunityHIVClinic Northwestern University, Chicago, IL, USA Two startedHAART hundredandeighty-sixpatients duringthe Failure inaPeruvian MSMPopulation Missed MedicalVisits PredictVirologic withvirologic All threemeasuresofMMVwereassociated RetentioninHIVcareiscrucialtoachievinggoodclinical We whostart reviewedmedicalrecordsofMSMpatients

(presenting) 1 10th International Conference on 10th International - - - 82 PMTCT regimensunderOption A inLusaka, Zambia. comparesadherenceto survey betweentwodifferent ARV medication when decidingonPMTCTprogramsinthefuture. This clinic-based which regimensmaximizeadherence should takeintoconsideration medication. Countrieswith ahighHIVprevalence, suchasZambia, HIV-positive pregnantandbreastfeedingwomen’s adherenceto ARV drugs. However, thesuccessofPMTCTprogramsdependscritically on is almostentirelypreventablethoughtheuseofantiretroviral(ARV) Background: 1 Karen Hampanda Center Transmission inanUrbanZambianHealth for thePreventionofMother-to-Child are requiredtotake ART dailyfortherestoftheirlives. pregnant andbreastfeedingwomenwhoarenotyetsymptomatic, but will bevitalunderOptionB+inZambiaandelsewhereforHIV-positive prophylaxis regimenunderOption A. Highqualitycounseling, however, adherence becausethe ART thanthe regimeniseasiertofollow ARV Conclusion: and breastfeedingwomenwillinitiate ART. OptionB+inZambiawhereallHIV-positivethe movetowards pregnant ter adjustingforanumberofpossibleconfoundingfactors. This supports mothers on ARV prophylaxis. remainedsignificantaf These relationships Mothers on than ART oddsofadherencetoallmedication hadgreater between mothersonthe ART andonthe ARV prophylaxisregimens. optimal. There weresignificantdifferencesintheoddsofbeingadherent Results: pregnancy andpostpartum. (ART)mothers onantiretroviraltherapy andon ARV prophylaxisduring ences intheoddsofadheringto betweenHIV-positiveARV medication center. modelsdeterminedsignificantdiffer andmultivariate Bivariate withHIV-positive alargeurbanpublichealth based-survey mothersat Methodology: University ofColoradoDenver, Denver, CO, USA Levelsofadherenceto weresub inthisstudy ARV medication Therapy andProphylaxisAdherence A ComparisonofAntiretroviral Option B+ may help to improve PMTCT medication OptionB+mayhelptoimprovePMTCTmedication Preventionofmother-to-child transmissionofHIV(PMTCT) Data werecollectedthroughaface-to-faceclinic Data

(presenting) HIV Treatment andPreventionAdherence 1 - - - 84 10th International Conference on 10th International compared withtraditionalHIVtestingstrategies. oftestingandwascost-effective streamlined counselingincreasedrates Care system, HIVtestingand routinescreeningwithrapid nurse-initiated er isuncertain. withintheUS populations Intwoprimary-care VA Health all healthcaresettings. besttoimplementroutinescreeninghowev How Conclusions: effectiveness ofModelBwasrobustinsensitivityanalysesbothsites. Model Bcost$30,911/QALY toModel relative A. cost The favorable Model A. When weincluded thebenefitfromreducedHIVtransmission, Model Bcost$26,965/Quality Adjusted Life Years (QALYs) to relative period. When weincluded thebenefitfromreducedHIVtransmission, testedduringthe4-monthpre-intervention to only10(0.04%)patients periodascompared testduringthe4-monthintervention ceived arapid period.the 6-monthpre-intervention At site2, re 2,522(9.1%)patients during periodascomparedtoonly101(1.2%)patients the intervention Results: HIVtestingandstreamlinedcounseling. rapid routinescreeningwith counseling andtesting;ModelB=nurse-initiated tions modelsforHIVcounselingandtesting: Model A =traditionalHIV outcomes werederivedfromtheliterature. We twointerven evaluated a previousrandomizedtrialof251patients. Long-termcostsandhealth Health CareSystem. costswerederived from andrelated Returnrates withintheUS studies (8,265and27,771patients) Veterans Affairs Prevalence andacceptanceoftestingbasedontwoimplementation Methodology: improve HIVtestingandreceiptofresults. to HIVstrategies rapid examine thecostsandbenefitsofnurse-initiated testing ofadultsandadolescents, arelow. HIVtestingrates We soughtto Background: 1 Anaya Henry Affairs HealthCareSystem CareSitesWithintheUSVeteransPrimary US Departmentof Veterans Affairs, Los Angeles, CA, USA At site1, testduring receivedarapid 2,364(28.6%)patients Rapid HIVTesting atHigh-Prevalence Cost-Effectiveness ofNurse-Initiated

CurrentCDCguidelinesrecommendroutinescreeningin Despite national guidelines for routine voluntary HIV guidelinesforroutinevoluntary Despitenational (presenting) Cost-effectivenessanalysisbasedonaMarkovmodel. 1 HIV Treatment andPreventionAdherence - - - 85 interest in treatment adherenceinresource–poorcontexts.interest intreatment This study access to settingshascontributedtoan ART country inlow-income failure.virological failureandsubsequentlyleadstotreatment Increased adherence totreatment. Poor adherenceleadstoimmunologicaland Background: 3 2 1 MohanRao Jagan Mangavalli Casper Johnson Ganesh Anusuya Centre inIndia Patients ART AttendingaGovernment be intensifiedduringcounsellingsessions. ofsmokingandalcoholconsumptionto counselling regardingcessation distanceto travel ART centres. Improvingtheliteracy levelofPLHIVand alldistrictandtaluklevelGovernmenthospitalscanminimizethe at Conclusions: (57.3%) (p=0.001). (p =0.006), smokers(57.3%)(p=0.0001)andalcoholconsumption 50 kilometeres (63.1%)(p=0.0001), (52.9%) whoareemployed people (55.7%) (p=0.0001), distanceto travel ART than fromhomeisgreater male(54.9%)(p=0.01), illiterate adherence levels<95%werebeing group31to40years.age 50.1%hadadherence>95%. Reasonsfor Results: <95%. variablesandclinicalsocio-demographic onadherencelevel categories test wasperformedtofindoutsignificantdifferencebetweenthe details werealsotakenfromthepatients ART card. treatment Chisquare details , CD4counts, WHO clinical andopportunisticinfection staging adherence foraperiodof2years(2010&2011), sociodemographic during theperiodfromSeptember2012to August 2013. of The average bysimplerandomsamplingtechnique.1,000 patients wasdone Study Andrapradesh, India. on Outofnearly4,500patients ART weselected PLHIV receiving ART fromaGovernment ART centrein Anakapalli, Methodology: aGovernment (PLHIV) attending ART centreinIndia. tonon-adherence factors related ART among peoplelivingwithHIV theadherencelevelto aims toinvestigate ART andidentifypossible Visakhapatnam, Andhra Pradesh, INDIA &ParaDepartment ofPsychology Psychology, Andhra University, Andhra Pradesh, INDIA Hospital,District Anakapalli, Visakhapatnam,Government Sree BalajiMedicalCollegeandHospital, Chennai, Tamilnadu, INDIA Ofatotalof1,000patients, 53.9%weremale. 42.2%werein Antiretroviral Therapy(ART)Antiretroviral in Factors AffectingAdherenceto Decentralisation of Decentralisation ART centrestherebyproviding ART An importantfactortoeffectivenessof ART isgood wasdoneamong1,000adult A crosssectionalstudy 2 , HariLakshmi V

(presenting) 2 1 , RajuBonuNaga 3 , RamaRavi 1 , P.M Udayashankar 2 ,

1 ,

POSTER ABSTRACTS 71 72 86 HIV, health. andmaximizing maternal-child tions, minimizinglosstofollow-up, transmissionof reducingperinatal accessing PMTCTcareiscriticaltomaximizinguptakeofrecommenda barriers tocare, andworkingwithproviders toreducestigmaforwomen forevolving strategies, therationale communicating reducingstructural transmission. toreduceperinatal changing recommendations Effectively Conclusions: PMTCT services. costs,transportation absentpartnersupport, andthestigmaofaccessing part ofOptionB+weredescribed, duetostructuralbarriersincluding providers. andchild Difficultiescomplyingwithmaternal clinic visitsas and pregnant, deliveredby primingthemtodistrustnovelinformation fusing providerexperiencessuchasbeingscoldedforHIV-infected to breastfeed, evenwhileon ART. Women andcon describednegative women whoknewachildinfectedduringbreastfeedingwerereluctant compelling thanadvicefromhealthcareprofessionals. For example, PMTCT practices. Personal andcommunityexperiencesweremore Women describedstrugglesunderstandingandadheringtoevolving women hadmorethanonepregnancy withHIV. sincebeingdiagnosed (IQR: 1.5-5.1), and95%werevirallysuppressed(<400copies/mL). Most last CD4cellcount677cells/mm3 (IQR: 440-767), 2.3yearson ART Results: NVIVO software. wasconductedusing interviews analysis oftranscribedandtranslated explored conception, pregnancy, andpostpartumexperiences. Content inUganda(February-August 2014).HIV cohortstudy guides Interview POSTERwomen withpregnancy inthepast2years, sampledfromanon-going Methodology: evolvingPMTCTguidelinesremainsunclear.navigate ART prophylaxisforinfants. andnevirapine womenunderstandand How guidelines recommendbreastfeedingforupto6monthswithmaternal (ART)HIV-positive antiretroviraltherapy forlife. womeninitiate National venting mothertochildtransmission(PMTCT)ofHIVwherebypregnant Background: 5 ABSTRACTS4 3 3 2 1 Yap Boum Robak Magda Bridget Burns Lynn Matthews Living WithHIVinRuralUganda Epicentre UgandaResearchCenter, Mbarara, UGANDA University ofCaliforniaSanFrancisco, SanFrancisco, CA, USA Simon Fraser University, Burnaby, BC, CANADA MedicalSchool,Harvard Boston, MA, USA Mbarara UniversityofScienceand Technology, Mbarara, UGANDA Massachusetts GeneralHospital, , Boston, MA, USA Twenty womenwereinterviewed: 33(IQR: medianage 28,35), 6 , Bangsberg David PMTCT StrategiesAmongWomen Challenges NavigatingEvolving 1 HIV-positive womenexpressconfusionandconcernabout In2012, forpre UgandaadoptedtheOptionB+strategy 3 , EmmaDunkley , JessicaHaberer We withHIV-positive conductedin-depth interviews

(presenting) 1 , Angela Kaida , Angela 1 4 , Schola Ashaba , , JasmineKastner 1 , Peter Hunt 4 5 , JeffreyMartin 2 , ChristinaPsaros 4 , AlexTsai 1 5 , ,

3 10th International Conference on 10th International , - - - 88 2014 (July), from onsexualriskbehavior byusingthemonitoringdata Methodology: Testing inthe publichealthfacilitiesinKanoState. services ofMSMinaccessingHIVCounselingand plusonthebehavior education and HIVknowledge. ofpeer theassociation The aimofthisistoevaluate 1.3 consideringthesexualriskbehavior, oftheMSM themobilenature prevalenceof isabout8.3whichhigherthantheState in KanoState Background: 3 2 1 Aderemi Joseph Oluwakayode Gomes Kano MetropolisNorthWest Nigeria confidential andconvenientaccess. referrals. specialspotsfor Condomsandlubricantswould beplacedat up,follow andcompleteHCT strengtheningthepreventionstrategies changethrough lives andsafetyisimportanttoMaintainingthebehavior without condoms. theirhealthy With thePEPmodeltheyunderstandthat condoms, sexwithoutcondoms;theirpartnerspaymore theyenjoy inconsistent condomusebecausetheycan’tbeseeninpublicbuying prevalence thanthegeneralpopulation. InKano, only6.7%reported MSMhadhigher tercourse carriedahigherriskoftransmissionandthat Conclusion: status, useofcondoms, multiplesexpartners. avoid among thetargetgroups, their theyseetheimportanceofknowing were intoskilledwork. change therewasbehavior After theintervention old, schooland diplomastudentsandfew mostofthemweresecondary pieces ofcondomsdistributed. ofthepeersis25years The midages and8065 with 20%prevalencerate were referredforHCT/STItreatment HCT wasconductedbytrainedcounselor&testers. About 2,052(80%) for PESandtoreferpeershealthcarecenterstreatment. Mobile which keyopinionleaderswereselectedamongstpeersaseducators wherethepeersrefertheirforPeerbilization Session(PES)from Result: change amongtheMSMinKanoMetropolis. Client IntakeformwereusedtoanalyzedtheHCTuptakeandbehavior trackingtools(PITT),structured preventionintervention ReferralandHIV African PrinceInitiative, Abuja, NIGERIA Population Council, Abuja, NIGERIA Love PlanetOrganization, Kano, NIGERIA Using Peer Plus(PEP)modelwehadcommunitymo Education Men WhoHaveSex WithMen(MSM)in HIV PreventionBehavioursAmong Previously MSM were unaware that unprotectedanalin that PreviouslyMSMwereunaware HIV prevalence among men who have sexwithmen(MSM) HIVprevalenceamongmenwhohave About 2,565MSMwerereachedfrom2013(May)to 3

(presenting) HIV Treatment andPreventionAdherence 1 , SuleimanIbrahim 2 ,

- - 89 10th International Conference on 10th International disparities incareoutcomes. different areasofthesecitiesmayhelpusresolvesomethepervasive in careoutcomesdifferforsub-populations ofhow Further exploration outcomes canbeusedinourcollectiveresponsetotheepidemic. policy ofHIVcarecontinuum mapping makersshouldconsiderhow Recommendations: these resourcesinthecity. careoutcomesmaycomparetothedistribution of us understandhow continuum outcomes. Testing mayhelp mapping location andtreatment than others, inworse care alsoseesimilarpatterns butwecannow ofnewHIVdiagnoses in whichsomeareasexperiencehigherrates impactedcitiestherearemicro-epidemics Even withinourmostheavily detail. andsub-population uum outcomeswithsubstantialgeographic Lessons Learned: White Care Act clinics. andRyan on HIVtestinglocations lays ofthemostcurrentinformation byrace/ethnicity,view maps sexandage. HIVContinuumalsohasover tocare,linkage incareandviralsuppression. engagement Userscan HIVdiagnoses, tomap diagnoses, frompublichealthagencies late data adelphia, and Washington, DC. HIVContinuumusesdiseasesurveillance impactedbyHIV- US citiesheavily Atlanta, Chicago, NewOrleans, Phil a freeonlineresourceforvisualizingHIVcarecontinuumoutcomesin5 Description: outcomes. forHIVcare everbeencreated have nointeractivemaps until now levelsintheUShasbeendoneforanumberofyears,geographic but healthcare andpublichealthresources. multiple HIVcasesat Mapping needmore/better resources canbeinstrumentalintargetingareasthat figures. orstatic arenotpossiblewithaggregate for insightsthat These Introduction: 1 Travis Sanchez HIV CareContinuumin5MajorUSCities Emory University,Emory Atlanta, GA, USA Visualize GeographicPatterns inthe Interactive OnlineResourceto HIVContinuum.orgwaslaunchedinFebruary 2015andis Online tools are robust for mapping illnessdata, Onlinetoolsarerobustformapping and allow 1 , Alexandra Ricca , Alexandra HIVContinuum allows userstovisualizecarecontin HIVContinuumallows HIVcareproviders, and publichealthagencies 1 , Patrick Sullivan HIV Treatment andPreventionAdherence

(presenting) 1 - - - 90 effective at reducingFIandstrengtheningtheHIVcarecontinuum. effective at arefeasible,evidence aboutwhichsupportivestrategies acceptable, and (ART) adherenceandretentionincare. However, thereisapaucityof Introduction: 4 3 2 1 Nancy Padian Otieno Simba Sandra McCoy HIV-Infected AdultsinTanzania TherapyAmongFoodInsecure Antiretroviral Adherenceto Cash AssistancetoImprove routines arefirstestablished. andcare when providedduringthecriticalperiodtreatment 2016), effectofNACplusfoodorcash wewillunderstandtherelative to HIVcarearefeasibleandacceptable. At thestudy’s conclusion (early ART innorthwestern initiates Tanzania. Cashandfoodtransferslinked Recommendations: cash transfers. of foodbasketswasacceptablebutdistributioncostsarehigherthanfor all providedamobilenumberbytheirfirsttransfer. Off-sitedistribution baselineformobilemoneytransferandnearly vided aphonenumberat (BMI <18.5kg/m2). Inthecashtransfergroup, 71%ofparticipantspro years, massindex(BMI)is20.8;19%areunderweight andmeanbody =99%).goal (responserate Overall, 57%arefemale, is37 age average date, enrolled, 589participantshave comprising 75%oftheenrollment FIand252(39.4%)wereseverelyFI.325 (50.8%)weremoderately To Lessons Learned: 6and12months. andviralloadat ratio outcome is ART possession adherencemeasuredwiththemedication conditional onmonthlyvisitswiththeHIVcareprovider. The primary transfer armsreceivemonthlyassistancefor with theHouseholdHungerScale. Participants inthefoodandcash ≥ food assistance, andNACpluscashtransfers. Eligibleparticipantsare yanga, Tanzania: nutritionassessmentandcounseling(NAC), NACplus for adultswithHIVinfectioninShin three short-termsupportstrategies Description: 18 years, initiated ART London SchoolofHygiene& Tropical Medicine, London, England, UK Regional MedicalOffice, Shinyanga, TANZANIA ofHealthandSocial Ministry Welfare, DaresSalaam, TANZANIA University ofCalifornia, Berkeley, CA, USA Study ofShort-Term Foodand Implementation ofaRandomized of We fromarandomizedstudy analyzedbaseline data 3 1 Food insecurity(FI)isabarriertoantiretroviraltherapy , William Dow , William

(presenting) Of 644 patients screened, Of644patients 577(90.2%)reportedFI: We foundalarminglevelsoffoodinsecurityamong ≤ 90 daysprior, andfoodinsecure, determined 1 , SuneethaKadiyala 1 , ProsperNjau 2 , Nancy Czaicki ≤ 6 consecutivemonths, 4 , NtuliKapologwe 1 ,

3 , - - POSTER ABSTRACTS 73 74 91 Yap Boum Kara Bennett Lynn Matthews Follow-Up inUganda Periconception, Pregnancy, andPostpartum for their own health. for theirown support duringpostpartumperiods, evenamongwomeninitiating ART underscorestheneedfortargetedadherence partum adherencegaps most visits, HIVtransmissionrisk. suggestinglow Higherrisksofpost Conclusions: 95% CI1.07-1.63). frequency washigherpostpartum(aRR1.32, of72hourgaps/90days likely duringpericonception(aRR0.69, 95%CI0.51–0.95)whereas pregnancy andpostpartumperiods. Meanadherence<80%wasless 94% (76-98%), and88%(67-97%)during non-pregnant, periconception, 1.33-3.49). Medianadherencewas92%(IQR79-98%), 93%(84-98%), was significantlymorelikelyduringpericonception(aOR2.15, 95%CI: tion, 93%ofpregnancy, and89%ofpostpartumvisits. Suppression 90%ofnon-pregnant,suppression waspresentat 97%ofpericoncep mm3, partner. and43%reportedanuninfectedorunknown-status Viral was29years, medianage of follow-up; medianCD4was165 cells/ Results: days, gaps/90 cation respectively, acrossperiods. likelihoodof<80%adherenceand72hourmedi regression evaluated viral suppression(<400copies/mL)ineachperiod. LogisticandPoisson pill caps. adjusted odds of Multivariablelogisticregressionestimated and/or inter-pregnancy. ART adherencewasmeasuredusingelectronic nancy-related’ (referenceperiod)definedas1quarterafter ART initiation ‘Postpartum’ livebirth, definedas2quartersfollowing and ‘Non-preg ‘Pregnancy’ definedasfirstreportofpregnancy untilreportofoutcome, included: ‘Periconception’ definedas3quartersprecedingpregnancy, work andquestionnaireswerecompletedquarterly. Follow-up periods ofindividualsinitiating Outcomes cohortstudy ART wereincluded. Blood between 2005-2011andenrolledintheUganda AIDS Rural Treatment Methodology: POSTERwomen receiving ART inUganda. HIVtransmissionrisksamongHIV-infectedeach periodtoestimate (ART)HIV viralsuppressionandantiretroviraltherapy adherenceacross infants duringpericonception, pregnancy, andpostpartum. We compared Background: 7 6 5 4 ABSTRACTS3 2 1 Bangsberg David University ofCalifornia, SanFrancisco, CA, USA Epicentre UgandaResearchCenter, Mbarara, UGANDA Mbarara UniversityofScienceand Technology, Mbarara, UGANDA Consulting,Bennett Statistical Inc., BallstonLake, NY, USA Simon Fraser University, Vancouver, BC, CANADA SchoolofPublicHealth,Havard Boston, MA, USA Massachusetts GeneralHospital, Boston, MA, USA 111womenwithpregnancy contributed486person-years 6 , JessicaHaberer Adherence toART During HIV-1 Viral Suppressionand 4 , MarkSiedner Women withpregnancy werevirologicallysuppressedat HIV-infected womenrisktransmissionto partnersand Women (18-49years) withself-reportedpregnancy

(presenting) 1 1 1 , NicholasMusinguzi , Peter Hunt 1 , Ribaudo Heather 7 , JeffreyMartin 5 2 , JeromeKabakyenga , Angela Kaida , Angela 7 ,

3 , 10th International Conference on 10th International

- - - - 5 , - 92 Kaitian Koo Kuala LumpurHospital, Malaysia uary 2015.uary betweensixandeighteenyearswererecruited Patients aged Paediatric InstituteKuala LumpurHospitalbetween 2013andJan April Methodology: study. possible affectingfactorsinHIV-infected childrenwereassessedinthis andviralloadsuppression.Virus (HIV)patients Adherence to ART andits ofHumanImmunodeficiencyadherence isessentialinmanagement Background: 1 Kamarul Azahar MohdRazali Jing Wen Tan dation (95%oftheprescribeddose).dation which ishigherthanNational AIDS Manual, United Kingdom recommen Conclusions: count (medianof92%vs98%;p=0.154). The introductionofMATs inpill improvementofadherencerate showed sideeffectsof None hadreportedthat ART affected theiradherence. den (45.5%), disbeliefin ART (18.2%)andinaccessibilityto ART (18.2%). were forgetfulness(60.6%), poorpsychosocialsupport(51.5%), ART bur welfare centers(p=0.453). Otherpossiblefactorsaffectingadherence caregivers, including biological, extended, adoptive, fosterparents, and wasfoundbetweendifferent significant differenceinadherencerates comparedtothemale(p<0.05). 4.9%higheradherencerate have No on theadherencerate. generally thefemalepatients Itwasfoundthat the baselinevisitstoassessimpactofgender, age, andethnicity female. from A multipleregressionmodelwasperformedon40patients study. was11.7 The meanage Results: software,were performedusingstatistical SPSSv19.0. only. whoarecurrentlyonpilltreatment patients analyses All thedata wereadministeredtothe andquestionnaireinterview self-logged diary of ‘Medication Adherence Toolkits’ (“MATs”), respectively. Pillcount, monthly visitsforbothpre-(baseline)andpost-introduction(treatment) during theirclinic visits. Samesubjectswereassessedbasedon3

Kuala LumpurHospital, Kuala Lumpur, Persekutuan,Wilayah MALAYSIA Of 49 patients recruited, Of49patients completedthetreatment 36have in HIV-Infected Paediatric Patients in Therapy Adherence toAntiretroviral

(presenting) 1 Adherence to ART hasachieved98%, inthispopulation Understanding paediatric antiretroviral therapy (ART) antiretroviraltherapy Understandingpaediatric , Suk Yen Chin wascarriedoutin A prospective, study observational HIV Treatment andPreventionAdherence 1 , Kuan Chau Yap 1 1 , Thahira JamalMohamed ± 2.8yearsand53%ofthecohortwere 1 , Zahari NurSyazwani 1 ,

1 ,

- - - 93 10th International Conference on 10th International es school-goingyouthexperiencewithpharmacy refills. skills withafocusonalcoholuse, familyengagement, andthechalleng strengthening programstoaddressadolescents’HIVself-management disclosure werelesslikelytomiss>48hrsof ART. These findingssupport youthwholivedinhomeswithcomplete adherence outcomesandhow Conclusions: 1.09-6.75). 95% CI1.57-5.34), andalcoholuseinthepastmonth(OR2.71, 95%CI school (OR2.21, 95%CI1.19-4.35), theclinic attending alone(OR2.90, apharmacyhaving MPR<90%(analysisn=239)include beingin- ≥ (OR 2.58, withmissing 95%CI1.16-5.78)weresignificantlyassociated (OR2.44,status 95%CI1.25-4.77), andalcoholuseinthepastmonth 1.92, oftheyouth’s 95%CI1.045-3.54), homeaware at noteveryone in-school, infection. and77.9%self-reportedperinatal Beingmale(OR 51.9%werefemale, andhadcompletedata; the interview 77.5%were sites.study Ofthese, 285wereon ART leastthreemonthspriorto at representing 84.7%of 15-19enrolledinHIVcarethe ALHIV ages Results: using bothadherenceoutcomemeasures. characteristics (e.g., clinic attends alone)withincompleteadherence (e.g., theyouth’s knows everyone status), andHIVself-management ofindividual(e.g.,assessed associations alcoholuse), homeenvironment data, adherence. wereusedtoestimate regressionanalysis Multivariate past threemonths, andsixmonthpharmacy (MPR) pillratio medication Participants´ self-reportofmissing>48consecutivehours ART inthe among threeHIVclinicsALHIV (15-19years)attending inZambia. Methodology: to incomplete ART adherenceinthispopulation. with HIV(ALHIV)increasedby50%from2005to2012, inpart attributed Background: 4 3 2 1 Namakau Nyambe Stalter Randy Julie Denison(presenting) Clinics inZambia (ART) AmongAdolescentsAttending3HIV 48 consecutivehoursof ART. Factors with significantlyassociated Arthur Davison ChildrensHospital,Arthur Davison Ndola, ZAMBIA FHI360, Lusaka, ZAMBIA FHI 360, Durham, NC, USA Baltimore, MD, USA Johns HopkinsBloombergSchoolofPublicHealth, A totalof309eligibleparticipantscompletedaninterview, Adherence to Antiretroviral Therapy Adherence toAntiretroviral Factors RelatedtoIncomplete 2 Resultshighlighttheimportanceofalcoholforboth Worldwide, HIV-related mortalityamongadolescentsliving , Patrick Katayamoyo We in2012-2013 conductedacross-sectional study 3 , SarahMercer 1 , Packer Catherine 2 , DonnaMcCarraher 3 , Mwansa Jonathan HIV Treatment andPreventionAdherence 2 , Banda Harry

2 4 ,

3 ,

- 94 a home-basedPA (MI) Interviewing withMotivational programintegrated terventions. examinedthefeasibilityandacceptabilityofFLEX,This study living withHIV, ithasnotbeeneffectivelycombinedwithadherencein disease. Although PA isimportanttopositivehealthoutcomesforyouth the toeffectivelymanage among youthlivingwithHIVareinadequate mune systemandcardiovascularriskofyouthwithHIV. Adherence rates canbepreventedwithphysicalactivity(PA).that PA canimprovetheim Background: 3 2 1 BroganHartlieb Kathryn (presenting) Angulique Outlaw With HIV Coaching inAfricanAmericanYouth Living Conclusions: 6-month program(40sessions)willalsobepresented. BMI. willbepresented. Healthoutcomesandadherencedata from Data 3 monthsinstrengthassessments, andreductionsormaintenanceof were completed.at findingsfromsuggestimprovements Preliminary Results: baselineand 3months.ments werecompletedat youth toself-monitorPA adherence. andmedication Fitness assess (N =3). addingindependentPA, Bothprogramsencouraged andtaught beyond 3months, resultedinthedevelopmentofa6-monthprogram program satisfaction, aswellastrongdesiretocontinuetheprogram design. The initialprogramwas3-months, 24sessions(N=12). High and resistanceworkout)adherencegoalsettingusingatapered PA bymotivational MI sessionfollowed training (highintensityinterval Fifteen eligibleparticipantswereconsented. FLEXconsistedofaninitial included HIV-positive, 16to24, age andsuboptimaladherencePA. to yoga. Youth wererecruitedfromthelocalyouthHIVclinic. Eligibility viewed asconvenientandacceptable. Resistancetrainingwaspreferred Results suggestedunanimousinterestinPA, withhome-basedservices 19to27;80%male).youth andyoungadultslivingwithHIV(ages Methodology: adherence. andappointment alsotargetsHIVmedication that University ofMiami, FL, USA University,Florida International Miami, FL, USA Wayne University, State Detroit, MI, USA For the3-monthprogram(24sessions), 18sessions(76%) Home-Based Personal Fitness HealthOutcomesWith Improving Pending. wasreported. Highprogramsatisfaction African ofdiseases ofmany higherrates Americans have A focusgroupwasconductedwith10 African American 2 , GabrielSomarriba 1 , SylvieNaar-King 3 , Alex Hill , Alex 1 , MauriceBulls 1 1 - , - - POSTER ABSTRACTS 75 76 95 policy decisions. should beprospectivelyevaluated, forlarger implications andmayhave waslongerhospitalstay.hospitalization Reasonsforthisassociation Conclusions: those whodidnot(median8days;IQR5, 13). longerstays(median24days;IQR20,discharge having 36)comparedto (OR 1.14, 95%CI1.04, 1.25), whostarted withinpatients ART priorto analysis, withinpatient wasassociated duration ART hospitalization (12%) patients ART priortodischarge. wasinitiated Inmultivariable with mediantimeto ART of48days(IQR18, fromdiagnosis 77). In10 ART in67persons(83%)withinoneyearofhospitalization, wasinitiated co-morbid mentalillness. Medianhospitalstaywas9days(IQR5,17). black, 75%uninsured, 29%substanceabuse, 16%homeless, 11% Results: ofdeferred determine date ART. werereviewedto hospitalization records foroneyearafterdiagnosis for oddsratios to estimate ART priortodischarge. initiation POSTERlogistic regressionmodelswithforwardselection. Modelswereused Variables significancelevel<0.10wereincluded withunivariate in including admissionservice, werecollected. andsocialworkvisitation as substanceabuseandhomelessness, andsystems-levelvariables, meningitiswereexcluded.culosis orcryptococcal Host-leveldata, such 2011throughDecember2012.January Patients admittedwithtuber with newlydiagnosed Hospitalin patients Grady AIDS at Atlanta, GAfrom Methodology: withinpatient and systems-levelfactorsassociated ART initiation. care. establishoutpatient patients We aimedtocharacterizepatient- ABSTRACTS issometimesdeferreduntil duringhospitalization afterdiagnosis tiation maydelaydiseaseprogressionanddeath.diagnosis However, ART ini Background: 1 Yijian Huang Neela Goswami U.S. Southeast Initiation ataLargePublicHospitalinthe Emory University,Emory Atlanta, GA, USA Eighty-one patients wereeligibleforanalysis: Eighty-onepatients 81%men, 80% During HospitalizationandART Time BetweenHIV/AIDSDiagnosis 1 , Wendy Armstrong with The onlyvariableassociated ART during initiation Prompt antiretroviral therapy (ART) after Promptantiretroviraltherapy initiation AIDS Data wereretrospectivelycollectedfromchartsof Data

(presenting) 1 , Colasanti Jonathan 1 , CarlosdelRio 1 1 , JakobKhoubian Electronic 10th International Conference on 10th International - 1 - , 96 Suk Yen Chin Lumpur Hospital, Malaysia in HIV-Infected Pediatric Patients inKuala outpatient settinginPaediatric InstituteKualaoutpatient LumpurHospitalbetween Methodology: in HIV-infected children. pill box,opinions andperceptionstowards boxand pilldiary medication Immunodeficiency Virus(HIV)patients. aimedtoassess Thisstudy (ART)tools inimprovingadherenceofantiretroviraltherapy inHuman Background: 1 Kamarul Azahar MohdRazali Jing Wen Tan pill diary. boxwithMDCbutnotpreferableover AM/PM pillboxandmedication Conclusions: the future, (53%). respectivelybutnottopilldiary box(92%)in ofusingpillbox(100%)andmedication on thecontinuation (78%). box(89%)andpilldiary medication The resultswereremarkable Overall, pillboxwere97%, toward satisfactions by patients’ followed However, about34%ofthemfoundtroublesomefillingupthepilldiary. addition, isusefultothem. foundpilldiary therewere78%ofpatients inconvenient tobringalongpharmacy refilling. duringmedication In error.tration boxis foundthesizeofmedication Nearly20%ofpatients adminis MDCcouldreducemedication foundthat to 86%ofpatients orouting. duringtraveling tle(s) ofmedications For box, medication up thanoriginalbot stillprefertobringthepillboxrather all thepatients week. foundtroublesomefillingupthepillboxevery of patients However, Results: analysis. used fordata MATs.perceptions towards software, Statistical SPSSversion19.0was toassesstheiropinionsand questionnaire wasadministeredtopatients only.six andeighteenyearswhoarecurrentlyonpilltreatment A between aged wereintroducedtothepatients (MDC) andpilldiary) (7-days AM/PM pillbox, dosingchart boxwithmedication medication 2015.August 2014andJanuary ‘Medication Adherence Toolkits’ (MATs) MALAYSIA Kuala LumpurHospital, Kuala Lumpur, Persekutuan,Wilayah wereincludedA totalof36patients intheanalysis. Almost 17% Pill Box, MedicationBoxandPillDiary Opinions andPrescriptionsTowards 1 Majority of patients preferredtheintroductionof7-days Majorityofpatients Pillbox, areadherence box and pilldiary medication , Suk Yen Chin

wascarriedoutat A prospective, study observational (presenting) HIV Treatment andPreventionAdherence 1 1 , Kuan Chau Yap 1 , Thahira JamalMohamed 1 , Zahari NurSyazwani 1 ,

1 , - - 97 10th International Conference on 10th International port, andretentioninHIVcare, linkage andhealth outcomes forPLWH. app inimprovingsocialsup ofpossiblebenefitsfromthe investigation played apositiveroleintheirstruggleswithHIV. Nextstepswillinclude other, forthecommunity, appreciation theapp andaperceptionthat PLWH. Participants whopostedontheCMBexpressedsupportforeach socio-economic status, andpotentiallyprovidepsychosocialsupportto nerable populations, including racial/ethnicminoritiesandthoseoflower Conclusions: difficulty.importance ofadherenceandsupportforothershaving members. Ofbiomedicalcontent, mostpostsdiscussedmedications, the greetings weremostcommonandincluded welcomingnew messages described stressorsandcopingstrategies. content, Ofcommunitychat biomedical content(10%). Ofpsychosocialcontent, postsfrequently 62% hadpsychosocialcontent, (29%), bycommunitychat followed and (1.13-23.30), p=0.034)]. over8months, Ofthe840CMBmessages had higheroddsofpostingiftheyunsuppressedviralloads[OR5.13 insurance[OR0.07(0.01-0.41),and hadprivate p=0.003]. Participants oddsofpostingiftheywerewhite[OR0.20(0.05-0.84),lower p=0.028] Results: usingaGrounded analyzed qualitatively approach. Theory ticipant characteristicsandpostingontheCMB. were CMBmessages on aCMB. betweenpar associations Logisticregressionsinvestigated included that theopportunitytointeractwithotherusers PL application ed throughproviderreferrals. Participants receivedcellphoneswiththe Methodology: (Positivewithin aclinic-affiliatedapplication Links, Smartphone PL). board(CMB) OSGdeliveredthroughacommunitymessage innovative to overcomebarriersmeetingtheseneeds. analyzesan Ourstudy support andinformation. thepotential Online supportgroups(OSGs)have Background: 3 2 1 Karen Ingersoll George Reynolds Colleen Laurence Tabor Flickinger(presenting) Johns HopkinsUniversity, Baltimore, MD, USA Health Decision Technologies, Sheboygan, WI, USA University of Virginia, Charlottesville, VA, USA 24participantspostedtotheCMB;14didnot. Participants had Group forPeople LivingWithHIV A Smartphone-BasedOnlineSupport This CMBonaclinic-affiliatedapp mayreachvul mobile People livingwithHIV(PLWH) unmetneedsfor oftenhave For thispilotstudy, 38HIV-infected wererecruit patients 1 , RebeccaDillingham 2 1 ,Cohn Wendy , ErinPlews-Ogan 1 1 , ClaireDeBolt , Beach Catherine Mary 1 , Ava Lena Waldman, Ava 1 HIV Treatment andPreventionAdherence 1 , Erin Wispelwey , 3 , 1

1 ,

- - - - 98 isons weremadebetweenthoseevertestedforHIVversuswho Jersey,at healthfairsandcommunityorganizations. identified Compar practices wasadministeredamongSAadultsresidingincentralNew Methodology: toHIVtestingamongSouth barriers related Asian (SA) Americans. among low Asians. We examinedthebeliefs, attitudes, knowledge, and tion, HumanImmunodeficiency aresignificantly Virus(HIV)testingrates Background: 1 Amoli Joshi Sneha Jacob the SouthAsianAmericanPopulation Immunodeficiency Virus andits Testing in understanding and utilization ofHIVtesting. understanding andutilization theSAcommunityareessentialtoincreasetheir larly targetedtowards HIV andlackofphysicianrecommendation. efforts particu Educational about perceptionsandknowledge was stronglyinfluencedbyinaccurate frequency inthiscommunityand ofHIVtestingwasconsiderablylow HIVtestingintheSA towards and attitudes American population. The Conclusions: <0.05. (4.4%vs18.6%),(6.2% vs13.2%)andbytouchingatoiletseat allp HIVspreads bysharingadrinkingglass and lesslikelytobelievethat and onecanleadahealthy, productivelifewithHIV(84.1%vs57.6%); chronic disease(59.5%vs38.8%) likely tobelieveHIVisamanageable talked totheirpartneraboutHIV(59.7%vs25.3%). They werealsomore for HIV testing(40.0%vs5.2%),received doctorrecommendation and fluent Englishspeakers, highereducation, have knewsomeonewithHIV, 384) werenot. Those whoweretestedmorelikelytobeyounger, n =114)ofparticipantswereevertestedforHIVwhereas72.0%(n degree (76.2%), andspokefluentlyinEnglish(79.2%). One-fifth(21.4%, The majoritywereborninSouth Asia (84.1%), leastacollege hadat (52.5%) oftheparticipantswereage Results: had not. New Brunswick, NJ, USA Rutgers-Robert Wood JohnsonMedicalSchool, wereadministered.A totalof533surveys half Approximately Surrounding Human Knowledge andPerception 1 , DevangiShukla ofitsscaletoexamineknowledge This isthefirststudy According totheCentersforDiseaseControlandPreven

(presenting) aboutHIVknowledge,A survey perception, and testing 1 , SheenuChandwani 1 ≤ 46 withevengenderdistribution. 1 , SunandaGaur

1 ,

- - - POSTER ABSTRACTS 77 78 99 and tosustainreferralstreatment. ofmultiplepartnering, riskybehaviors life byavoiding alcoholanddrugs and HCT, withPEPmanual, theyunderstoodcouldliveahealthier distributed. PEPmanualwaseffectiveforsustainingdesiresafersex of unprotectedanalsex. 10,020condomsand3,340lubricantswere Conclusions: sex. while theyusecondomsforvaginal analsexwithoutcondoms, arebisexualandreportedtheyenjoy lations use ofcondomsduetohighpayingclients, while40%ofsamepopu weremalesexworkerswhoreportedinconsistent the 713MSMtreated students andsomewereofskilledunskilledcasualworkers. 30%of school,20 yearsoldmadeupofsecondary polytechnic anduniversity withabout45%prevalencerate.treatment ofpeersis ages Average Result: ChangeMaintenance. uptake andBehavior POSTERForms, ClientIntakeForms, CondomForecast Forms toanalyzeHCT October 2014usingPreventionIntervention Tracking Tool (PITT), Referral was usedtoreach864MSMinZariacityfromNovember2013 prevention methodofStructural, andBiomedicalapproach Behavioral Methodology: of Defense, Walter ReedsFoundation ClinicinKadunastate. USDepartment intheMSMcommunityapproved testing andtreatment ofMSMinassessingHIV/STIcounseling,Plus manualonthebehavior ponent ofNational Action Committeeof Peer AIDs approved Education com ChangeCommunication theeffectofBehavior evaluating aims at ABSTRACTS9.2%. Consideringthefearofpassed Anti-Same SexBill, thisstudy prevalenceof isabout17.2%higherthanthestate in Kadunastate Background: 2 1 Benneth Ikeokwu(presenting) North Central, Nigeria, West Africa With Men(MSM)inZariaCity, KadunaState, Population Council, Abuja, NIGERIA Wave MakersInitiative, Kaduna, NIGERIA Outof835MSMreferred, 713successfullyassessedHCT/STI Behaviors AmongMenWhoHaveSex Sexual RiskandHIVPrevention Most MSM previously were unaware ofthehigherrisk MostMSMpreviouslywereunaware HIV prevalence among men who have sexwithmen(MSM) HIVprevalenceamongmenwhohave Inter Personal Communication IPC using the combination InterPersonal IPCusingthecombination Communication 1 , Collins Austin , 1 , Abdullahi Hafiz , Abdullahi 2 10th International Conference on 10th International - - used toidentifythemesacrossthefocusgrouptranscripts. inthreeNorthCarolinaregions.organizations Dedoosesoftwarewas histories. Participants wererecruitedthroughclinics and AIDS service facilitators. We characteristicsand alsocollectedsociodemographic ART focus groupswith56PLWH regarding ART adherencebarriersand Methodology: adherence challengesinthecontextofHIVasalife-longcondition. (ART)antiretroviral therapy iscrucialforhealth. Patients facenumerous Background: 2 1 Kemi Amola Muessig(presenting) Kathryn Therapy: Intentionality, Power andControl medication takingpractices. medication toexertcontrolvia drivepatients strugglesandpressuresthat power shift amongprovidersandpractitionerscouldhelpaddressperceived as acontinuousandchangingprocess, notafixedstate. Aperspective Conclusions: adherence.comorbidities furthercomplicated thesestruggles,assuaged whileperceivedside-effectsandmultiple some amountofcontrolintheirlives. Supportiveproviderrelationships Instead, thesedecisionsbecamewaysparticipantsfelttheycouldregain ART exclusively wasnotalways one’s adecisionaboutbesttreating HIV. instances whereparticipantsfeltmorein-control, totake choosinghow personal controlandsubsequentabilitytotake ART asprescribed. In tance programs. Across theseareas, participantsdescribedlimitstotheir systems including thecriminaljusticesystem, hospitals, anddrug assis HIV disease, bodies, 2)theirown 3)healthcareproviders, and4)social assert consistentcontrolacrossmultipleareasincluding with: 1)their Maintaining optimaladherencerequiredparticipantstoindefinitely struggles.through whichtheydescribedexperiencingnumerouspower totake how ART, andphasesoftakingnotmedications ofadherence.nature Participants describedprocessesoflearning and livingwithHIV4to20years. Discussionsreflectedthefluid, complex Results: Merck &Co., Inc., West Point, PA, USA University ofNorthCarolina, Hill, Chapel NC, USA 100 Participants were59%male, 77%Black, 23to67years, aged 1 , Stein Kathryn Intervention messaging couldbetterconveyadherence messaging Intervention Among peoplelivingwithHIV(PLWH), adherenceto From February toJuly2012, weconductedsixrecorded Patients HIV onAntiretroviral Medication Taking Practicesof HIV Treatment andPreventionAdherence 1 , JosephMurphy 1 , Abigail Panter, Abigail 1 , EricMaiese 1 , Mouw Mary 2 , David WohlDavid , 1 ,

1 -

10th International Conference on 10th International 14siteswithinthe ed at Adolescent Trials NetworkforHIVInterventions. Phase IISBIR, wewillfurtherrefine Epic Alliesforuseinatrialconduct networking, for ishighlyappealing that YMSM. Inourrecentlyfunded ing anengaging, interactiveapproach, including andsocial gamification through low-cost, (mobilephones)and byus widelyutilizedtechnology promote that need forinterventions ART uptakeandadherencedelivered Conclusions: enhancements. offered concretesuggestionsforapp In usabilitytesting, prototypewaswellreceivedandparticipants theapp learningandskillbuilding,encourage andmaintainuserengagement. daily adherencetracking, promotesocialnetworkingsupportamongusers, HIV-positive engineeredtoreinforce YMSM; and4)agamingapproach 3)connectiontoanetworkofother messages; reminders andmotivational 2)tailored visualizations; trackingofadherencewithgraphic real timedata informational, customizableandpersonalized. of:This ledtofinalization 1) isinteractive,including that anapp theimportanceofcreating social, Results: toaddresstheseneedsviaamobileapp. and strategies YMSM toassess ART adherence, changeneeds, andbehavior motivation conducted focusgroupsandusabilitysessionswith27HIV-positive changethroughtechnology.(FBM) ofbehavior From 9/13to5/14, we SkillsmodelandtheFogg Behavioral Model tion-Motivation Behavioral developed theinitialconceptforEpic Allies, guidedbytheInforma Methodology: YMSM. ART uptake, amongHIV-positive adherenceandviralsuppressionrates incare, toimproveengagement chanics andsocialnetworkingfeatures utilizesgameme that (app) mobilephoneapplication theory-based or achieveviralsuppression. Inresponse, wedevelopedEpic Allies, a medical care, (ART) anddonotoptimallyadheretoantiretroviraltherapy Background: 3 2 1 Emily Pike Lisa Hightow-Weidman the World Caktus Group, Durham, NC, USA Duke University, Durham, NC, USA University ofNorthCarolina, Hil, Chapel NC, USA 101 revealedseveraloverarchingthemes Analysis offocusgroupdata 1 , CaktusGroup Epic Allies contributessignificantlybyaddressingacritical After diagnosis, HIV-positive many YMSM delayentering Through aPhaseIsmallbusinessgrant(SBIR), ourteam Remember Your Meds, Save Epic Allies:FightBadGuys, 1 , SaraLeGrand 3 HIV Treatment andPreventionAdherence 2 , Kathryn Muessig(presenting) Kathryn - - 1 - - , 102 based application to improve adherence to antiretroviral therapy among toimproveadherenceantiretroviraltherapy based application Description: the realplacesandtimestheyneeditasgoabouttheirdailylives. dous opportunitytoprovidesupportforadherenceHIV-positive youthin Youth whichrepresentsatremen constantlyconsumemobiletechnology outside thedoctor’s decisions. officeinwhichtheymakehealthbehavior 5,000wakinghoursperyear chronic diseaselikeHIVspendapproximately adult counterpartstoachieveviralsuppression. Individualslivingwith new HIVinfectionseachyearandaresignificantlylesslikelythantheir Introduction: 1 Nadia Dowshen Approach Youth UsingaPatient-Centered, Incubator adherence to medication andcareoutcomes. adherence tomedication HIV-positive onsatisfaction, youthandwewillcollectdata usage, and to giveinputandfeedback. willthenbepilotedwithagroupof The app will meetweeklyandconsultregularlywithayoungadultpatient-expert developers.pleted bytheprofessionalapp team The multi-disciplinary group techniquewithHIV-positive tobe com youthtoprioritizefeatures Next steps: the clinician researchers. prototype weredevelopedbyagamedesignerwithregularinputfrom anonymously.offer supporttoothersusingapp Wireframes andabasic rewards, (non-monetary) system towingraphic abilitytojointeamsand and provideroradherencesupportpartnertocalleachother, points triggersalerttoyouth that to detectmultipledaysofmissedmedication feedback withpositivereinforcementfortakingmedication, algorithm (i.e.recording takingmedication button, pillcam), visual immediate ized, andrefillreminders, time-basedmedication multipleoptionsfor experience withHIV-positive youthincluding: interactive, personal basedontheirclinical teaminitiallydeterminedfeatures The study HIV-positive youthusingauniquepatient-centered, approach. incubator Children’s HospitalofPhiladelphia, PA, USA We arecurrently conducting focusgroupsusingnominal Ourgoalistodevelopandpilottestamobilephone- Adolescents and Young Adults accountfornearly40%of Adherence forHIV-Positive Developing anApptoImprove

(presenting) 1 , MarkMeisarah 1 , SusanLee 1 - - - POSTER ABSTRACTS 79 80 103

continuum. with the relationship ART useandadherencethroughoutthecare among thosewithidentifiedriskfactors. Futurestudiesshouldexplore shouldbeprioritized,screening andriskreductioneducation particularly occurred inamajorityofyouthwithin2yearsdiagnosis. RegularSTI Conclusion: anincidentSTI(HR1.53,more likelytohave p=0.023). model,in themultivariate leastonefactor were butindividualswithat use, withincidentinfection andothersubstanceusewerenotassociated tective services, mentalhealthdiagnosis, >20lifetimepartners, tobacco withincidentinfection.were associated ofchildabuse, History childpro (HR 1.38, othersubstanceuse(HR1.29, p=0.05)andany p=0.09) time toincidentSTI1.64years. comparisonstobaccouse Inbivariate 51.1%, 77.9%. was3.3years(2.4) andmedian duration Meanfollow-up 12.8%; anogenitalwarts10.3%, 18.1%(clinical STI any diagnoses); 49.8%; syphilis10%, confirmed);herpes0.9%, 14.2%(laboratory wererespectively:STI co-infectionrates GC22.7%, 47.6%;CT20.2%, POSTERuninsured, 91%Black, 69%MSMtransmission. Baselineandincident Results: withincidentSTIrisk. ofbaselinecovariates association multivariable cox-proportionalhazardsmodelswereusedtomodelthe theproportionofindividualswithanincidentSTI.evaluate and Bivariate period. wereusedto encounter duringthestudy curves Kaplan-Meier each clinical baselineandat wereabstractedat andpsychosocialdata anadolescentHIVclinicsented forcareat from2002-2011. Laboratory, Methodology: ABSTRACTSthroughout thecarecontinuumamongacohortofHIV-positive youth. ofincidentinfectionsandcorrelates andrates HIVdiagnosis co-infections at transmission.for secondary aimstodescribeprevalenceofSTI This study among HIV-positive youthrepresentasignificantrisktoindividualhealthand Background: 1 WebbDavid Nadia Dowshen Cohort ofHIV-Positive Youth Children’s HospitalofPhiladelphia, PA, USA Subjects were mean age =18.7(2.5), Subjectsweremeanage 76%male, 38% 1 BaselineSTIco-infectionswereprevalentandincidentSTIs , JenniferCulhane Other sexually transmitted infections (STI co-infections) Othersexuallytransmittedinfections(STIco-infections) Retrospectivechartreviewofyouth(n=310)whopre Transmitted Co-InfectionsAmonga Baseline andIncidentSexually

(presenting) 1 1 , Mathew Leny 1 , SusanLee 1 ,

10th International Conference on 10th International - - 105 • • • • • on: providerstointeractivelyaccessinformation service website. The Treatment communitymembersand willallow Access Map ontheCTAC willbeavailable isacomprehensiveonlinetoolthat Map Background: 1 Barbara Santosuosso stimulate national discussion on treatment accessissues. discussionontreatment national stimulate C,and supportforpeopleaffectedbyHIVhepatitis whichinturnwill foraccesstotreatment, itwillstrengthenavenues wide andthat care nation ondrugavailability ways peopleareabletoaccessinformation Conclusions: accessdoesnotexist. to treatment andprocesseslinked legislation cross-provincial listofrelocation-related and perprovince/territory Ctreatments HIVandhepatitis ing available publicly fundeddrugprograms. Currently, ofCanadademonstrat amap reliantonobtainingaccesstoessentialmedicines through the population there are19differentpublicplansinCanada, withroughly40percentof CinCanada.comes ofpeoplelivingwithHIVand/orhepatitis Intotal, Results: access totreatment. structuralbarriersaround resources andtoolsinordertobetternavigate Cbyequippingthemwithinformation,living withHIVand/orhepatitis professionals, people atoolwasneededtoempower itwasevidentthat community members, providersandhealthcare frontlineservice Methodology: Canadian Treatment Action Council(CTAC), Toronto, Ontario, CANADA moving betweenprovinces Links toindividualandcommunityresourceseasetransitionwhen access linked totreatment andprocesses legislation Cross-provincial listofrelocation-related Treatments currentlyunderdevelopment Treatments coveredunderthesixfederalpublicdrugplans information Publicly Ctreatment fundedprovincialandterritorialHIVhepatitis iscriticalforthebestpossiblehealthout Access totreatment The Treatment willbeusedtochangethe Access Map First ofitskindinthecountry, the Treatment Access withseveralstakeholders,After consultations including Treatment AccessMap

(presenting) HIV Treatment andPreventionAdherence 1

- - - 10th International Conference on 10th International arewarranted. studies withadditionalfollow-up and 6-months)mayberequiredtoaffectlong-termretention. Larger term retention. experiences(e.g., Consistentlybetterpatient baseline at Conclusions: baseline. 0.188) at (median 95.5vs93.9, p=0.163)orHIVcare(median94.7vs93.3, p= report significantlybetteroverallexperienceswiththeirHIVcareprovider dian 95.8vs77.9, p=0.021). 0–12monthsdidnot Patients retainedat 6months(me better overallexperienceswiththeirHIVcareproviderat 88.2, baseline. p=0.001)at 6–12monthsreported Patients retainedat provider (median95.7vs90.4, p=0.017)andHIVcare(median96.7vs 0–6monthsreportedbetteroverallexperienceswiththeir HIVcare at surveys, 6–12months. 77%ofwhomwereretainedat Patients retained 0–12months.at (56%)completed 6-month Seventy-nineof140patients baseline surveys. 0–6months;59% Sixty-ninepercentwereretainedat Results: 0–12monthswasbasedonnumberof3-monthquarters withavisit. at (defined as having asecondvisitinthefirst6months) and 6–12months (defined ashaving HIV careexperience. We 0–6months assessedshort-termretentionat overall experiencewiththeHIVcareprovider;fivemeasuredtheir 6-months(±30days).visit andat Sixquestionsmeasuredpatients’ aftertheirfirstHIVmedical immediately completedasurvey patients new toHIVcareinHouston, Texas. From August–December 2013, Methodology: relationship. care. However, prospectivestudiesareneededtodeterminetemporal adherenceandretentioninHIV medication withgreater been associated Background: 3 2 1 Thomas Giordano Bich Dang(presenting) Cohort Study Retention inHIVCare:APilotProspective Houston,USA TX, VA inQuality, CenterforInnovations EffectivenessandSafety, Rice University, Houston, TX, USA Baylor CollegeofMedicine, Houston, TX, USA 106 (81%)completed A totalof140out173eligiblepatients Better patient experiences were associated withshort- experienceswereassociated Betterpatient Incross-sectionalstudies, experienceshave betterpatient We ofadults conductedapilot prospectivecohortstudy 1 ≥ 1 visit in that second 6 months).1 visit in that Long-term retention Patient Experiencesand Pathways LinkingBetter 1 , Robert Westbrook, HIV Treatment andPreventionAdherence 2 , ChristineHartman 3

, - 107 Kathryn BroganHartlieb(presenting) Kathryn Care intheUS Training toEnhanceYouth LinkagetoHIV Traditional MItrainingprogramsmaynotbefeasibleinHIVdue competency deliveringMIwithadequate suggest that canbedifficult. behaviors, andprovidertypesincluding formats HIVcare. Studies acrossmultiple engagement changeandtreatment to promotebehavior youth arelinkedtocare. (MI)hasbeenshown Interviewing Motivational Introduction: 4 3 2 1 Bill Kapogiannis cilitate uptakeofevidence-basedpracticesinthecontextclinicalcilitate care. tofa are promisingandofferinsightsaboutfeasibletrainingapproaches Recommendations: LTC-C reachedcompetency timepoint. any at LTC-Cs beginningcompetency demonstrated respectively. Nocontrol competency inMIskills/spirit. At 3and6months, 70%and60%ofthe baseline, 15%oftheLTC-Cs beginning intheMIconditiondemonstrated Lessons Learned: withbeginningcompetence behaviors calls. MIcompetency bya12-itemtoolassessingkeyMI wasevaluated MI trainer. ControlLTC-Cs standardizedpatient completed6audiotaped individual coachingcalls(n=9)guidedbycodedMIfeedbackwithan calls(n=9)and ofstandardizedpatient phone programwithaudiotaping to-face MItraining, LTC-Cs intheMIconditioncompletedaninnovative Care forHIV-Infected Youth (PEACOC). Inadditionto16-hoursofface- entitled ProjectfortheEnhancementand Alignment oftheContinuum Control &Prevention, andHealthResourcesServices Administration lescent Trials Network(ATN) withtheCentersforDisease incollaboration HIV continuumofcaresites(17sites;13MI/4control)withinthe Ado (LTC-Cs) coordinators deliveredtolinkage-to-care plementation inyouth Description: require codingofrecordedclient interactions. to relianceonexpert-ledface-to-facetrainingandongoingcoachingthat Indiana UniversitySchoolofMedicine, Indianapolis, IN, USA Bethesda, MD, USA InstituteofChildHealthandHumanDevelopment,National Wayne University, State Detroit, MI, USA University,Florida International Miami, FL, USA We presentearlyresults ofanewmodelMItrainingim IntheUS, asfew31%ofHIV-infected, 13-24yearold of Motivational Interviewing of Motivational Interviewing Nationwide Implementation 3 , J. DennisFortenberry Protocolfidelitywashigh(98%ofcallscompleted). At Results from this implementation research study researchstudy Resultsfromthisimplementation ≥ 4 1 2.5 ona4-pointscale. , SylvieNaar-King 2 , PhebeLam

- - 2 , - POSTER ABSTRACTS 81 82

address adherence. deficitsand/orskillacquisitionto focusquicklyonknowledge that amine use. briefinterventions ofrelatively Resultssupporttheutilization methamphet andself-efficacymotivations ofcrystal inthetreatment Conclusions: condition( treatment regardlessof post-intervention daysimmediately missed medication benefits. withmore beliefprofile wasassociated Thepre-contemplative condition( inthetherapy greater sions, non-adherenceovertimewassignificantly theslopeofmedication ences inadherence. Among participantswhoreceived3orfewerses completed 4ormoresessions, therewerenobetween-conditiondiffer Amongmenwho presence ofCASand/ortheself-efficacy deficitprofile. wassignificantly diminishedby the Theeffectoftreatment follow-up. significantly lessmethamphetamineuse( sex (CAS), with wasassociated treatment incondomlessanal engage Results: months follow-up. adherence. 3, at Useandadherencewerethenevaluated 6, 9, and12 tosubstanceuseandmedication assessedhealthbeliefsrelated survey control. (MI+CBT)topsychoeducational intervention havioral A baseline andcognitivebe interviewing trial comparingan8-sessionmotivational inarandomizedclinical non-adherenceparticipated and medication POSTER 24-63(M=41.4)reportingrecentmethamphetamine use GBM aged Methodology: outcomes. intervention moderate IMBprofiles to has examinedthepotentialforthesepre-intervention methamphetamine.men (GBM)whousecrystal To date, littleresearch and oneas amongHIV-positive“precontemplative”) gayandbisexual adherence(onecharacterizedas and HIVmedication “change-ready” characterized byself-efficacy deficits) deficitsandonebymotivation tion, self-efficacy andbehavioral withsubstanceuse (one associated (IMB)modelhasidentifiedprofilesofknowledge,tion-behavior motiva ABSTRACTSBackground: 2 1 Jeffrey Parsons (presenting) for Tailoring Services Use andMedicationAdherence:Implications forMethamphetamine MI+CBT Intervention New York, NY, USA Studiesand Center forHIV/AIDSEducational Training, Hunter College, New York, NY, USA 108 deficitprofilewhodidnot Among menwiththemotivation theimportanceofaddressingsexual These resultsindicate Previousresearchwhichutilizedtheinformation-motiva A diversesample(69.7%non-White)of185HIV-positive β = .29, p <.01). p .29, = Moderate OutcomesFollowing Pre-Treatment HealthBeliefs 1 , TyrelStarks β = 2.5, p<.01), diminishing indicating β

= .63, p <.01) at 3month <.01) at = .63,p 1 , BrettMillar

2 10th International Conference on 10th International ------110 trend. A multivariablemodelwasconstructedwithyear, (13-29vs. age a proportionoftotalEDvisits. Logisticregressionwasusedtotestfor were identifiedbychiefcomplaint. visits as PEP-related We calculated from2002-2013. data NYC syndromicsurveillance visits PEP-related Methods: emergencyPEP-related department(ED)visitsinNew York City(NYC). 2005. existsonPEPuptake. Littleinformation We examinedtrendsin exposuressince tional exposuressince1998andfornon-occupational mended bytheCentersforDiseaseControlandPreventionoccupa Background: 1 Zoe Edelstein(presenting) Departments, 2002-2013 may beneededtoincreaseaccessaffordablePEP. PEP, work suggest that butfindingsregardingneighborhood povertyrate targetingof appropriate maydemonstrate rates higher HIVdiagnosis sex withmen. withresidenceinneighborhoods The association uptake possiblyincreasingamongaprioritygroup: youngmenwhohave changesinPEPprescribingpatterns,over timecouldindicate with decade. grewstronger withmalesexandyoungerage associations That Conclusions: 2.0) andmalesex(OR=1.6toOR5.4). (OR=1.2toOR increasedfrom2002-2013forage tude ofassociation themagni that andmalesex;interactiontermsindicated younger age (OR=1.7;CI:rate 1.6-1.9). with visitswerealsoassociated PEP-related (CI):confidence interval 1.7-2.0)andhigherneighborhoodHIVdiagnosis with year, (OR)=1.8;95% (oddsratio neighborhoodpovertyrate low <0.0001). Inthemultivariablemodel, visitswereassociated PEP-related visitsincreasedfrom0.004%in2002to0.013% in2013(p PEP-related Results: changedovertime. associations quartiles). Interactiontermswithyearwereusedtoexaminewhether high), (topvs. rate andneighborhoodannualHIVdiagnosis three lower 30-64 years), sex, vs. (low neighborhood-basedpovertyrate patient Queens, NY, USA New York CityDepartmentofHealthandMentalHygiene, We visits. identified2162PEP-related Theproportionof We 13-64years-oldusing analyzedEDvisitsamongpatients PEP-related visitsinNYCEDsincreasedoverthepast PEP-related HIV post-exposureprophylaxis(PEP)hasbeenrecom in NewYork CityEmergency HIV Post-Exposure Prophylaxis HIV Treatment andPreventionAdherence 1 , StephanieNgai 1 , Don Weiss, 1 , JulieMyers

- - - 1

10th International Conference on 10th International andritonavir-boostedraltegravir andatazanavir. darunavir and emtricitabinewasprescribedmostoftenalongwithefavirenz, regimendurability.3-times greater Fixed-dose oftenofovir combination under 3years, however, remainingontheirinitial patients ART hadover Conclusions: (8%,ritonavir 963days). days), (12%, withdarunavir/ritonavir 1,000 days), andwithatazanavir/ (47%,efavirenz 952days), medianduration (14%, withraltegravir 1,058 most commonlyprescribedwereemtricitabineandtenofovirwith (n=57).were side-effects(n=57)andlosstofollow-up Regimens continuing theirregimen. The mostcommonreasonsfordiscontinuation of1,457days(range:median duration 730to2,732days)amongthose was442days(range:median duration 15to2,365days), comparedtoa endperiod. thestudy imen at Among those discontinuingtheirregimen, whiletheremaining85(34%)werestillon theinitialreg (66%) patients days), roughly2.5years. The initialregimenwasdiscontinued in167 MSM). Mediandurabilityofallregimenswas925days(range15-2,732 of36,age 84%male, 62% African American, 42%uninsured, 59% Results: and todeterminereasonsfor ART discontinuation. Manual abstractionwasdonetoconfirmregimenstartandstopdates inDecember2014. censoringofdurations record withadministrative wereextractedfromtheelectronicmedical compositions anddurations 2007toDecember2012wereincluded.January Initial ARV regimen Ryan aSouthernurbanacademically-affiliated at WhiteHIV clinic from Methodology: inaclinical naïvepatients for treatment setting. thecompositionanddurabilityofnewer uated ARV regimensprescribed 2 to3yearswithnoconsensusonthemostdurabledrugclass. We eval inrecentyears.combinations Priorstudiessuggestinitialregimenslast (persistency) withtheintroductionofnewdrugclasses isdated and Background: 1 Ali Khalofa Ellen Eaton(presenting) Regimens inTreatment NaivePatients University of Alabama, Birmingham, AL, USA 111 This retrospectivecohortanalysisincluded (mean 252patients 1 Durability of most contemporary Durabilityofmostcontemporary ARV regimens remains Existing literature onantiretroviral(ARV)durability Existingliterature Treatment therapy naïveHIV-infected initiating patients Patterns ofInitialHIV Durability andPrescribing 1 , MichaelMugavero HIV Treatment andPreventionAdherence 1 , AshutoshTamhane 1 ,

- - 112 switching to second-line antiretroviral therapy (ART) tosecond-lineantiretroviraltherapy andadherence switching cents inSub-Saharan Africa. Understandingbaselinepredictorsof Background: 4 3 2 1 Julie Denison Banda Harry Randy Stalter(presenting) Regimens Adherence AmongThoseonSecond-Line Predictors ofTreatment Switchingand recommended. outcomesfor treatment regimensis onefavirenz-based ALHIVs initiated adherence.achieve adequate Regularmonitoringofdrugtolerabilityand socialandfamilialsupportaroutineto they maylackadequate ALHIV onsecond-line ART wereolderandmorelikelytobeoutofschool, second-line ART. Higher pillburdensmaybepartlyresponsible. Also, as Conclusions: 6.4). regimens(HR=2.7;95%CI:1.1,than thoseputonnevirapine-based switching tosecond-lineregimen hadsignificantlyshortertimesto ART adolescentswhoinitiated that indicated ART withanefavirenz-based found forMPR<90%. The multivariablecoxproportionalhazardsmodel in thepast3months(p<0.01). more likelytoreportmissing48consecutivehoursoroftheirdrugs ART longer(p=0.03). werealso Adolescents onsecond-linetreatment second-line ART wereolder(p=0.03), outofschool(p=0.03)andon ond-line ART. Comparedtothosestillonfirst-lineregimens, ALHIVson Results: andclinicalgraphic tosecond-line variablesontimetoswitching ART. the effectofbaseline ards modelwasusedtoestimate ART socio-demo psychosocial and ART adherencecharacteristics. A coxproportionalhaz tions betweenbeingonsecond-line ART andvarioussocio-demographic, square andone-way ANOVA totestassocia werecalculated statistics were abstractedforalladolescentswhocompletedthesurvey. Chi- (MPR), possessionratios pharmacy medication tocalculate refilldata clinics intheCopperbeltProvince, Zambia. Medicalchartdata, including three to 309eligibleadolescentslivingwithHIV(ALHIV)attending ART Methodology: outcomes. mayhelppreventpoortreatment switched among adolescentswhohave Baltimore, MD, USA Johns HopkinsBloombergSchoolofPublicHealth, ChildrensHospital,Arthur Davison Ndola, ZAMBIA FHI360, Lusaka, ZAMBIA FHI360, Durham, NC, USA

collection,At thetimeofdata 10%ofadolescentswereonsec 2 , Pai-Lien Chen 4 Self-reported adherence was lower among Self-reportedadherencewaslower ALHIVs on HIV/AIDSisthemaincauseofmortalityamongadoles

In2012-2013, wasadministered survey aquantitative ART AmongAdolescentsinZambia: Transitioning toSecond-Line 1 1 , Patrick Katayamoyo , Mwansa Jonathan Nodifferencebetweengroupswas 3 , DonnaMcCarraher 2 , Packer Catherine

- 1 - 1 , , - - - POSTER ABSTRACTS 83 84 113

cation strategies,cation areneededtoimprovepatient’s adherenceto ART. counseling programs, simplifi aswellthe developmentoftreatment withbehavioral thehealth-careservice tics. at attention Multidisciplinary adherence, characteris andtherapy topatient especiallythoserelated dimension (timing, ordoses). medication Severalfactors hindered ART Conclusion: more dimensions. 1.51; 95%CI: 1.12, 2.04)weremorelikelytoreportnon-adherenceat 2.95) andthosewhofound ART intoroutine(OR: difficulttoincorporate 95% CI: 1.53, 4.09), uncertaintyaboutfuture(OR: 1.78;95%CI: 1.08, 2.68; 95%CI: 1.31, 5.50), forgetfulnessintakingthe pills(OR: 2.50; “side-effects” (23%). Patients whoreportedalcohol/drugabuse(OR: intoroutine”to incorporate (40%), “lack ofsocialsupport” (23%)and andthemostcommonlyreportedwere participants’ answers “difficult threedimensions.sions and11%at We identified14barriersfrom herence, onedimension, 27%non-adherenceat twodimen 24%at Results: (95% CI)wereestimated. using ordinalregression. (OR)with95%confidenceintervals Oddsratios identified barriersandself-reportednon-adherenceto ART wasassessed were identifiedthroughcontentanalysis. between Theassociation tothreeopen-endedquestionsabout answered ART andthebarriers POSTER(i.e., impropertiming, andskippingdoses). skippingmedication Patients “zero” non-adherence, one, non-adherenceat two, orthree dimensions vices inBrazil, andconsistsinafour-category scaleofnon-adherence: WebAd-Q, atoolto monitorself-reportedadherencein AIDS publicser dependent variable, non-adherenceto ART, was measuredthroughthe in2010.collected usingface-to-facesemi-structuredinterviews The der carein17 from12Brazilianstates. was AIDS referralservices Data Methodology: reported non-adherence. aimed toidentifywhichperceivedbarriersmightpotentiallyinfluence ABSTRACTS (ART). adherencetoantiretroviraltreatment to adequate This study Background: 2 1 Francisco AssisAcurcio Nemes Maria InesBattistella Celline Almeida-Brasil Therapy Non-Adherence University ofSaoPaulo, BRAZIL Minas Gerais, BRAZIL Federal UniversityofMinasGerais, BeloHorizonte, Of595participantsincluded, 38%reported “zero” non-ad Most participants reported non-adherence at least at one leastat Mostparticipantsreportednon-adherenceat People livingwithHIV/AIDSfrequentlyexperiencebarriers Cross-sectional national study ofHIV-positive study adultsun Cross-sectionalnational Use as Predictors of Antiretroviral Use asPredictorsofAntiretroviral Perceived BarrierstoMedication 1 , 1 Maria dasGraçasCeccato(presenting) , 2 , MarkDrewCroslandGuimaraes

1 ,

10th International Conference on 10th International 1 , - -

- - - - 114 a preferencefororalversusLAIPrEP. adherence,lower thoughitispresentlyunclear whetherindividualshave protection,greater particularlyamonggroupswhoarelikelytohave projects,suboptimal indemonstration thusLAIPrEPmayprovideeven a long-actinginjectable(LAI). Adherence toonce-daily Truvada hasbeen of HIVintheformsonce-daily Truvada and, inemergingresearch, as Background: 2 1 Thomas Whitfield Jeffrey Parsons (presenting) Bisexual Men Representative USSampleofGayand Acting InjectablePrEPinaNationally availability ofLAIPrEPmayincreaseuptakebiomedicalprevention. availability perceive itspotentialhealthconsequencessimilarly, suggestingthe PrEP. GBMnotonlypreferLAIPrEPbutalso These resultssuggestthat LAI PrEPwasmorestronglypreferredthandailyorintermittentoral it, oforalPrEP. willingnesstoLAIPrEPwascomparablethat Infact, ofLAIPrEP,sample ofGBMwaslargelyunaware thoughoncetold about Conclusions: respectively. (3.1of4) for bothdailyandLAI-PrEP, rating average p=.94, p=.20, on healthandthepotentialsideeffects, whicheachreceivedthesame taking PrEP, thetwomostsalientwerepotentiallong-lastingeffects 22.4%, 14.0%, and63.6%, respectively. Asked aboutthebarriersto between daily, intermittent, andLAIPrEP, participantpreferenceswere effective, whileonly14.2%preferreddailyoralPrEP. Asked tochoose PrEP andanother10.0%saidtheywouldpreferwhicheverwasmore choice betweendailyandLAIPrEP, nearlyhalf(46.6%)preferredLAI proportion (53.4%)expressedwillingnesstotakeLAIPrEP. Giventhe than half(56.5%)expressedwillingnesstotakedailyPrEPandasimilar Results: and preferencesfororalLAI-PrEP. gay andbisexualmen(GBM)askedaboutbothwillingnesstotake Methodology: Center for HIV Educational Studiesand Center forHIVEducational Training, New York, NY, USA Hunter College, New York, NY, USA A majorityofGBM(84%)hadneverheardLAIPrEP. More Somewhat unsurprisingly, Somewhat representative thisnationally PrEP has been shown tobeefficaciousinthe prevention PrEPhasbeenshown sampleof857 We representative recruitedanationally for OralVersus Long- Familiarity WithandPreferences 2 , ChristianGrov HIV Treatment andPreventionAdherence 1 , H. Rendina Jonathon 2 2 ,

10th International Conference on 10th International reaching themostvulnerablepopulations. an HIVclinic isahigh-yieldstrategy. Nonetheless, PrEPmaystillnotbe higher socioeconomicstatus. HIVtestingin ScreeningforPrEPneedat perceived themselvesashigh-riskforHIV. Patients startingPrEPhad for testing, eventhosenotpursuing a preventionprogramappointment, Conclusions: report anannualincomeover$10,000(65.5%vs. 44.1%p=0.04). 41.9%, p=0.04), bestablyhoused(78.6%vs. 50.9%p=0.02)and, thannon-users(55.2%vs.PrEP usersweremorelikelytobeemployed toamalepartner;and10.8%whoweresingle.who reportedmarriage prescribed PrEP. PrEPusersincluded 44.8%women(p=0.72);17.2% them hope(100%vs. 89.2%p<0.01). Ofattendees, 29(76.3%)were 40.6%, p<0.01). notedPrEPgives thannon-attendees Moreattendees (71.1%vs. aboutinfidelityaccusations worrying more likelytodeny (42.1%vs.condom usethannon-attendees 24.2%, p=0.04)andwere effects (92.1%vs. 72%, p=0.01). Attendees reportedhigherbaseline reportedinterestinPrEPdespitepotential side than non-attendees panic, 26.3%Hispanicand5.3%otherrace/ethnicity. Moreattendees including 52.6%Blacknon-Hispanicpatients, 15.8% White non-His doms. However, aPreventionProgramappointment, 38(18.5%)attended during theirlifetimeand61.7%reportedpartner(s)opposedcon Results: compared byChi-SquareorFisher’s exacttest. Frequencies werereportedfor variables bygroupand andpercentages sion, preventionandPrEP. data. yieldedlinkage data Administrative perspectivesonHIVtransmis investigating testing completedsurveys Methodology: prophylaxis (PrEP). condoms, andtenofovir/emtricitabine(TDF/FTC)asHIVpre-exposure in Houston, TX. Patients receiveHIVpreventioncounseling, STItesting, at Thomas StreetHealthCenter(TSHC), apublically-fundedHIVclinic Background: 2 1 Kenneth Mayer Charlene Flash(presenting) Program inHouston, TX (PrEP) AmongPatients inanHIVPrevention Fenway CommunityHealth, Boston, MA, USA Baylor CollegeofMedicine, Houston, TX, USA 115 Of205screenedclients, 64.2%thoughttheymightacquireHIV Among thisdiversepopulation, presenting mostpatients An HIVpreventionprogramwasestablishedinJuly2013 Clients 2 , Thomas Giordano , Thomas HIV Pre-ExposureProphylaxis Perspectives onHIVRiskand ≥ 18 years old who present for walk-up rapid HIV 18 yearsoldwhopresentforwalk-uprapid 1 , Carmen Avalos , 1

HIV Treatment andPreventionAdherence 1 , Xiaoying YuXiaoying , 1 ,

- - - 117 vention andPrEP. Mean, standarddeviation, frequency andpercentage knowledge,vestigated andbeliefsaboutHIVtransmission, attitudes pre November 2014wererecruited. in Participants that completedsurveys apublically-fundedHIVclinictesting at betweenDecember2013and Methodology: of PrEP. andperception knowledge (PrEP) uptakemaybeinfluencedbypatients’ influence HIVpreventionchoices. Antiretroviralpre-exposureprophylaxis Background: 2 1 Kenneth Mayer Charlene Flash(presenting) Among HIVTesting ClientsinHouston, TX tion withcondoms. inevitable. Mostparticipantsreported interestinPrEP, eveninconjunc partner issuesoftenimpededcondomuseand64.2%feltHIVinfection Conclusions: interestintakingPrEP. and74.8%showed services; PrEPgivesthemhope;90.1%reportedinterestinHIV prevention that or requiredregularHIVtesting(92.6%). Ninety-onepercentreported sideeffects(75.7%),temporary hadtobeusedwithcondoms(85.2%) partner. Participants reportedbeingwillingtotakePrEPdespitepotential than half(60.6%), non-condomuseenhancedconnectednesstotheir condoms and52.2%worriedaboutinfidelityaccusations. For more partners didnotlikecondoms, 38.2%worriedpartner(s)wouldrefuse 63.3%. condomuseemerged: Challengesnavigating 61.7%reported condomsreduceHIV/STIrisk,that somecondomusewasreportedby HIV, and81.1%knewsomeonelivingwithHIV. Although 99.5%agreed participants(64.2%)believedtheywouldbecomeinfected with Many 17.8% hadhouseholdincomeover$25,000and33.2%weresingle. Most wereuninsured(66.8%), 84.0%completedhighschoolormore, worked fullorpart-time, and18.8%werehomelessorunstablyhoused. White non-Hispanicand11%otherrace/ethnicity. Almost half(43.8%) were female, 49.8%wereBlacknon-Hispanic, 25.9%Hispanic, 13.2% 92.2%).rate was39.4±11.6yearsand36.3% Meanparticipantage Results: variablesrespectively.were reportedforthecontinuousandcategorical Harvard University,Harvard Boston, MA, USA Baylor CollegeofMedicine, Houston, TX, USA wascompletedby205participants(response The survey For thisyoungadult, uninsured, minoritypopulation, Patient HIV risk perception and attitudes towards condoms towards Patient HIVriskperceptionandattitudes Patients 2 Pre-Exposure Prophylaxis(PrEP) Perspectives onHIVRiskand , Thomas Giordano , Thomas ≥ 18 years old presenting for walk-up rapid HIV 18 yearsoldpresentingforwalk-uprapid 1 , Carmen Avalos , 1 1 , Xiaoying YuXiaoying , 1 ,

- - - POSTER ABSTRACTS 85 86 120

second phasewillalsobepresented. substance useand12youthwithout). ofthis post-testdata Immediate analysisin24youth(12with multiple baselinedesignwithtrajectory Conclusions: (“Imagine reminders forvisualization That”). bytextmessage followed cue- intentionpairingadherenceintervention did not. We and subsequentlydevelopedasinglesessionvisualization POSTERtions improvedPMinyouththelab, butthemonitoringmanipulation Results: 16to24).and cuesalience)in60youthwithHIV(ages encoding,traditional cognitiveneurosciencetasks(strategic monitoring, improve threecomponentsofPMusingawithin-subjectsdesignand Methodology: point inthefutureresponsetoaspecificcue. to successfullyform, maintain, aparticular andexecuteanintentionat portant pieceofthepuzzle. PMisdefinedastheneurocognitivecapacity ABSTRACTS (PM)couldrepresentanim prospectivememory evidence suggeststhat scienceareneeded.ventions groundedinbasicbehavioral Emerging thedisease, toeffectivelymanage are inadequate and novelinter Background: 2 1 Angulique Outlaw Salome (Nikki)Cockern(presenting) forYouthAdherence Intervention WithHIV University ofHouston, TX, USA Wayne University, State Detroit, MI, USA Results suggested that encodingandcuesaliencemanipula Resultssuggestedthat We arecurrentlytesting “Imagine That” inaninnovative Medication adherence rates amongyouthlivingwithHIV adherencerates Medication studiesto We laboratory firstconducted theory-driven Prospective Memory intoaNew Prospective Memory Translating theNeuroscienceof 1 , Steven Woods, 2 1 , SylvieNaar-King 1 ,

- 10th International Conference on 10th International - - 121 sisted of32heterosexualmales, 51gay/bisexualmales, 38heterosexual ence. The samplewaspredominantly African-American (79%), andcon adher targetingsubstanceuseandmedication study for anintervention Methodology adherence,HIV medication healthattitudes, andqualityoflife. ofOALWH’sexamine thechronology comorbidities, with and associations compared totheirHIV-negative peers. wasto The purposeofthisstudy numberofcomorbidhealthconditions,greater andwithearlieronset, Background: 2 1 Brett Millar(presenting) With HIV Among Substance-UsingOlderAdultsLiving other health conditions that anindividual maybeconcurrentlyfacing. other healthconditionsthat needtoconsiderthenumerous population adherence inthisgrowing adherence.bidities onmedication improvingHIVmedication Effortsat comorbidities facingthissampleofOALWH, andtheimpactofco-mor Discussion p =.015). adherence(r=-.16,less confidentinabilitytomaintainHIVmedication with feelingdespairaboutcurrenthealth(r=.15, p=.042), andfeeling wassignificantlyassociated number ofconditionspriortoHIVdiagnosis numberoflifetimechronicconditions(r=.14,with greater p=.03). The p <.001). Poorer adherencewassignificantlyassociated HIVmedication (r=.32,health limitations p<.001), (r=.27, andsociallifelimitations bodilypain(r=.25, withgreater was significantlyassociated p<.001), (38%), andarthritis(30%). The numberofcurrent co-morbid conditions sis. Mostcommonweredepression(54%), anxiety(40%), hypertension of2.0(SD=1.9)conditionsoccurringpriortotheirHIVdiagno average comorbid conditions, and5.0(SD=2.9)lifetimeconditions, withan Results: diagnosis, adherence, medication health history, andqualityoflife. females, and7gay/bisexualfemales. Participants onHIV provideddata Hunter College, New York, NY, USA Studiesand Center forHIVEducational Training, New York, NY, USA Participants reported an average of3.8(SD=2.4)current Participants reportedanaverage : variabilityinthenumberof uncoveredgreat This study OlderadultslivingwithHIV(OALWH) typicallylivewitha : The NYC-basedsampleincluded 128OALWH recruited on HIVMedicationAdherence The ImpactofCo-Morbidities HIV Treatment andPreventionAdherence 1 , TyrelStarks 2 , SitajiGurung 1 , JeffreyParsons

- - - - 2 122 10th International Conference on 10th International targets. selectionofpotentialintervention strategic whichpermit andtheuseofinterventions oftheIMBtheory nature withmethamphetamineusesupportsthebehavior-specificassociated appropriate. Inaddition, adherenceIMBprofileswerenot thefactthat maybe acombinedintervention in bothofthesedomainssuggeststhat and self-efficacy. ThepresenceofadistinctgroupGBMwithneeds maybemore effectiveforenhancingknowledge approaches behavioral however, motivation; with low to addressproblemsassociated cognitive maybeparticularlyuseful interviewing suchasmotivational Strategies Conclusions: of methamphetamineuse. χ load (t(77.1)=-1.96, days(Wald p=.05)andfewermissedmedication to adherence. viral groupreportedsignificantlylower The change-ready ficacy scores. Theyalsoperceivedfewerbenefitsandmoredrawbacks andself-ef knowledge group wasdistinguishedbysignificantlylower toadherence.and fewerdrawbacks Incontrast, the “precontemplative” andself-efficacy.ed knowledge Thisgroupalsoperceivedmorebenefits The “change-ready” groupwascharacterizedbyhigheradherence-relat Results: improving adherence. assessing knowledge, self-efficacy, andperceivedprosconsfor use andnon-adherencetoHIVmedication, completedabaselinesurvey methamphetamine 24-63(M=40.8)reportingrecentcrystal GBM aged Methodology: isinter-related that non-adherence. population withmedication men (GBM)whousesubstances, whichposeahealthconcernforthis seling. This isparticularlyimportantforHIV-positive gayandbisexual priortoadherencecoun ofIMBfactorsobserved examined patterns foci;however, fortailoringintervention implications littleresearchhas includingbehavior substanceuse. DeficitsinvariousIMBdomainshave broadlytounderstand health-related (IMB) modelhasbeenapplied Background: 2 1 Jeffrey Parsons Tyrel Starks(presenting) Methamphetamine use Crystal AmongGayandBisexual Menwho Observed Motivation, andBehavioralSelf-Efficacy 2(1) =4.5, p=.03). The groupsdidnotdifferontheamountorseverity Center for HIV Educational Studiesand Center forHIVEducational Training, New York, NY, USA Hunter College, New York, NY, USA Class A Latent Analysis supportedthepresenceoftwogroups. These findings have implications for intervention tailoring. forintervention implications These findingshave The information, motivation, self-efficacy andbehavioral A diversesample(67%non-White)of210HIV-positive 1 Adherence-Related Information, Patterns ofHIVMedication 1 , BrettMillar HIV Treatment andPreventionAdherence 2 , Lassiter Jonathan 2 ,

- - - 123 programming andalegalclinic. 28Black/ Novelmodesofre-engaging ofcolorpreviouslyoutHIVcareviaworkshop and retaintranswomen Description: project. andretention demonstration color inaHIVcarelinkage Francisco Bay of transwomen Area agency tore-engage isemploying livingwithHIV.populations We willdiscussnovelmethodsanEastSan HIV, comparedtoother rates andsurvival HIVcareengagement low have Introduction: 2 1 Sean Arayasirikul Erin Wilson HIV care African AmericanandLatinaTranswomen in funders. byexternal in additiontosupportofnovelmodelsforre-engagement inaccessingHIVcareareneeded ofcolorhave challenges transwomen beyond typicalmodelsofHIVcareengagement. Researchtoidentifythe ofcolormustbewillingtogothedistanceandmove transwomen gage Recommendations: effect onsocialandclinical toHIV. outcomesrelated HIV-specific apositive contentcanalsoboostretention incareandhave focused ontransgenderhealth, thanononly wellnessandsafetyrather throughworkshopssessionswithcontent structured regularservices can decreaseinstitutionalbarrierstocare. Addressing thedesirefor methods.follow-up Providingaccesstoarangeoflegalsupportservices requiring extremeflexibilityanduniqueoutreach, recruitmentand beentimeandlaborintensive, MartellProjecthave HIV intotheBrandy Lessons Learned: to criminaloffenses. changes fromidentification foranything access freelegalrepresentation can wheretranswomen anddrop-inbasedservice is anappointment their time, andcommitmenttotheprogram. participation The legalclinic for model, transwomen engagement compensating andappropriately with curriculuminformedbyparticipants, establishingapeerreferraland vouchers,delivering transportation deliveringanongoingworkshopcycle African included intheintervention transwomen American andLatina Tri CityHealthCenter, Fremont, CA, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA 1 , Tiffany Woods tore-engage Martellprojectisanintervention The Brandy Transwomen impactedby ofcoloraredisproportionately Martell ProjecttoEngageBlack/ Going theDistance:TheBrandy 1 Efforts to engage transwomen ofcolorlivingwith transwomen Effortstoengage Interventionists and organizations that seektoen that andorganizations Interventionists 2 , Perla Nolasco 2 , Terry Washington (presenting) - 2 , POSTER ABSTRACTS 87 88 124

their HIV status at agiventime. at their HIVstatus of outreach effortsbettertargetthoseleastlikelytotestorbeaware aresubstantiallyhigherinMSM,rates prevention anditisessentialthat population.testing intheoverallstudy HIVprevalenceandtransmission ofMSM,study andmeasuredtheprevalencefrequency ofregular characteristics predictingregularHIVtestinginanonlinecross-sectional Conclusions: between tests. 3months(14.3%),peaked at 6months(41.8%), and12months(26.5%) identifying asHispanic, andbeingolderthan35. Regulartestingintervals hadrecentsexualactivity, oddsofhaving with greater arecentHIVtest, paring regularandnon-regulartesters, regulartestingwasassociated 25, insurance, private having andidentifyingasHispanic. When com months, beyondahighschoollevel, education having beingolderthan recentsexualactivity,with having beentestedwithinthelast12 having undergoingregularHIVtestingwasassociated that analyses showed testing. asawhole, population Incomparisontothestudy multivariate pleted theentiresurvey, 496(41%)reportedregularly undergoingHIV POSTERResults: ported regularHIVtesting. withundergoingself-re factorsassociated andbehavioral demographic Facebook. Multivariablelogisticregressionmodelswereusedtodescribe MSM whowererecruitedusingonlinesocialnetworkingsitessuchas Methodology: with differenttestingpatterns. assess whichfactorsareassociated in thispopulation. characteristicsto comparesdemographic This study predictorsofregularandnon-regularHIVtesting evaluated studies have ABSTRACTS withHIVtesting. addressedsomefactorsassociated have However, few sexwithmen(MSM),is commonamongstmenwhohave andstudies HIV-positive individualsintotheHIVcontinuumcare. HIVtransmission Background: 1 Kevin Weiss (presenting) Men Online CohortofMenWhoHaveSex With Emory University,Emory Atlanta, GA, USA Ofthe1,200MSMinouradjustedanalyticsamplewhocom andbehavioral This analysisidentifieddemographic HIV testing is an important gateway intoconnecting HIVtestingisanimportantgateway wasadministeredtointernet-using An onlinesurvey Regular HIVTesting Patterns inan Prevalence andPredictorsof 1 , Patrick Sullivan 1 10th International Conference on 10th International - - - 125 STR toMTRadherencemeasures. wasconductedtocompare and meta-analysisofpublishedliterature toimprovehealthoutcomes.disease management review A systematic healthcare providersandpolicy makersregardingmodalitiesofpatient and economicmodelsfocusedonadherencemeasurescouldinformHIV containing FDC)usingrandomizedcontrolledtrials, studies observational frequency,tablet regimens(STR)tomulti-tablet(MTR;ofany Background: 3 2 1 Patrick Clay(presenting) (FDC) Regimens Versus Multi-Tablet FixedDoseCombination associated withSTRs. associated clinical burdenamongHIVpatients, savings andthepotentialHRU/cost between associations ART adherenceandimprovementsinhumanistic/ inresource-limitedsettings,management consideringtheknown to MTR. policyThese findingsmayhave forHIVdisease implications andcostsincomparison overallHRU adherence andpotentiallylowering Conclusions: (ICER). incrementalcost-effectivenessratio based onitslower STR groupcomparedtoMTR, andSTRwasalsodeemedcost-effective, (annual, bi-annual, monthlyorper-diem) forthe werefoundtobelower andcostsamongSTRgroupversusMTR:reduction inHRU meancosts ly MTR(OR:1.81(1.15, 2.84)). Severalstudiesreportedsignificant (p <0.001)), twice-dailyMTR(OR:2.53(95%CI:1.13, 5.66)andonce-dai frequency ofany (OR):MTR patients (oddsratio 2.37(95%CI:1.68, 3.35) adherencegoals)comparedto adherent (perrespectivestudy-defined for meta-analysis. significantly more werestatistically STRpatients adherenceoutcomesand5hadquantifiabledata 22 reportedpatient Results: ta-regression. Adherence, aresummarized. evaluations HRU/Cost meta-analysis wasperformedandheterogeneityexaminedusingme and costswereassessedcomparingSTRtoMTR. A randomeffects Adherence, efficacy, safety, tolerability, healthcareresourceuse(HRU) two independentresearcherstofinalizearticles forevidencesynthesis. and ClinicalTrial.Gov databases. Two-level screeningwasundertakenby was searchedusingEmbase, Medline, PubMed(Medlinein-process) Methodology: Ipsos Healthcare, Washington, DC, USA Ipsos Healthcare, Boston, MA, USA Fort Worth,USA TX, University ofNorth Texas SystemCollegeofPharmacy, Ofthe39articles evidencesynthesis, identifiedforqualitative STR demonstrated significantimpactonimproving STRdemonstrated once-dailyfixeddosesingle A comparisonofallavailable Published literature inEnglishbetween2005and2014 Publishedliterature Adherence: AComparisonofSingle Therapy(ART)Antiretroviral HIV Treatment andPreventionAdherence 1 , CameliaGraham 2 , SivaNarayanan

3 - - 126 10th International Conference on 10th International forwhomPrEPmightbeindicated. uneven distributionofpatients unevenadoptionofPrEPprescribingor indicate to whichtheserates citywide.rates isneededtodeterminetheextent Moredetailedstudy and inonepredominantlyaffluentareawiththehighestHIVdiagnostic andindependentpracticesettings inhospitaloutpatient concentrated recently.with thelargestincreaseobserved tobe Prescribingappeared Conclusions: combined (n=530;32per100,000). area, (n=31;764per100,000), Chelsea-Village thaninallotherareas inQ32014washigher(p<.001)oneManhattan The prescriptionrate 100,000) thanincommunityhealthcenters(n=27;56per100,000). (n =4;210per100,000)andindependentpractices(n=530;121 Q3 2014, settings werehigherinhospitaloutpatient prescriptionrates (p <.001). increasewaswithin2014(219%).The largestrelative In 33/517,679) inQ12012to118per100,000(725/613,768)Q32014 Results: seen.100,000 patients Significancewasassessedbychi-squaretest. or HIV-related opportunisticinfections. per werereportedasrates Data other HIVmedications, excluding ofHIV, thosewithdiagnosis B, hepatitis as current aged TDF/FTC prescriptiontopatients settings.centers orhospitaloutpatient PrEPprescriptionwasdefined NYC, andwereclassified asindependentpractices, community health included saw Project,Information quarter1(Q1)2012-Q32014. The 579practices inNYCHealthDepartment’s practicesparticipating tory Care Primary Methodology: inPrEPprescription. trends andidentifiedpatterns from New York practices, City(NYC)ambulatory wemeasuredquarterly It isunclear whetherprescribinghasincreasedconcurrently. Usingdata for HIVpre-exposureprophylaxis(PrEP), supportforPrEPhasincreased. Background: 1 Laura Jacobson Zoe Edelstein(presenting) York City, 2012-2014 Queens, NY, USA New York CityDepartmentofHealthandMentalHygiene, PrEP prescription rates increasedfrom6per100,000(n/N= PrEP prescriptionrates ≥ PrEP prescribingincreased2012-14inNYCpractices, Since FDA approval oftenofovir/emtricitabine(TDF/FTC) Since FDAapproval We queriedtheelectronichealthrecordsofambula 50 patients aged aged 50 patients in Ambulatory CareClinics,in Ambulatory New Pre-Exposure Prophylaxis(PrEP) 1 1 , RemleNewton-Dame ≥ 13 in2012, throughout werelocated HIV Treatment andPreventionAdherence ≥ 13 intheabsenceof 1 , JulieMyers

1 , -

censoring). We plotstodescribeLTFU usedKaplan-Meier overtimeand for>3monthsafterlastscheduledvisitor administrative appointments of 4.6yearsfrom (LTFU—missingART tolost-to-follow-up initiation adults whostarted ART foramedian between2005-2007wasfollowed Hospital in Addis Ababa, Ethiopia. A cohortof385treatment-naïve Methodology: ART rollout. withretentioninthecontextofaninitial and exploredfactorsassociated (ART).antiretroviral therapy stayincare We wellpatients assessedhow Background: 1 Ira Wilson Yordanos Tiruneh (presenting) Ethiopia: AMixed-MethodsStudy, 2005-2011 enrollment. to thosewithadvanceddiseaseaswellwhoarehealthierat healingoptionsareneeded.alternative shouldbetailored Interventions social support, andregularadherencecounselingaddressingstigma retention.ed barriersinhibitoptimumpatient Bettertracking, enhanced Conclusion: incare. engagement companied bysenseofbeingluckyaswellsocialsupportmotivated fromstayingincare.patients Restoredhealthandfunctionalabilityac nomic constraints, fearofstigma, discouraged andcaredissatisfaction likely tobeLTFU. usingholywater, revealedthat data Qualitative eco participants at weremore education ART andthosewithlower initiation withbaselineCD4countsof100-200cells/mm3.to patients Bedridden 1.03–2.55; andHR=2.06;95%CI: 1.15-3.70, respectively), compared CD4 counts200cells/mm3hadhigherriskofLTFU (HR=1.62;95%CI: LTFU droppedoutduringfirstyearoftreatment. withbaseline Patients mm3 (IQR: 61-175). Thirty percentwereLTFU end;57%of bystudy 32% were WHO-stage-IV. MedianstartingCD4countwas115cells/ Results: analysis. wasusedfordata approach conducted; groundedtheory focus groupdiscussions, enrolledincare, eachwith6-11patients were withLTFU.Cox-regression modelstoidentifyfactorsassociated Six Brown University,Brown Providence, RI, USA 127 Median baseline age was34years;64%werefemaleand Medianbaselineage 1

Complexsocio-cultural, economic, andhealth-system-relat Poor retentioninHIVcarechallengesthesuccessof BlackLion We at conductedamixed-methodsstudy HIV-Positive AdultsinUrban Retention-in-Care Among 1 , OmarGalarraga 1 , BeckyGenberg 1 , -

- - POSTER ABSTRACTS 89 90 128

safely integrate CAMwhileadheringto safely integrate ART. helppatients that meaningfulconversations settings needtoencourage compromise successwith ART; thereforehealthcareprovidersinsuch even where ART isaccessible. CAMusecould that Ourfindingsindicate Conclusions: CAMand believed that ART aremutuallyexclusive. replaced ART frombiomedicaldependenceor withCAMsoughtliberation bothCAMand belief that ART representGod’s healingpower. People who use ofCAMand ART included andthe seekingholismorself-regulation exclusively priortoorafterstarting ART. forsimultaneous Motivations ART wasconcurrentlyusedby61%ofCAMuserswhile39% and thoseusing ART forlessthan2yearsweremorelikelytouseCAM. Women, youngeradults(18-29), income, education/ peoplewithlow Over half(53.3%)usedCAM, orherbalmedicine. mainlyholywater incomeandthemajority(62.9%)wereOrthodox Christians.tremely low ornoeducation.and 42%hadprimary Overtwo-thirdshadnoorex Results: POSTER analysis. guideddata Grounded theory of CAM, ofCAMuse, theintensityandduration with anditsrelation ART. onexperienceswithandtheperceivedbenefits tions elicitedinformation theclinicat wheretheyreceivedconventionalHIVcare. ques Interview HIV-positive adultsin Addis Ababa, Ethiopia. Participants wererecruited Methodology: (ART).ral therapy andchoosehealingitinerariesintheeraofantiretrovi peutic landscape PLWHA choicesandexaminehow treatment shape thethera navigate ABSTRACTSsettings. tounderstandfactorsthat We study conductedaqualitative forconventional HIVcareinlow-resource of CAMuseortheimplications medicine(CAM). andalternative mentary aboutpatterns Littleisknown Background: 1 Yordanos Tiruneh (presenting) Ethiopia Implication forConventionalHIVCarein Brown University,Brown Providence, RI, USA ofparticipantswas38years;59%werefemale The meanage CAMuseamongPLWHA settingsishigh inlow-resource Many peoplelivingwithHIV/AIDS(PLWHA) Many usecomple Data were collected using in-depth interviews with105 werecollectedusingin-depthinterviews Data Alternative Medicineandits and Use ofComplementary 1 , Ira Wilson , 1 10th International Conference on 10th International - - - - - 129 on ART (n=383). Measuresincluded beingbothered oftenoralways Methodology: ed withtheir ART adherence. relationships,and patient-doctor beenfoundtobeassociat whichhave health, onIDUs’behavioral painmanagement inadequate socialsupport tothisbyexploringeffectsof to addressthedearthofresearchattention analgesics. powerful less likelytobeprescribed(adequate) We sought conditions, withchronicpain-related ciated andIDUsvsnon-IDUsare Background: 1 Amy Knowlton Implications forHIVCareandQualityofLife Support andPatient-Doctor Relationships: with persistentdisparitiesinchronicpainand ART outcomes. ity ofHIVproviderrelationships, andqualityoflifeamongthispopulation andmodeling, for theory implications andhave ART adherence, continu doctor-patient relationships. The findingscontributetobiospsychosocial depression anddrugabuse, anditsadverseeffectsonsocialsupport inthispopulation,management andhighlighttheroleofchronicpainin Conclusions: supportondepressivesymptoms. tive effectbetweenpainandnegative drug use, sex, andHIVcarevisits. We alsofoundevidence of aninterac evenafteradjustingforcurrent relationship with worsepatient-doctor painanddepressivesymptomswereassociated that results indicated allthreetimepoints. at relationship patient-doctor Logisticregression Results: used formultiplelogisticregressionanalysis. (Bollen&Brand, andunknown are known 2010). was Baselinedata eachof3timepointstocontrolforpotentialconfounders that on painat relationship approach wasusedtoregresspatient-doctor fixed effects 2000), socialsupport(Newsometal2005)andtheCES-D. negative A by painintheprior6months, (Bakkenetal relationship patient-doctor Baltimore, MD, USA Johns HopkinsBloombergSchoolofPublicHealth, Inthefixedeffectmodel, withworse painwasassociated Ourresultsunderscoretheneedforimprovedpain Inject drug use (IDU) and antiretroviral therapy areasso Injectdruguse(IDU)andantiretroviraltherapy Participants wereclinic-recruited formerorcurrentIDUs

Behavioral Health, Social The RoleofChronicPain in (presenting) HIV Treatment andPreventionAdherence 1

- - - - 10th International Conference on 10th International facilities. RWHAP-funded those notpracticingat and especially amongproviderswithsmallnumbersofHIVpatients guidelines, toincreaseadoptionofcurrenttreatment develop strategies prescribing ART regardlessofCD4count. Researchmaybeneededto guidelines, supportamongHIVcareprovidersfor thereismoderate Conclusions: with universal in practicewerenotassociated ART prescribing. funding.RWHAP Providertype, physicianspecialty, andnumberofyears ART regardlessofCD4countthanthosepracticinginfacilitieswithout facilities (48%ofallHIVproviders)were23%morelikelytoprescribe Providers practicinginRyan White HIV/AIDSProgram(RWHAP)-funded (26%ofallHIVproviders).count thanthosewith200ormorepatients providers) were33%lesslikelytoprescribe ART regardlessofCD4 77.8). (15%ofallHIV Providerswhocaredfor20orfewerHIVpatients prescribed regardlessofCD4countby71%providers(CI: 64.6- were nursepractitioners, and5%werephysicianassistants. ART was whom 79%werephysicians(45%infectiousdiseasespecialists), 22% [CI]:interval 6,902-9,611)HIVcareprovidersintheUnitedStates, of sponse rate, 64%). therewere8,257(95%confidence We that estimated Results: logisticregressionmodel. from amultivariate dicted probabilitiesforselectedsubgroupsofproviderswereestimated CD4 countwereassessedwithRao-Scottchi-squaretests. ofpre Ratios between providercharacteristicsandprescriptionof ART regardlessof sampleofHIVcareprovidersintheUnitedStates.tative Associations Methodology: adoption ofthenewguidelinesbyHIVcareproviders. oradherenceconcerns.contraindications However, about littleisknown HIV-infected individualsregardlessofCD4cellcount, barringclinical (ART) recommendedprescribingantiretroviraltherapy for Services Background: 3 2 1 WestBrady John Weiser (presenting) TherapyintheUnitedStates Antiretroviral Altarum Institute, Ann Arbor, MI, USA ResearchCenter,University ofMichiganSurvey Ann Arbor, MI, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA 131 Of2,023eligibleproviders, 1,234responded(adjustedre 2 , ChrisDuke More than a year after release of updated treatment treatment Morethanayearafterreleaseofupdated In2012, theU.S. DepartmentofHealthandHuman During2013-2014, represen anationally wesurveyed Universal Prescribingof Adoption ofGuidelinesfor 3 , GarrettGremel 1 , JacekSkarbinski HIV Treatment andPreventionAdherence 3 , LindaBeer 1 , JohnBrooks 1 1 ,

- - - 132 to mostorallpatients. We usedtheRao-Scottchi-squaretesttoassess least twoofthree HIV providerswhoperformedat ART supportactivities HIV careprovidersintheUnitedStates. of We thepercentage estimated Methodology: byHIVcareproviders. oftheseservices delivery (ART).adherence toantiretroviraltherapy However, about littleisknown forclinicalrecommendations providerstosupportsustained, high Background: 3 2 1 WestBrady John Weiser (presenting) intheUnitedStates Care Providers patient caremayincreasetheprovisionof patient ART adherencesupport. support. providersmoretimefor wouldallow Structuralchangesthat receiveappropriate theirnon-adherentpatients assistance toensurethat facilitiesmayneed care andthosewhodonotpracticeinRWHAP-funded tonon-adherentpatients. services Providerswhodonotprovideprimary adherence assessmentbutproviderslessfrequentlyreportoffering Conclusions: 1.22, p<0.01). (aPR enough timetoprovideallneededcareestablishedHIVpatients facility (aPR1.34, p=0.03), orusuallyhaving andreportingalways p =0.02), practicinginaRyan White HIV/AIDSProgram(RWHAP)-funded nurse practitioner(aPR1.33, p<0.01), care(aPR1.45, providingprimary leasttwo withprovidingat sociated ART supportactivitieswerebeinga two ofthesethreeservices. Providercharacteristicsindependentlyas forsupportiveservices,non-adherent patients least and70%providedat 60% offeredadviceabouttoolstoincreaseadherence, 54%referred 64%). visit, every Almost allproviders(96%)discussedadherenceat Results: leasttwo (aPR)forprovidingat prevalence ratios ART supportactivities. model toidentifysignificant(p<0.05)predictorsandtheiradjusted p<0.05inamultivariable withtheoutcomeat variables associated ofthisoutcomewithprovidercharacteristics.associations We included Altarum Institute, Ann Arbor, MI, USA ResearchCenter,University ofMichiganSurvey Ann Arbor, MI, USA Centers forDiseaseControlandPrevention, Atlanta, GA, USA Inall, of (adjustedresponserate 1,231providersparticipated 2 , GarrettGremel Most providers report following guidelines forregular Mostprovidersreportfollowing IAPAC recentlyupdated andseveralfederalagencies During2013-2014, aprobabilitysampleof wesurveyed Adherence Support Services byHIV Adherence SupportServices Therapy ofAntiretroviral Delivery 1 , JacekSkarbinski 3 , ChrisDuke 3 , LindaBeer 1 , JohnBrooks 1 1 ,

POSTER ABSTRACTS 91 92 133

youth withPHIV. in management and monitoringmedication forstudying information with eachother, suggestingbothprovidevaluablebutcomplementary strong inpredictingSVLandhigherCD4%butonlyweakagreement Conclusions: however, <0.20). wasweak(Kappa agreement between 4-monthrefillandyouth7-dayrecall(OR=4.67, p=0.01); pharmacy refillwassignificant, observed withthestrongestassociation 6-months (OR=4.02, p=0.01). between7-dayrecalland Association over 2-months(OR=4.37, p<0.01), 4-months(OR=3.43, p=0.01), of caregiver/youth7-dayrecall(OR=5.32, p<0.01), pharmacy refill withCD4% ed significantassociations 6-months (OR=3.95, p=0.01). Adherence measures alsodemonstrat 2-months (OR=3.96, p=0.01), 4-months(OR=2.44, p=0.07), and withSVL(OR=2.79,associations p=0.05), asdidpharmacy refill, models, adherencebyworseofcaregiver/youth7-dayrecallshowed 53%, and46%bypharmacy refillover2, 4, and6months. Inadjusted adherent byworseofcaregiver/youth-reported7-dayrecall, and60%, years), 74%Black, 16%Hispanic, and44%male. Overall, 78%were Results: and pharmacy auto-refill. characteristics, responsibility, medication numberof ARVs inregimen, recall. Adjusted logisticregressionanalysesconsidereddemographic takenbasedonbothcaregiverandyouth7-day and >90%medication POSTER(% prescribeddosescoveredbyprescriptionsfilled)perpharmacy refill adherence inpredictingsuppressedviralload(SVL;>90%coverage pared withcaregiver, youthand worseofcaregiver/youth-reported7-day Substudy. Pharmacy refillrecordsover2, 4, and6monthswerecom Methodology: methods. notobtainedfromshort-termrecall insight intoadherencebehaviors overthelongertermandmayadd availability measure ofmedication disease responseinPHIVyouth. Pharmacy offeranobjective refilldata Background: ABSTRACTS4 3 2 1 Megan Wilkins Cenk Yildirim (presenting) Youth withPerinatally-Acquired HIV(PHIV) and PredictingHIVDiseaseMeasuresin University ofCalifornia, SanDiego, CA, USA St. JudeChildren’s ResearchHospital, Memphis, TN, USA Children’s & Diagnostic Treatment Center, Fort Lauderdale, FL, USA SchoolofPublicHealth,Harvard Boston, MA, USA =14.7 A totalof174PHIVparticipantsenrolled(meanage Pharmacy refilland7-dayrecallmeasureswereequally Antiretroviral (ARV)adherenceiscriticalinmonitoring 3 Participants werePHIVyouthfromthePHACSMemory , Patton Doyle Measures inAssessingAdherence The RoleofPharmacy Refill 1 , Patricia Garvie 2 , Paige, Williams ≥ 25 inadjustedmodels: worse 2 , MiriamChernoff 1 , SharonNichols 4 1 ,

10th International Conference on 10th International - - 134 Sharon Nichols(presenting) Youth WithPerinatally AcquiredHIV identify targetsforintervention. executive functioningpredicted ARV non-adherenceinyouthwithPHIVto through adolescence. and examinedwhetherpoorermemory This study HIV(PHIV)transition ment iscriticalasyouthwithperinatally-acquired Background: 6 5 4 3 2 1 Patricia Garvie Cenk Yildirim requires furtherstudy. ence. inearlierstudies,Although observed thiscounterintuitivefinding withnon-adher measureswasalsoassociated verbal orspeed-related adherence amongyouthwithPHIV. However, betterperformanceon (i.e.,dysfunction fluency withpoorer setlosserrors)wasassociated Conclusions: macy withbiological-parentcaregiver. refillwasassociated more verbalfluency income, set-losserrorsandlower phar whilelower for medication, with 7-daynon-adherencewassignificantlyassociated and fewer ARVs inregimen. leastpartiallyresponsible Among youthat performanceandolderage, biological-parentcaregiver,gory-switching andcate and designfluency set-losserrorsbutbetterverbalcategory pharmacy withmoreverbal refilladherencewassignificantlyassociated learning, letterfluency, andcolor/wordnamingperformance;lower withmoreverbalfluencyly associated set-losserrors, butbetterverbal 12.4 years). Inadjustedanalyses, 7-daynon-adherencewassignificant responsible for ARV adherence(81%)weresignificantlyolder(15.1vs. report, and45%of157withpharmacy refilldata. at leastpartially Youth ARVs. ofnon-adherencewere55%154withcompleted7-day Rates black, 12noton and16%Hispanic;26%withCDCClassCdiagnosis; Results: using logisticregressionmodels. tonon-adherence inrelation characteristicswereevaluated mographic caregiver questionnaires. Memory, executivefunctions, andsociode refill records. giver report, or<90%prescribed accordingtopharmacyARV availability missed any ARV doseovertheprevious7daysbyeitheryouthorcare 9to<19. ages Substudy Non-adherencewasdefinedas PHACS Memory Methodology: Children’s & Diagnostic Treatment Center, Fort Lauderdale, FL, USA St. JudeChildren’s ResearchHospital, Memphis, TN, USA Northwest UniversityFeinberg SchoolofMedicine, Chicago, IL, USA University ofHouston, TX, USA SchoolofPublicHealth,Harvard Boston, MA, USA University ofCalifornia, SanDiego, CA, USA 14.7)were44%male,The 174participants(meanage 78% 2 Medication responsibilitywasidentifiedusingyouthand Medication ConsistentwithfindingsinadultsHIV, executive Successful antiretroviral (ARV) medication manage Successfulantiretroviral(ARV)medication , Malee Kathleen 6 Participants included PHIVyouthfromtheUS-based and MedicationAdherenceAmong Functioning Executive andMemory HIV Treatment andPreventionAdherence 1 4 , MiriamChernoff , Megan Wilkins , 5 , Paige, Williams 2 , Steven Woods, 2 3 , ,

------135 10th International Conference on 10th International among theprisonscommunity. tomeettheunmetdemand prison barracksthroughoutreachservices resources areessentialtosupportscalingup toother VMMC services andstaffofUPStoprovidespace,with management timeandhuman Recommendations: achieve ahighnumberofcircumcisions. basedontheneedsofprisonscommunitycan delivery of service demandforservices.creating Flexibility, promptresponse, andadaption andiii)ensuringsupplychainsystems tion ofprisonsmanagement; providers,within prisonsdependson;i)trainingofservice ii)coopera programs. intocareandtreatment initiated Successof VMMC programs counseled forHIV. A totalof2,349malestestingpositiveforHIVwere 34 prisonbarracks. A totalof13,156menwerecircumcised, testedand Lessons Learned: sites. campaigns in34prisonsbarracksthroughfixed, outreach, andmobile high volume circumcision andcarringout22integrated VMMC services; strengthening thesupplychainof outbarracksfor VMMC kits;mapping communities. ofhealthworkers; SPEARfocusedonbuildingthecapacity and sustaining address thechallengesofinitiating VMMC amongprison tional Development(USAID), (UPS)to supportedUgandaPrisonsServices (SPEAR) projectfundedthroughtheUnitedStates Agency forInterna Public sectorworkplacestoExpand Action andReponsestoHIV AIDS Description: policy.to non-existingnational notbeenscaledupamongprisonsdue Male Circumcision(VMMC)have prevalence, especially HIVpreventioninterventions Voluntary Medical 7.3%. at HIV incomparisontothegeneralpopulation Despitethishigh highest inUganda. areinfectedwith 11%ofinmates Approximately Introduction: 3 2 1 Melanie Lopez(presenting) SPEAR Project inUganda:LessonsFrom Prison Services World Vision, Washington,USA DC, World Vision, Kampala, UGANDA WorldFederal Vision, Way, WA,USA BetweenOctober2012andMay2014, theSupporting HIVprevalenceinprisoncommunitiesisamongthe Medical MaleCircumcisionin AccesstoVoluntary Improving Twenty-two VMMC campaignswerecarriedoutin Continuedadvocacy engagement andstrategic 1 , Erasmus Tanga, HIV Treatment andPreventionAdherence 2 , GloriaEkpo 3 - - 138 tices. UnderstandingadherencetoPMTCTcanaidinpreventingvertical about theroleofdepressioninadherencetopostpartumPMTCTprac Depression isarobustpredictorofnon-adherenceto ART; littleisknown of contraception, (ART). antiretroviraltherapy inadditiontomaternal shifts postpartumtoinclude andinitiation infantfocusedbehaviors Background: 4 3 2 1 Jennifer Smit Kara Bennett Christina Psaros(presenting) Depression of SouthAfricanWomen: theRoleof the postpartumPMTCTcascadeisrequired. toidentifywomenwhowillstrugglewith understandingofhow Greater ofdepressionthanwomenwhodidnot. rates PMTCT cascadeandlower betteradherencetothe caremayhave women whoenrolledinantenatal withPMTCTbehaviors.sociated Resultsmaybeinfluencedbysampling; carewashigh,women enrolledinantenatal anddepressionwasnotas Conclusions: adherenceto withmaternal was notassociated ART orotheroutcomes. clusively contraception. breastfeeding)and94%hadinitiated Depression 100% ofwomenreportedasinglefeedingmethod(only28%wereex of infantsreceivedanHIVtest, and99%ofmothersobtainedtheresult. infants takingnevirapine, reportedadherencewas94%. average 99% 3(2%)ofwerenot. beenreceivingnevirapine; 44 infantsshouldhave Of median (Q1, was88.3%(81.4, Q3)adherencescoresincedelivery 93.9). and 79%reportedremainingon ART postpartum. Among womenon ART, Results: White standarderrors. self-report questionsstandardized0-100)usinglinearregressionwith from principal componentsoffour of adherencescore(calculated sion wasdefinedasaHopkinsscore>1.75andexaminedpredictor infant HIVtest, feedingmethods, maternal ART, contraception. Depres about depressionandadherenceto: administration, infantnevirapine >6weekspostpartum at nancy 29years)wereinterviewed (medianage Methodology: transmission andimprovinglivesofHIV-infected mothers. Bennett Statistical Consulting,Bennett Statistical Inc., BallstonLake, NY, USA Massachusetts GeneralHospital, Boston, MA, USA Maternal, Adolescent andChildHealth, Durban, SOUTH AFRICA MedicalSchool,Harvard Boston, MA, USA 10%ofthesamplemetcriteriafordepression,Approximately 4 2 Adherence tothepostpartumPMTCTcascadeamong Preventingmothertochildtransmission(PMTCT)ofHIV , Faith Luthuli , StevenSafren 156HIV-infected womenenrolledinPMTCT duringpreg PMTCT CascadeAmongaSample Adherence tothePostpartum 2 , RossGreener 1

1 , NzwakieMosery 2 , Bangsberg David 2 , JocelynRemmert 3 ,

- 3 - - , - - POSTER ABSTRACTS 93 94 139

result inbetteroutcomes. allianceswitheachotherandclinictreatment staff, whichmay adherence, mighthelpadolescentsand theirparentstodevelopstronger feedback fortruth-telling, thanpositivefeedbackonlyforexcellent rather reasons.non-adherence forseveralmotivating Receivingpositive Conclusions: adherence. to lieclinic feedbackforpriorpoor receivednegative staffbyhaving supervision. Adolescents andparentsboth describedbeingmotivated socialsupport,maintain; andnotprovidingadequate including consistent difficultexcellentadherenceisto how for adherence;notappreciating highexpectations Discordant adolescentsreportedtheirparentshaving ofpastpooradherence. awareness despitehaving adherent totreatment theiradolescentswerecurrently adolescents expressedconfidencethat adults,appointing andfeelingsofguilt. Severalparentsofnon-adherent beingreferredforadherencecounselingsessions,avoiding fearofdis deception included admonishmentbyparents andclinic avoiding staff, tices including lying, hidingpills, anddiscardingpills. for Motivations Results: pill count). contentanalysis. wereanalyzedusingqualitative Data between methods(e.g., adherence100%byself-report, but<90%by witha least two3-monthintervals views. at Discordancewasdefinedduringthefirstyearofmonitoringas POSTER focusgroupsandinter (“parents”) wereinvitedtotakepartinseparate adherencemeasures. and4low-cost caps Their parentsorguardians usingmicroelectronicmedication adherencestudy in aBotswana-based discordantresults performed withadolescents(10-19yearsold)having Methodology: adherence. treatment tomonitoringandsupporting forbetterapproaches ment mightallow discordant adherenceresults. Understandingreasonsforthedisagree parent-report, pillcounts, andpharmacy frequentlyyield refilldata Background: ABSTRACTS4 3 2 1 Ontibile Tshume Jennifer Chapman Elizabeth Lowenthal(presenting) Adolescents Gaborone, BOTSWANA Children’sBotswana-Baylor ClinicalCentreofExcellence, University ofBotswana, Gaborone, BOTSWANA Children’s HospitalofPhiladelphia, PA, USA University ofPennsylvania, Philadelphia, PA, USA 55adolescentsand26parentsdescribeddeceptiveprac Our data suggest that adolescents are deceptiveabout suggestthat Ourdata Low costmeasuresofadherencesuchasself-report, Low Focus were groupsandsemi-structuredinterviews Between AdherenceMeasuresin Reasons forDiscordance 4 , RobertGross 2 , NeoMoshashane 1 , Gabriel Anabwani , 1 ≥ , Elizabeth Yang, 10% differenceinadherencevalues 3 , BoineeloBula 4 1 , SeiponeMphele , ShadrackFrimpong 3 , Tafireyi Marukutira

10th International Conference on 10th International - 3 - - - 1 4 , , 140 divided into2groups: group1(basic)wascomposedof50womenwith includedtion understudy 148HIV-infected pregnantwomenwhowere Methodology: HIVtransmission. risk ofperinatal Research Objective: as regularityoftakingantiretroviralmedicines. onPMTCTaswell ofrecommendations adversely influenceobservance considerable biological, economicandsocialdifficultieswhichcan Background: 2 1 Turgunpulat Daminov Khilola Nasirova and thereuponerrorsinitsassessmentarepossible. presentedbythepatient,jective beingfrequentlybasedonlyonthedata However, ofadherenceissub evaluation itshouldbeemphasizedthat HIVtransmissions(thevalueofthetest factors ofperinatal Conclusions: ARVT aswell, transmissionofHIV. itbeingariskfactorofperinatal influenceonadherenceto consumption undoubtedlyrendersnegative registered 4timesmoreoften(thevalueofthetest women withtheoccurredHIV-transmission, injectionuseofdrugswas women whereasinthecomparisongroup, made78.6%. thisindicator In basic group, ahighlevelofadherencewasfoundonlyin14%the In thecomparisongroup, allwomenreceivedthe ARVT course. Inthe HIVtransmissions tothenewborns.the majorcauseofperinatal during pregnancy andchildbirthforthevariousreasons;itpossiblywas Results: son) included 98womenwhosechildrenwerebornnon-infected. group2(compari HIVtransmissiontotheirneonates; occurred perinatal TashkentMedical Academy, Tashkent,UZBEKISTAN Diseases, Tashkent,UZBEKISTAN Research InstituteofEpidemiology, andInfectious Microbiology Inthebasicgroup, mostofwomen(76%)didnotreceive ARVT Absence oradecreaseinadherenceto ARVT isoneofrisk HIV-positive womanduringpregnancy canexperience The researchwasconductedin2007-2012. The popula Risk ofPerinatal HIVTransmissions Effect ofAdherencetoARVTonthe 1 , Gulnara Khudaykulova (presenting) To theeffectofadherenceto study ARVT onthe 2 HIV Treatment andPreventionAdherence χ 2is99%). Drug 2 ,

χ 2is99%). - - - 141 10th International Conference on 10th International priortodischargemayimproveoutcomes. patients report unmetneeds. EffortstoaddressunmetneedsinhospitalizedHIV Conclusions: incare. withre-engagement er unmetneedswerenotassociated experience =0.45;p<0.03)althoughgreat VL improvement(oddsratio needs. Patients withunmetneedsforhousing(p>3)werelesslikelyto nancial (58%), food(50%), (47%). andtransportation 56%had>3unmet need. The mostfrequentlyreportedunmetneedsweredental(68%), fi Results: outcomes andthuswasnotincluded asacovariate. unmet needsandoutcomes. hadnoeffectonthese The intervention between analyseswereconductedtoexamineassociations Multivariate VL improvement(log within0-30daysand30-180days) HIVappointments (attended withtheoutcomes.associated incare Outcomeswerere-engagement independentlyandthecountofunmetneedswas needs wereevaluated andwhethertheseneedsweremetorunmet.talization Individualunmet 19-items onpersonalandmedicalneedsinthe6monthsbeforehospi July 2010andJune2012wereused. includedThe baselinesurvey trialbetween hospital whowereenrolledintoarandomizedintervention alargepublicallyfunded out-of-care hospitalizedHIV-infected at patients Methodology: in HIVcareand VL. HIV patients, weexamined theimpactofunmetneedsonre-engagement ing toworseclinical outcomes. fromout-of-carehospitalized Usingdata discharge, inHIVcarefollowing or preventengagement potentiallylead Background: 3 2 1 Melinda Stanley Jessica Davila(presenting) Out-of-Care HospitalizedHIVPatients University ofMichigan, Ann Arbor, MI, USA DeBakey VA MedicalCenter, Houston, TX, USA Baylor CollegeofMedicine, Houston, TX, USA 417HIV-infected wereenrolled. patients 83% had>1unmet The vastmajorityofhospitalizedout-of-careHIVpersons Unmet needs among hospitalized HIV patients maydelay UnmetneedsamonghospitalizedHIVpatients Baseline and 6-month follow-up data fromacohortof data Baselineand6-monthfollow-up Poor OutcomesinHIVCareAmong Unmet NeedsareAssociatedWith 1 , KRivet Amico 10 reduction at 6-monthsor reductionat VL <400copies/mL). 1 , ChristineHartman 3 , Thomas Giordano , Thomas HIV Treatment andPreventionAdherence 2 , JeffreyCully 1 1 ,

- - - - 142 Methodology: inmobile-healthsettings.tion interventions We reportbaselineresults. ofevidence-based,prevention package gender-specific preven primary adults. The MP3 Youth HIV deliversacombination inKenya pilotstudy riskofcontractingHIVcomparedto at Africa aredisproportionately Background: 4 3 2 1 Eunice Omanga Charles Cleland Ann Kurth(presenting) the MP3Youth PilotStudy undiagnosed HIV-positiveundiagnosed youthandlinkthemtocare. youth. caneffectivelyidentifypreviously HIVservices Mobileintegrated tomaleandfemale HIVpreventioninterventions offering combination Conclusion: 9% maybeeligibleforPrEP. 46%offemalesparticipantsmaybeeligibleforCCTand approximately MMC uptakewaslow. Only3of26eligiblemaleschoseMMC. To date, referrals werecompleted. All wereenrolledinalongitudinalSMS-cohort. M =7). Thirty-percent wereeligiblefor ART andfacilitated initiation 5-22 yrs). Twenty (F=23; of30HIVinfectionswerenewdiagnoses ofcoitarche(range:reported sexualactivity;15yearswasthemeanage 294 participants;57%female, 19years. meanage Eighty-fourpercent Results: acceptability, andfeasibility. for thosein-school. coverage, evaluates The study uptake, intervention out-of-schoolfemales,negative andconditionalcashtransfer(CCT) contraception/family planning, Pre-ExposureProphylaxis(PrEP)forHIV HIV-positive; For males: medicalmalecircumcision(MMC);For females: Counseling and Testing, tocarefor linkage condomsandfacilitated through focusgroups, review, systematic andmodeling. All youth: HIV forfemaleandmaleyouth,tion HIVpreventioninterventions identified University ofNairobi, KENYA ofHealth-Kenya, Nairobi,Ministry KENYA Impact ResearchandDevelopmentOrganization, Kisumu, KENYA New York University, New York, NY, USA Inthefirstfourof10plannedmobilehealthevents, weenrolled Mobile events are an acceptable/feasible strategy for Mobileeventsareanacceptable/feasiblestrategy Female 15-24)insub-Saharan andmaleyouth(ages The MP3 Youth includes package effectivecombina 1 2 Prevention: BaselineResultsFrom Gender-Specific CombinationHIV , Peter Cherutich , Alfred Osoti , Alfred 1 , Kawango Agot Kawango , 4 , SamwelRao 3 , JamesKiarie 2 , JasmineButtolph 2 , IreneInwani 4 , RuthNduati 4

1 , 4

- - POSTER ABSTRACTS 95 96 143

these differencesandreliabilityvalidityofPPC. was taken). Furtherresearchisrecommendedtomorefullyinvestigate differenttimesoftheday(e.g.,ducted at beforeorafterthedailydose cies mayinclude errors, typographical miscounts, orPPCs/SPCscon dropped20%betweentimepoints.agreement Reasonsfordiscrepan SPCs at T1/T2; however, theproportionofparticipantswithperfect Conclusion: PPC results. = 26). wasevenlysplitbetweenreportinghigherSPCor Disagreement between PPCsandSPCs. At T2, decreasedto77%(n exactagreement At T1, exactagreement 97%ofparticipants(n=33)demonstrated PPCs andSPCsat T1 (r=1.0;p 18-56 years[mean34]). between strongagreement showed Correlations at T1 and T2 (African American [n=24;71%];male26;77%]; Results: POSTER andratios. wereexaminedwithcorrelations Data 38%), alphabeticallylistedwasusedforanalysis. thefirstmedication one drugonly. For participantsprescribedmulti-drugregimens(n=13; their remainingpills/pillbottles(PPCs). This analysiswasconductedfor of pillsremainingintheirpillbottles(SPCs)andtransmittedpictures (T2).pendently repeated Participants electronicallyreportedthenumber staff assistance. Onetosixdaysafterward, PPCsandSPCswereinde post-baseline (T2). At T1, participantscompletedthePPCandSPCwith Methodology: participants. ABSTRACTSWe criterionvalidityofthePPCamongMFHP reportthepreliminary services.and sendingthemtoresearchstaffviamultimediamessaging ofthepillsremainingintheirpillbottles taking smartphonephotographs adherence.cation Through PPCs, participantsreport ART adherenceby (SPC)toassessmonthlymedi (PPC) andelectronicself-reportsurvey picturepillcount usesan innovative that intervention self-management Background: 1 Maya Baumann(presenting) Emory University,Emory Atlanta, GA, USA Of 37participants, 92%(n=34)completedPPCsandsurveys There werenear-perfect betweenPPCsand correlations The MusicforHealthProject(MFHP)isanmHealthHIV We baseline(T1)and comparedPPCandSPCresultsat Pill CountAdherenceMethod Validity Testing Picture ofANovel 1 , JulieZuniga ≤ 0.001) and at 0.001) andat T2 (r=0.997;p 1 , MarciaHolstad 1 ≤ 10th International Conference on 10th International 0.001). - - - - 144 southern China. The 6-monthtrialprovidedsubjectswithweb-linked (ART) in the effectofanantiretroviraltherapy adherenceintervention Background: 7 6 5 4 3 2 1 Keyi Xu Allen Gifford Lora Sabin(presenting) TrialAdherence Intervention inChina Participation Therapy inanAntiretroviral and otherchronicillnesses. ofHIV promisingforimprovingtreatment Real-time feedbackappears counseling. todelivertriggeredremindersanddata-informed technology usingreal-timemonitoring inanadherenceintervention participating Conclusions: as helpfulinsupportingtheiradherence. counseling;ofthese, indata-informed jects participated twodescribedit not tomissany.” Sincethemajorityhadhighadherence, onlyninesub “this real-timereminderremindsmetotakemymedicineontimeand reminders, portrayingthemas “discreet” and “helpful”. Oneexplained: ormonitored.(6/20) likedbeingwatched All subjectslikedthetriggered petency tobeadherent. andincreasedtheirmotivation Nearlyone-third about useofthedevice, itimprovedtheiradherencecom notingthat and themajorityweresingle(17/20). Nearlyall(18/20)werepositive was32.3.(13/20); meanage Most(18/20)hadcompletedmiddleschool Results: approach. English; transcriptswerecodedinNVivousingathematic adherencedata.ated IDIswererecorded, transcribed, into andtranslated use, thetriggeredreminders, andcounselinginformedbydevice-gener guide, withquestionscoveringviewsandexperiencesregardingdevice vention-period clinic visit. IDIswereconductedusingasemi-structured theirsixthandfinalinter (IDIs)at inin-depthinterviews participation Methodology: componenttoexploresubjects’experiences. qualitative month. Giventhenoveltyofintervention, a incorporated thestudy sub-optimaladherence(<95%)duringtheprevious monitoring indicated not takenontime, counselingwhen supplementedbydata-informed triggered SMSreminderstosubjects’cellphoneswhendoseswere a devices facilitated encompassed that ‘real-time feedback’intervention monitoradherenceinrealtime. containersthat medication These Beth IsraelDeaconessMedicalCenter, Boston, MA, USA Ditan Hospital, Beijing, CHINA Research CenterFor PublicHealth, Tsinghua University, Beijing, CHINA FHI360, Beijing, Beijing, CHINA Veterans Health Administration, Bedford, MA, USA Center forGlobalHealthandDevelopment, Boston, MA, USA Boston UniversitySchoolofPublicHealth, Boston, MA, USA 6 ,Li Yiyao Twenty subjectsparticipated. intervention 65%weremale 3 , LiZhong ART inChinaweregenerallypositiveabout patients The ‘China Adherence through Technology Study’ assessed through Technology Study’ The‘ChinaAdherence Intervention subjectswereselectedpurposefullyfor Intervention my DosesonTime’: Views of ‘It WillRemindmetoTake 2 , StephanieRoche 4 , Wubin Xie , Wubin HIV Treatment andPreventionAdherence 1 , Taryn Vian 4 , Ariel Falconer, Ariel 7 , ChristopherGill 1 , BachmanDeSilva Mary 2 , Feng Cheng 1 2 , 5 ,

- - - - 145 10th International Conference on 10th International reach, with ART programsforHIV/HCVco-infectedindividuals. treatment adherencesupportandsocialservices,integrating suchashousingout within thisdemographic. The findingshighlighttheimportanceof withimproved adherence wereassociated adherence supportservices ART adherencethanHIVmono-infectedindividuals. Stable housingand Conclusions: support program(AOR: 4.76;95%CI: 2.62-8.57). housing (AOR: 1.86;95%CI: 1.14-3.05)andaccessinganadherence withstable among HIV/HCVco-infectedparticipantswasassociated optimally adherent(AOR: 0.53;95%CI: 0.28-0.99). Optimaladherence (AOR:and incarceration 2.52;95%CI: 1.41-4.51), andlesslikelytobe [AOR]:justed oddsratio [CI]: 20.8;95%confidenceinterval 11.2-38.5) ofIDU(ad ahistory individuals weresignificantlymorelikelytohave were HIV/HCVco-infected. Inadjustedmultivariableanalysis, co-infected Results: optimal ART adherenceamongco-infectedindividuals. HIV mono-infectedindividuals, of aswellindependentcovariates models comparedoptimaladherencebetweenHIV/HCVco-infectedand based onpharmacy refillcompliance. Multivariablelogisticregression tained throughself-report. Optimal ART adherencewasdefinedas provincial Drug Treatment Plan(DTP). wasob HCVco-infection status islinkedwithlongitudinalclinicalcross-sectional data throughthe data collectedbetween2007and2010acrossBritishColumbia.study This intoSupportiveand (LISA) Investigations HealthServices Ancillary Methodology: individuals inBritishColumbia, Canada. among co-infectedindividualsenrolledinalargecohortofHIV-positive ofoptimal fected individualsandtodeterminecovariates ART adherence clinical characteristicsbetweenHIV/HCVco-infectedandHIVmono-in and wastocomparesocio-demographic The purposeofthisstudy face serioushealthchallengesincluding liverdisease. riskofend-stage withHIV.comorbidity associated IndividualswithHIV/HCVco-infection Background: 2 1 Robert Hogg Angela Cescon Cathy Puskas(presenting) British Columbia and HepatitisCCo-InfectedIndividualsin AdherenceAmongHIV Antiretroviral Improve Vancouver, BC, CANADA British ColumbiaCentreforExcellenceinHIV/AIDS, Simon Fraser University, Burnaby, BC, CANADA Of912included participants(28.2%women), 536(58.8%) 2

HIV/HCV co-infected individuals exhibit significantly lower HIV/HCVco-infectedindividualsexhibitsignificantlylower Hepatitis Cvirus(HCV)isariskfactorforandcommon Hepatitis The study utilizes survey data from theLongitudinal data utilizessurvey The study 2 , ZishanCui Adherence Support Services Adherence SupportServices Access toStableHousingand 2 , JuliaZhu 1 , Salters Kate HIV Treatment andPreventionAdherence 2 , Angela Kaida , Angela 2 , SuritaParashar 1 , CariMiller

2 ,

1 , ≥ - 95% - - - 146 sought to validate adailytextingadherencemetric(individualized sought tovalidate Texting Background: 4 3 2 1 Peter Anderson Corado Katya Jill Blumenthal Prophylaxis (PrEP) Who HaveSex WithMenonPre-Exposure Dried BloodSpotConcentrationsAmongMen firmed adherencemarker, iTAB mightbeusefultomonitorMSMonPrEP. taking >5doses/week. As iTAB withthisbiologically-con correlates data TFV-DP levelsandweremorelikelytohave TFV-DP levelsconsistentwith Subjects withahigherproportionofpositiveiTAB responseshadhigher Conclusions: ethnicity (p=0.027)andlessdruguse0.005). higher adherencecluster included (p=0.002), olderage non-Hispanic adherers(p=0.037).than moderate with Baselinevariablesassociated Perfect/high adherershadsignificantlyhigher TVF-DPconcentrations of 1547 (n=40)adherencecorrespondingtomean and moderate TFV-DP levels 3 adherencegroupsbytextresponses: perfect(n=37), high(n=75) tive iTAB responses(89versus76%, p=0.003). Subjects clustered into >891 (consistentwith>5doses/week)hadahigherproportionofposi of positiveiTAB responses(r=0.26, p=0.001). Subjectswith TFV-DP betweensignificant correlation TFV-DP andproportions concentrations 87% ofdosesasmeasuredbypositiveiTAB responses. There wasa was 1353 Results: and and heatmap Ward HierarchicalClusteringforadherencepatterns. sis included testand correlation Wilcoxon ranksumtestforassociation, ofadherence.were exploredascovariates analy Methodsforstatistical DP half-lives)priortoweek12. Baselineriskfactorsanddemographics over34days(two responded topositivelyandadherencepatterns TFV- available. TFV-DP levelswerecomparedtoproportion ofmessages randomized toiTAB withweek12DBS TFV-DP levelsandiTAB data adherence inHIV-uninfected MSM. Analysis wasperformedonsubjects Methods: phate, TFV-DF, levelsindriedbloodspots, DBS). for Adherence Building, iTAB) usingabiologicmarker(tenofovirdiphos University ofColorado, Denver, CO, USA Los Angeles, CA, USA University ofSouthernCaliforniaKeckSchoolMedicine, Center, Torrance, CA, USA Los Harbor-UCLAAngeles BiomedicalResearchInstituteat Medical University ofCalifornia, SanDiego, CA, USA ± Among 152subjectsincluded, themean TFV-DP concentration 694, 1356 ± CCTG 595isa48-weekRCTtestingiTAB topromotePrEP 558fmol/punch. Participants reportedtakingameanof 2 PrEPeffectivenessisstronglylinkedtoadherence. We Early adherencetoPrEPwashighamongiTAB users. , MichaelDube 4 Correlate WithTenofovir-Diphosphate Text MessagingResponses , SheldonMorris

(presenting) ± 484and1167 3 , Jason Young, 1 , Moore David 1 , RichardHaubrich ± 495fmol/punch, respectively. 1 , Sun Xiaoying 1 , SoniaJain 1

1 , 1

- - - - POSTER ABSTRACTS 97 98 147

and transportation assistance may mitigate barrierstocare. assistancemaymitigate and transportation onhealthcarecoverage,individuals withinformation stigmareduction maypresent.al settingswheresickpatients After HIVtesting, providing moting routine, freeHIVtestingtoincrease accessibilityinnon-tradition Conclusions: incare(17versus5%,incentive forengaging p=0.05). were infected(50versus16%, asan p<0.001)andcitedtransportation cost. HIV-positive individualswereconcernedaboutpeoplethinkingthey toaccesscareand how were similarwithbothgroupsnotknowing routine medicalcareasreasonsfortesting. Barrierstoaccessingcare individuals mostfrequentlycitedunprotectedsex, freetestingand often duetoillness(20versus5%, p=0.017), whereasHIV-negative sex (91versus60%, p<0.001). HIV-positive individualstestedmore viduals reportedmoreSTIs(66versus33%, p=0.003)andcondomless insured(45versus3%,and wereprivately p<0.001). HIV-negative indi versus 50%, p=0.001), (53versus84%, hadmoreeducation p<0.001) HIV-negative individualsmoreoftenlivedintheUStheirwholelives(83 HIV-negative and-positiveindividualswas3536years, respectively. All subjectsweremaleexceptfor1HIV-positive female. of The meanage Results: individuals. tests wereusedforcomparisonsbetweenHIV-positive and-negative demographic, data. socioeconomicandriskbehavior Chi-square POSTERcare orPrEP. SubjectscompletedaniPad-based questionnaireincluding toeitherHIV search-centered testingsiteacceptassistancewithlinkage aUniversity-basedER,tested at localhealthdepartmentorre Methodology: HIV-positive andhigh-riskHIV-negative individuals. ofnewlydiagnosed thetimeoflinkage riskfactorsat and behavioral in thecarecontinuum. We exploreddemographics, healthcareattitudes tions remainsstable. Testing tocarearecriticalinitialsteps andlinkage Background: ABSTRACTS4 3 2 1 Richard Haubrich Kelly Walsh Jill Blumenthal Tested forHIVinNon-Traditional Settings University ofSouthernCalifornia, Los Angeles, CA, USA Los Angeles, CA, USA University ofSouthernCaliforniaKeckSchoolMedicine, Center, Torrance, CA, USA Los Harbor-UCLAAngeles BiomedicalResearchInstituteat Medical University ofCalifornia, SanDiego, CA, USA Of118individuals, 88wereHIV-negative and30HIV-positive. 1 , EricEllorin Our findings support the National HIV/AIDS Strategy pro HIV/AIDSStrategy OurfindingssupporttheNational DespiteadvancesinHIVpreventionandcare, newinfec CCTG593examineswhetherindividualsrecentlyHIV

Attitudes inIndividualsRecently Barriers toLinkageandHealthCare (presenting) 1 , Jacobson Kathleen 1 , MichaelMenchine 1 , SoniaJain 4

1 , Corado Katya 3 , MichaelDube 2 , Sun Xiaoying 3 , -

10th International Conference on 10th International - - 1 - , - 148 may allow formoreforgivenessinregardstoadherence. may allow resistance, lesstoxicitiesthanpreviouslyusedregimens. andhave This regimensaremorepotent,current medication ahigherbarrierto have forsuccess. >95%adherenceisnecessary that However,showed of thevirus. Previousstudies, usingunboostedproteaseinhibitors, isconsideredessentialforsuppression therapy adherence tomedication disease. toamanageable transformed HIVinfectionfromafatal Strict Background: 3 2 1 Mishra Arya Jacob Langness Academic OutpatientMedicalClinic successful treatment and overall patient health. andoverallpatient successful treatment line. Patients shouldcontinuedtobecounseledonadherencesupport cessful” adherencemaynotbeafirmnumber, butmore ofagradual viral suppression, the95%cutofffor suggeststhat butthisstudy “suc Conclusions: based regimens. regimens, proteaseinhibitorbasedregimens, andintegraseinhibitor true acrossnon-nucleoside reversetranscriptaseinhibitor(NNRTI) based had a69.4%ofbeingvirologicallysuppressed. These resultsremained (96.2%), OR=0.95, p=.92. Patients whowerelessthan80%adherent significantly whenweincluded whowere patients had suppressedvirus. Interestingly, didnotchange thispercentage ing intoaccountadherence, whowere 95.8%ofpatients (90%) hadsuppressedvirus(HIVviralload Results: were included. least6months) whowerestableontheirregimen(onforat patients fillinthe120dayspriortoviralload.30-day medication Only using pharmacy filldata.at leastone wererequiredtohave Patients covered (PDC)wasusedastheadherencemeasurementandcalculated pharmacy withinanacademicmedicalcenter. The proportionofdays infectiousdisease at anoutpatient filling the HIVviralloadsofpatients Methodology: Pharmaceutical Sciences, Aurora, CO, USA SchoolofPharmacyUniversity ofColoradoSkaags and University ofColoradoSchoolNursing, Aurora, CO, USA University ofColoradoHospital, Aurora, CO, USA Overall 308 patients wereincluded Overall308patients inthisanalysisand277 3

isessentialtosuccessful Adherence toHIVmedication Highly active antiretroviral therapy (HAART) Highlyactiveantiretroviraltherapy has This single-centerretrospectiveanalysisinvestigated Adherence andViral Loadin Analysis ofHIVMedication

(presenting) HIV Treatment andPreventionAdherence 1 , Paul Cook ≤ 2 , StevenJohnson 200 copies/mL). When tak ≥ 80% adherent ≥

95% adherent 1 ,

- - 149 10th International Conference on 10th International more researchisneededtostronglysupportthisfinding. NNRIs orboostedPIsareless “demanding” intermsofadherence. However levels ofadherenceclose to100%, butitappears, HAART that regimenswith Conclusions: HAART adherence lessthan95% a levelof A of100%. alevelof (39.6%)have A totalof111patients Results: wereanalyzed. those patients 100%, 99-95%, 94-90%, 90-80%and<80%. The HAART regimensof accordingtotheirdrugrefillpercentage:divided intofivecategories with 280 patients VL <50copies/mLwerereviewed. were The patients Buenos Aires, Argentina. The Pharmacy recordsoftheyear2013 Methodology: viral load(VL)<50copies/mL. macy drugrefills)andtheHAART with regimensinagroupofpatients The aimofthisworkistodescribetheamount A (measuredbyphar about theamountof success. toachievetreatment wasnecessary A that resistance, limitingtheeffectivenessoftherapy. There wasuncertainty ence toHAART failureandthedevelopmentofdrug willleadtotreatment consequence inpeoplelivingwithHIV/AIDS. Nevertheless, pooradher Background: 1 Maria Morales Load <50copies/mL Regimens inaGroupofPatients WithViral Hospial RamosMejia, Buenos Aires, ARGENTINA . Only 11 patients (less than 4%) have athird-lineHAART (lessthan4%)have regimen Only 11patients More than a half of patients with Morethanahalfofpatients VL <50copies/mL, have As referredbybibliography, thebestresultsareachievedwith High active antiretroviral therapy (HAART) Highactiveantiretroviraltherapy hasapositive HospitalRamosMejia, carriedoutat A retrospectivestudy

Adherence andtheHAART Description oftheAmount (presenting) , among them 65 (58.6%) have aNNRTIamong them65(58.6%)have intheir 1

, Javier ToibaroJavier , HIV Treatment andPreventionAdherence 1 , MarceloLosso 1

- - . 150 7 6 5 4 3 2 1 Donald Patrick Michael Mugavero Kari Alperovitz-Bichell Cristina Gutierrez Melonie Walcott Rob Fredericksen for MultipleChronicCo-Morbidities highly specified to patients’ needs. highly specifiedtopatients’ are that strategies reasons fornon-adherencemayinformintervention offood.and availability Systematic, ofpatient-reported routinecapture cluding depressivesymptoms, difficultyacceptingillness, lackofprivacy, resources,tially addressablewithmentalhealthorcasemanagement in Conclusions: withdrugsoralcohol(6%). cations enough privacy (6%), (6%), nofoodavailable ofmixingmedi avoidance taste(7%),to swallow/bad (6%), feltwasontoomuchmedication not (9%), feelingsick/ill(9%), (8%), didnotthinkneededmedications hard not wantingtoberemindedofillness(9%), changeindailyroutine effects (33%), feelinghopeless/depressed (13%), beingbusy(12%), Results: language. American, and22%Latino, and14%spokeSpanishastheirprimary ofnewitems.for creation Participants were36%female, 38% African method. toitempoolcontentwereevaluated didnotmatch Excerptsthat in whichitemswerecodedintothe8barrierareasusingsame tothecontentofapreviouslydevelopedadherence itempool matched team memberreconciledcodingdifferences. excerptswere Interview and transcribed, thencodedbytwocodersinto8barrierareas. A third ininterviews. wereaudio-recorded $25 forparticipating Interviews clinics (Birmingham, AL; SanDiego, CA;Seattle, WA). Patients received (Baltimore, MD;Ridgeland, SC;Boston, MA)andthreeHIVoutpatient English andSpanishspeakersfromthreecommunityhealthclinics sants, moodstabilizers, antipsychotics, osteoporosis. We interviewed (cholesterol/lipids), diabetesmedications, anticonvulsants, antidepres classes: antiretrovirals, antihypertensives, cardiovascularmedications medication prescribed1ormoreofthefollowing with 218patients Methodology: severeillness ordeath. adherence inordertoavoid forconditionsdependentonhigh treated herence amongpatients Background: Georgia RegentsUniversity, Augusta, GA, USA Chase BrextonHealthServices, Columbia, MD, USA Ridgeland, SC, USA Beaufort JasperHamptonComprehensiveHealthServices, Fenway CommunmityHealth, Boston, MA, USA University of Alabama, Birmingham, AL, USA University ofCaliforniaSanDiego, SanDiego, CA, USA University of Washington, Seattle, WA, USA Top reasonsforintentionalnon-adherencewere: side toavoid We soughttodiscover reasonsforintentionalnon-ad Many reasonsforintentionalnon-adherencewerepoten Many 1 We conducted one-on-one in-depth qualitative interviews We interviews conductedone-on-onein-depthqualitative , HeidiCrane Adherence AmongPatients Treated Reasons forIntentionalNon- 3 , Lydia Dant 4 , Anna Church , Anna 3

, KennethMayer (presenting) 6 , Frances, Yang 1 4

, SharonBrown 1 1 , MonicaGodfrey , ToddEdwards 4 , ChrisMathews 7 , JaneSimoni 1 , StephanieLoo 1 , EdgarPaez 5 , AlexWang 1 , James Willig , 2 , Paul Crane 4 , 2 6

, ,

1 3 , , -

- - - - POSTER ABSTRACTS 99 100 151

pills ortheirvisualrepresentations. of eachmedication’s purpose, whichideally wouldoccurwiththeactual assessmentofadherence.systematic Patients maybenefitfromareview for andnecessary isimportantforeffectivecommunication medications Conclusions: inquestionwereforseriouschronicconditions). medications (11%) couldnotidentifyamedication’s purpose(in4ofthesecases, the or confused “blood pressure” and “cholesterol” medications. Sixpatients “blood pressure” or “cholesterol” werenot;25%oftheseconflated that fied. In36%ofthese, asbeingfor mistookmedications patients “heart”, 33misconceptionswereidenti about oneormoreoftheirmedications; ning meds”). leastonemisconception hadat Onethird(37%)ofpatients ortimeofdaytaken(“morning/eve methods werebydiseasecategory more difficultynamingindividualmedications. Commoncategorization class, onantiretrovirals. particularlypatients Patients onmedi-setshad withina “HIV meds”)anddidnotdistinguishbetweenmedications (i.e., bydiseasecategory overwhelmingly referredtotheirmedication Latino, 21%Spanish-speaking, and60%livingwithHIV. Patients Results: usingopencoding.category Inter-rater reliabilitywashigh. and perceivedfunctionofmedications. foreach Sub-codeswerecreated werecodedforthemesincludinginterviews identification, categorization, ics (Birmingham, AL; SanDiego, CA;Seattle, WA). With contentanalysis, (Baltimore, MD;Ridgeland, SC;Boston, clin MA)andthree HIVoutpatient both EnglishandSpanishspeakersfromthreecommunityhealthclinics stabilizers, antipsychotics, osteoporosismedication. We interviewed lipids), diabetesmedications, anticonvulsants, antidepressants, mood tiretrovirals, antihypertensives, (cholesterol/ cardiovascularmedications classes: medication prescribed3ormoreofthefollowing patients an Methodology: POSTER purpose. andtheirunderstandingofmedication medications for multiplechronicconditionsincluding referredtotheir patients how Background: 7 6 5 4 3 2 ABSTRACTS1 Paul Crane Michael Mugavero Kari Alperovitz-Bichell Anna Church Edgar Paez Rob Fredericksen Morbidities Patients Treated forMultipleChronicCo- Georgia RegentsUniversity, Augusta, GA, USA Ridgeland, SC, USA Beaufort JasperHamptonComprehensiveHealthServices, Chase BrextonHealthServices, Columbia, MD, USA University of Alabama, Birmingham, AL, USA University ofCalifornia, SanDiego, CA, USA Fenway CommunmityHealth, Boston, MA, USA University of Washington, Seattle, WA, USA Participants were40%female, 29% African-American, 22% 1 3 , DonaldPatrick , Melonie Walcott, 1 , SharonBrown Understanding how patients labelor thinkabouttheir patients Understanding how We literacy assessedthemedication treated ofpatients We with58 conductedone-on-onein-depthinterviews Medication UnderstandingAmong Qualitative Assessmentof 4

, KennethMayer (presenting) 5 , Frances, Yang 1 , HeidiCrane 4 1 , CristinaGutierrez , AlexWang 1 , ToddEdwards 2 , ChrisMathews 7 , James Willig , 1 5

, MonicaGodfrey 2 1 , StephanieLoo , Lydia Dant 4 , 3 , JaneSimoni

6 ,

2 ,

2 , 10th International Conference on 10th International

1 ,

- - - - 152 ART. indecen wastoexplorecostimplication The aimofthestudy testing andreceivingresultsonthesameday, of hencetimelyinitiation healthcarefacilitiesispossibleandmayleadtoCD4 testing toprimary tohealthfacilities.present late IntroductionofPoint-Of-Care (POC)CD4 (ART)Therapy iscosteffectivebutthemajorityofHIV-positive individuals assessment insub-Saharan Africa. on Earlyinitiation Antiretroviral are lostfromcarebeforecompleting Antiretroviral medicineseligibility Background: 1 Hiltruda Temba Njombe Regions in Tanzania-Case StudyinIringaand Technology HealthCareFacilities inPrimary of-Care CD4Testing UsingAlerePima affordable inlimitedresourcecountries. inordertomakecostperCD4testmore cartridge needstobelowered of initiation ART forimprovedhealthoutcomes. The highcostofthePIMA care facilitiesisfeasibleandcanbeexpectedtocontributeearly Conclusions: test. total unitcostperCD4testandhencethemaindriversof specific suppliesandqualityassuranceconstituted53%30%ofthe constituted 53%and30%ofthetotalunitcostperCD4test. PIMA inIringa.US$ 15.75fordispensary andqualityassurance PIMAreagents 12.19 forhealthcentreinIringa, inNjombeto US$14.78fordispensary respectively; rangingfromUS$11.02forhealthcentreinNjombe, US$ level healthcenteranddispensary isUS$11.60and15.26at ogy Results: into 2012prices. cility inIringaandNjomberegions Tanzania. All priceswereconverted healthcarefa establish unitcostperPoint-Of-Care primary CD4testat peer reviewedliterature. tocostingwas usedto Micro-costingapproach Methodology: in Tanzania.facilities tralizing Point-Of-Care Alere PIMACD4 Testing HealthCare inPrimary Ministry ofHealthandSocial Ministry Welfare, DaresSalaam, TANZANIA unitcostperCD4testusing Average Alere PIMAPOCtechnol Decentralization of POC CD4 testing to primary health ofPOCCD4testingtoprimary Decentralization Fifty tobeHIV-positive percentofindividualsdiagnosed Relied on secondary data byreviewingboththegreyand data Reliedonsecondary Diagnostics: CostingofPoint- Expanding AccesstoHIV

(presenting) HIV Treatment andPreventionAdherence 1

- - - 153 10th International Conference on 10th International engagement. withpoorHIV treatment targetingpatients as partofinterventions applications approach mayhave theassessment findings suggestthat assessmentapproach.was feasibleasapatient-centered Inaddition, Conclusions: andadherence. initiation as barrierstotreatment orserved particularthoughtseitherfacilitated how mapped figurations andbehaviors. motivation tospecifictypesoftreatment related Thecon anindividualpatient’s depictedhow that thoughtsandbeliefswere = 39;range137to253). two-dimensionalconfigurations MDSgenerated Results: behaviors. beliefs affectedtreatment-related anindividualpatient’sconducted toexaminehow specificthoughtsand and extrinsicmotivation. Multidimensionalscaling(MDS)analyseswere toapproach, related well asdescriptivestatements avoidance, intrinsic, the similarityofallpossiblepairingstheirthoughtsandbeliefsas viewers. Usingtheweb-basedassessmentprogram, participantsrated inter thoughtsandbeliefswereelicitedfromparticipants by study lated hospitals. twoChicago forHIVcareat follow-up A rangeoftreatment-re Methodology: engagement. treatment withpoor amongpatients motivation hensive assessmentoftreatment patient-centered, designedtoprovideacompre web-basedapproach needs oftheindividualpatient. wastotesta The purposeofthisstudy tailoredtothe andaidinthedevelopmentofinterventions population andbarriersformembersofthispatient facilitators on specifictreatment upforcare.lost tofollow Suchassessmentscouldprovideinformation amongpatients motivation the individual-levelassessmentoftreatment prevent theonwardtransmissionofHIV. Littleresearchhas focused on major challengefacingeffortstoimproveindividualhealthoutcomesand Background: 4 3 2 1 Williams Maryanne Eric Houston(presenting) HIV Care Among Patients LosttoFollowUpfor HIV CareProgram, Chicago, IL, USA Mercy Hospital&MedicalCenter, Chicago, IL, USA Mt. SinaiHospitalMedicalCenter, Chicago, IL, USA Illinois Instituteof Technology, Chicago, IL, USA Participants (SD comparedameanof188pairedcombinations Findings showed that the web-based approach usingMDS theweb-basedapproach Findings that showed Retaining patients livingwithHIVinmedicalcareisa Retainingpatients whowerelostto The sampleconsistedof18patients for AssessingTreatment Motivation A Patient-Centered Approach 4 , Nancy Glick 1 , Brenda Wolfe, 2

HIV Treatment andPreventionAdherence 2 , NormaRolfsen 3 ,

- - - - 154 2014 within40randomlychosen ART healthfacilities;wedidasecond Methodology: program.treatment among asamplednumberofHIV-positive mothersenrolledincareand comparedtoadults,coverage ofthisgap weassessedthemagnitude EPis Spectrumestimates, alow childrenunder15yearsoldhave ART of93.5%(annualreport)asJune2014. coverage usingUNAIDS resultinginto services HIVfullpackage facilities acrossRwandahave ofHIVservices, andintegration morethan90%health decentralization Background: 1 Nadege Umuhoza Program inRwanda Currently EnrolledinHIVCareandTreatment the community. programsandin mothers currentlyenrolledinHIVcareandtreatment shouldbeimplementedtoimprovetestingforchildren of strategies of 50% gap.number islessthantheestimates These findingssuggest althoughthis testingstatus; childrenwithunknown have mothers that Conclusion: 15.9% werepositive. respectively. Among 249childrentestedreportedbytheirmotherforHIV didn’t , ofwhich10.1%;3.5%;1.7%hadone, twoandthreechildren child lessthan15years;84.7%reportedtotestallofthemand15.3% was 4;,Among364women, leastone at 288(79.1%)reportedhaving Results: proportion ofchildrenwhomissedtheopportunityforHIVtesting. amongthoselessthan15years.HIV testingstatus We the estimated in lifeandafterHIVdiagnosis, numberofchildrenunder15years, and oral interview, participantswereaskedregardingnumberofpregnancies analysisamong364HIV-positiveary women, 15-63yearsold. Through Rwanda BiomedicalCenter, Kigali, RWANDA Overall, The mediannumberofpregnanciesamongoursample This analysis revealed a gap of15.3% amongHIVinfected This analysisrevealedagap Rwanda hasmadetremendousimprovementinthe From conductedin HIVdrugresistancemonitoringsurvey Amongst ChildrenofMothers Pediatric HIVCaseFinding

(presenting) 1 , NdahimanaJeand’Amour 1

101 POSTER ABSTRACTS 102 155

deadly co-infectionneedsmoreattention. on ART freeof TB longershouldbelookedinto. giventothe The attention from the riskofdeath TB decreases. Treatment optionstokeeppatients evenwith infected patients ART. stayfreeof Ifpatients TB longer, then occurs earlyinthecourseofHAART) increasesthemortalityamongHIV Discussion: ART treatment, theriskdecline by3%(95%CI0.95-.99)eachmonth). ofactive to thediagnosis develops TB (whenapatient intheir TB later withtheHRgoingupby4%(95%CI1.00-1.08)),being associated time startof at wereage population ARTin thestudy (with1yearincrease = 2.77;95%CI: 1.86-4.12). ofmortality Othersignificantdeterminates significant(AdjustHR characteristics theHazardstillremainsstatistically no who have TB. After adjustingforbaselineclinical anddemographic (crudeHR=3.9095%CI:risk ofdeath 2.33-6.54)comparedtothose Patients whodeveloped TB whileon ART hadsignificantlyincreased tified resultingin TBincidenceof2.5[2.3-2.8]per100person-years. participantsatotalof355incident Among thestudy TB caseswereiden Hence, collectedfrom4,026wasincluded information inthispaper. Results: with TB andthosewithout TB. mortality werecomparedusingtimeon ART andbetween ART patients amongsites. characteristicsofpatients mographic Incidenceof TB and POSTERwas usedtoassesshomogeneityintermsofbaselineclinical andde astimedependentvariable.participants wastreated test Breslow-Day couldpotentiallybeoverrepresented.survivors ofthestudy TB status Those whostarted ART after wereexcluded,TB treatment becausethe who developed TB afterstarting ART wereincluded participants. asstudy Methodology: involves7universityhospitalsitesinEthiopia. that study thesevenadvancedclinicalat monitoring(ACM) – amulti-sitecohort ofthe vival anddeterminantsofsurvival TB/HIV co-infectedparticipants total TB casesareamongPLHIV. Inthisstudy, weintendtoexaminesur ABSTRACTSPLHIV accountsforonly0.5%oftheworldpopulation, yet13%ofthe more than1.1million(13%)werepeoplelivingwithHIV/AIDS(PLHIV). HIV/AIDS. According to WHO, ofthe9.0millionnew TB casesin2013, tion alone. TB remainstobeamajorillnessamongpeoplelivingwith risk ofprogressingtoactive TB diseasethanpeoplewithlatent TB infec Background: 1 Alula Teklu on HAART MERQ, AddisAbaba,ETHIOPIA 4,328 patients were followed foramediantimeof1,710days. werefollowed 4,328patients

(presenting) The findings of this study revealthatThe findingsofthisstudy TB(especiallywhenit People withHIVandlatent muchhigher TB infectionareat inwhichallHIVpatients A prospectiveacohortstudy Mortality ofHIVPatients whoare TB isStillaKeyDeterminantinthe 1 , Abiy Nega , Abiy 1

10th International Conference on 10th International - - - - 156 Michael Hager Initiative Cross-Part CareContinuumCollaborative five states (Arkansas,five states Mississippi, Missouri, NewJersey, Ohio), impacting Ryan granteesin (H4C) hasengaged White HIV/AIDSProgram(RWHAP) Methods: groups isafocusinthisimprovementactivity. work forandclosing disparitiesinperformanceamongkeydemographic provideaframe NHAS andthePresidentialCareContinuumInitiative state.dence-based qualityimprovementprojectsineachparticipating ofevi along theHIVContinuumofCarethroughimplementation Background: 2 1 will be invited to participate inH4Cactivities. will beinvitedtoparticipate granteesfromotherstates areemphasizedandRWHAP across states learning sessions. withinand Opportunitiestomaximizerapport-building collection,improvement strategy regionalparticipanttraining, andvirtual 2015, include sustainabilityplansarebeingdraftedthat and data Conclusions: ing overtime(ns). beensteadilynarrow groups have performance betweendemographic aims (i.e., infrastructuresinplace). qualitymanagement allhave in Gaps (88%, n=602PLWH achieving VLS). Overall, H4Chasmetkeynational mid-point oftheinitiative, metits hasalready onestate VLS cohortgoal improvement inperformancealongtheHIVContinuumofCare. Bythe Results: face-to-facelearningsessions. ed anddiscussedat collected. arecollect implementedineachstate Improvementstrategies Care Continua, areroutinely andviralloadsuppression(VLS)cohortdata to implementH4Cactivities. Performance measurement(PM)data, HIV 33,905 peoplelivingwithHIV(PLWH). hasaleadershipteam Eachstate Organizational Ideas,Organizational Blacksburg, VA, USA QualityCenter,National New York, NY, USA Learning collaboratives are an effective way to accelerate areaneffectivewaytoaccelerate Learning collaboratives Since 2014, theHIVCross-Part CareContinuumCollaborative To frameworkbeyond ensurelongevityofthecollaborative This national initiative seeks to reduce statewide gaps gaps seekstoreducestatewide initiative This national

Achieve theEndofAIDS-HIV Collaborating AcrossStatesto (presenting) HIV Treatment andPreventionAdherence 1 , ClemensSteinbock 1 , LoriDeLorenzo - 2

- - - 157 10th International Conference on 10th International monitoring. busy clinic routine, shouldbeimplemented tocomplementadherence suppression. The mostuser-friendly adherencemeasure, bestfittinginto assessment on VAS weresuperiorto3-dayrecallinpredictingviral Conclusions: (p <0.001), and3-dayrecall[AUC0.52, 95%CI0.48…0.56](p<0.001). pared topatient’s self-assessment VAS (AUC0.70, 95%CI0.65…0.75) physician’sfor treating VAS report(AUC0.82, 95%CI0.79…0.86), com (AUC)forpredictingundetectableviralloadwaslarger the ROC-curve VAS-report onpatient, and55%by(undetectable)viralload. Area under 3-day recall, self-report 52%bypatient VAS, physician 56%bytreating use), andon 3.1years.ART foraverage Highlyadherentwere74%by drug 8.3years(49%ofthemthroughintravenous infected foraverage Results: istic (ROC)curve. character theareaunderreceiver operating bycalculating evaluated measure topredictviralsuppression(HIV-RNA <40copies/ml)was cian-reported VAS weredefinedasadherent. Abilityofeachadherence Patients withadherenceof95%by3-dayrecall, andphysi patient- 0 and100%, correspondingtotheproportionofprescribeddosestaken. physician.adherence bytreating The VAS representedalineanchoredby [3-day recall, visualanaloguescale(VAS)], and VAS reportonpatient clinics inEstonia. Adherence wasassessedby2self-reportmeasures carein2largestHIV receivingout-patient among 512adultpatients withviralsuppression measures ofadherenceandtheirassociation Methodology: practicalimportance. instruments tomeasureadherenceareofgreat comprises adheringtothetreatment. Easytoimplement, validandcheap reached2ofthe3milestones,(ART) already have fullHIVcontrolalso ment targethasbeensetfor2020. While PLWHA onantiretroviraltherapy Background: 2 1 Liis Lemsalu Kaja-Triin Laisaar in Estonia National InstituteforHealthDevelopment,National Tallinn, ESTONIA Department ofPublicHealth, Universityof Tartu, ESTONIA Study participantswere60%male, Study 34years, meanage 2 , LiiliaLõhmus Treating physician’s andpatient’s adherence(self) To endtheHIV/AIDSepidemic, anew90-90-90HIVtreat multipleindirect evaluated This cross-sectionalstudy Adherence inClinicalCareSettings Therapy Measuring Antiretroviral

(presenting) 2 , Anneli Uusküla , Anneli 1 , MaitRaag HIV Treatment andPreventionAdherence 1 1

, KristiRüütel 2 ,

- - - - analyze theeffectofmultiplepsychosocialconditionsor “a syndemic” on substance use, andHIV-related stigma. wasto The purposeofthisstudy to multiplepsychosocialfactors, including mentalhealthproblems, theiradherenceissuboptimalandrelated regard asevidenceindicates transmission. inthis HIVinfectedyouthareanimportantpopulation is criticalgivenitsimpactonlimitingdiseaseprogressionandonward Background: 3 2 1 John Schneider Abigail Muldoon Lisa Kuhns Adherence AmongHIV-Positive Youth treatment aspreventionforyouthlivingwithHIV.treatment syndemic conditionsarelikelyrequiredinconcertwithbiomedical adherence amongHIV-positive youth. address multiple that Interventions betweenmultiplepsychosocialconditionsandmedication relationship Conclusions: 0.02). increasing numbersofsyndemicconditions(lineardoseresponse, p= correlations. Inadjustedregressionanalysis, adherencedecreasedwith of clustering tohigh ofpsychosocialconditionswithsignificantmoderate levels ofHIV-related stigma. analysis, Incorrelational therewasevidence orhighalcoholuse.and 25%amoderate A totalof46%reportedhigh levelofmarijuanause amoderate/high were characterizedashaving reported ahighlevelofdepressivesymptomsand34%anxiety. 25% infected(91%).(87%) andbehaviorally Among theoverallsample, 38% ofparticipantswas24withthemajoritybeingmale(89%),age Black Results: well asenrollmentsite. social conditions, factorsas andtreatment controllingfordemographic Adherence wasregressedonanindexofincreasingnumberspsycho alcohol use, andHIV-related stigma)onself-reported ART adherence. conditions (i.e., depressivesymptoms, anxietysymptoms, marijuanause, 16-29, wereanalyzedtoassesstheeffectofmultiplepsychosocial targetingHIV-positive inChicago youth,adherence interventions aged Methodology: (ART)antiretroviral therapy adherenceamongHIV-positive youth. University ofChicago, IL, USA County, Chicago, IL, USA Division ofInfectiousDiseases, JohnH. StrogerHospitalofCook Lurie Children’s, Chicago, IL, USA 158 Data from212HIV-positive Data youthwereanalyzed. The mean

(presenting) This isoneofthefirststudiestodocumentevidence ofthe Medication adherenceamongHIVinfectedindividuals Medication Cross-sectional data fromtheenrollmentvisitfortwo Cross-sectionaldata 3 1

, Jaffe Kate Associated WithMedication A SyndemicIndex is 1 , Anna Hotton , Anna 3 , Alida Bouris , Alida 2 , RobertGarofalo 3 , Dexter Voisin, 3 1 , ,

103 POSTER ABSTRACTS 104 159

women-centered HIVcareandsupportservices. subgroups. Emphasisshouldbeplacedonproviding betteraccessto vulnerability tosuboptimal ART adherencethanmen, overallandwithin Conclusions: people whodonotinjectdrugs(AOR: 0.41, 95%CI: 0.27to0.46). use injectiondrugs(AOR: 0.56, 95%CI: 0.39to0.80)andnon-Aboriginal 0.43 to0.66)andamongsubgroups, including Aboriginal peoplewho [AOR]: (adjustedoddsratio population 0.53, [CI]: 95%confidenceinterval withsuboptimaladherence,tained anassociation withinthetotalstudy p <0.001)andpersubgroup. models, Inmultivariate womenmain optimal ART adherence, withintheentiresample(54.3%versus76.3%; of54months,erage attained proportionofwomen asignificantlylower Results: andethnicity.drug usestatus in ART adherence. Sub-analysescomparedmenandwomenbyinjection models withlogisticregressionwereusedtoexaminetheroleofgender onwards.of therapy analysesandgeneralizedlinearmixed Bivariate based onpharmacy refillcompliancepersix-monthperiodfrominitiation between 2000and2011. Optimal ART adherencewasdefinedas POSTER andResearch(HOMER)cohort,Medical Evaluation collection withdata British Columbia(BC), Canada, enrolledintheHAART Observation Methodology: confounders,for known ethnicityandinjectiondruguse. optimaladherencewithlong-term in attaining ART use, whilecontrolling (ART) adherence. We toexaminegenderdifferences undertook thisstudy with HIV, including higherprevalenceofsuboptimalantiretroviraltherapy vulnerability topoorHIV-related healthoutcomesamongwomenliving resultinvulnerabilitytoinfectionamongwomenmay that lence ofHIVamongwomen. The samegenderandstructuralinequities ABSTRACTSBackground: 2 1 Angela Kaida Cathy Puskas Based CohortofHIV-Positive Individuals Longitudinal StudyWithinaPopulation Vancouver, BC, CANADA British ColumbiaCentreforExcellenceinHIV/AIDS, Simon Fraser University, Burnaby, BC, CANADA Of3,612individuals, 718(19%)women, foranav followed 1 Women livingwith HIVinBC, Canada, greater areat The pastdecadehasseenaglobalincreaseinthepreva , CariMiller sampleconsistedofHIV-positiveThe study adultsin

(presenting) Understanding Adherence:A The ImportanceofGenderin 1 , RobertHogg 1 , Salters Kate 2

2 ,Zhang Wendy

2 ,

10th International Conference on 10th International - ≥ 95%, - - 160 Danielle Osowski Methodology: assessed. intheclinicof universalscreeningsonsubstanceusebehaviors was of routinecareinaninfectiousdiseaseclinic inColorado. The impact ofsubstanceuse,early identification SBIRT wasimplementedaspart and reducedependenceontobacco, alcoholandotherdrugs. To increase and Referralto Treatment aimstoidentify (SBIRT) that isanapproach and adherencetoantiretroviraltherapy. Screening, BriefIntervention, outcomes,poor HIVtreatment including ofretentionincare rates lower ofsubstanceuse. higherrates HIV have Leftuntreated, thiscanresultin Background: 2 1 Steven Johnson changes inreportedtobacco, alcoholanddruguse. withmodest providedinanHIVcaresettingareassociated services most reportedsubstancesinourclinic. SBIRTThe resultssuggestthat Conclusions: among patients, withlessthana1%refusalrate. to 2%inmenand3%women. werewellreceived The interventions men. Tobacco usefellby3%. Alcohol UseDisordersdroppedfrom4% reductionsinallsubstanceuse,showed exceptcannabisuseamong decrease inpositiveSBIRT screens(53%comparedto49%). Results in Year 2. from Data Year a14% 1and2werecomparedshowed Results: specialty treatment. one ofthreeinterventions: briefintervention, brieftherapy, orreferralto ASSIST wasadministered. Dependingonthescore, received patients screensreceivedpositivereinforcement.with negative Ifpositive, the 2014.April SBIRT screeningwasofferedannuallytoallpatients. Patients Colorado Hospital. Two werecollectedfromMay2012to yearsofdata theUniversityof at 1,700patients HIV clinic approximately serving Colorado and AIDS Education Training Center, Aurora, CO, USA University ofColoradoHospital, Aurora, CO, USA In Year 1, werescreenedversus1,210patients 875patients ofuseforthe ustoseetherate This analysisallowed Comparedtothegeneralpopulation, peoplelivingwith This isaretrospectiveanalysisofSBIRT resultsinan HIV Clinic Impact ofanSBIRT Programinan 1

(presenting) HIV Treatment andPreventionAdherence 1 , JacobLangness 1 , LisaLawrence 2 , 162 10th International Conference on 10th International HIV carebutmayneeddistinctinterventions. suppression. Bothgroupsofreferredclients hadhighneedsforaccessto levelsofcareandviralload referralhadlow the timeofre-engagement Conclusions: RR: 1.5995%CI: 1.05, 2.42). only clients withcaremarker: transitioning=46%, continuing=29%; = 27%, continuing=15%;RR: 1.8395%CI: 1.14, 2.91;Restrictedto continuity clients duringtheyearpriortoreferral(Allclients: transitioning ed). Clientsreportingtransitionsincarehadhigherlevelsof VLs vs. when restrictedtothosewithamarkerofcare(36%, missing=exclud 95% CI: 0.93, 1.42). VLs, in12mpriortoreferral, even low wasvery continuity clients hadsimilarmarkersofcare(58%vs. 51%;RR:1.15 incomplete (n=118, 24%). Priortothereferral, transitioningclients vs. (n =177, (n=90, 36%);werenotlocated 18%)orrecordswere the clients reportedtransitionsincare(n=112, 23%);notransitions can (n=377, 76%);heterosexual(n=234, 47%). At thetimeofcontact, Results: (VLs, HIVRNA<200copies/ml). for caremarkers(aCD4orHIVRNAperformed)viralloadsuppression incompleterecord. (eHARS)wereused 4) having data HIVsurveillance or Continuing care(noevidenceofanothersite)3)unabletolocate withanewprovider);2) orre-engaging a caretransition(relocating future medicalappointment. as1)having Outcomeswerecategorized as outofcarebymedicalclinics, i.e., withoutbothrecent(>6-9m) and BridgeCounselors, team(State health service SBCs)toPLWH identified Methodology: June 2014. transitions, fromJuly2013to referraldata weanalyzedre-engagement betweenpriormarkersofcareand determine theassociation and/orchangeproviderswithdisruptionsincare.need torelocate To Background: 4 3 2 1 Jacquelyn Clymore Arlene Sena Evelyn Quinlivan at theReferringMedicalClinic Those whoRelocateandRemain for Referred forHIVRe-EngagementServices Wake Forest UniversitySchoolofMedicine, Winston Salem, NC, USA Duke University, Durham, NC, USA Raleigh, NC, USA North CarolinaDepartmentofHealthandHumanServices, University ofNorthCarolina, Hill, Chapel NC, USA Re-engaging clients Re-engaging weremale(n=349, 71%); African-Ameri 1 , Amy Heine , Amy Clients with both care transitions and care continuity at Clientswithbothcaretransitionsandcontinuityat People livingwithHIV(PLWH) frequentlyexperiencethe Re-engagement services wereprovidedbyapublic services Re-engagement Suppression AmongIndividuals Low LevelsofViral Load

(presenting) 2

1 , CynthiaGay 1 , JennaDonovvan HIV Treatment andPreventionAdherence 1 , AimeeWilkin 2 , KristenSullivan 4 , TyffanyColeman

3 , - - 1 , 163 newly diagnosed HIV-positive on newly diagnosed pregnantwomenandthosealready for ofantiretroviraltherapy ofsamedayinitiation for implementation In accordance, the2014NamibianNational Treatment Guidelinescalled Introduction: 8 7 6 5 4 3 2 1 Okitemun lama Simbarashe Mpariwa Johnface Mdala in subSaharan Africa. make therolloutofOptionB+feasible ineventheremotestlocations ment, and do notrequireanHIVtrainednurseordoctortoinitiate Recommendations: clinics whereOptionB+hadbeenrolledout. ofcART from 100%penetration inpatients one regionalhospitalshowed regional, NIMART and>30outreachclinics. wardregistriesin Maternity Lessons Learned: 6. 5. 4. 3. 2. 1. to careforPMTCT. proceduresweredeveloped: operating The following and testingcounselorsaddressedtheurgentneedforimprovedaccess Description: northern Namibia. proceduresfromtworegionsofrural successful OptionB+operating roll outofOptionB+, particularlyinlargelyremotelocations. We present AZT PMTCT. Despitetheserecommendations, challengesremaintothe University ofSouthernCalifornia, Los Angeles, CA, USA Okongo DistrictHospital, Okongo, NAMIBIA Oshikango, NAMIBIA HealthCentreOdibo/AnglicanMedicalServices,Saint Marys Tsumeb District, Tsumeb, NAMIBIA Eehnana DistrictHospital, Eehnana, NAMIBIA DistrictHospital,Omuthiya Omuthiya, NAMIBIA Hospital,Engela State Engela, NAMIBIA Onandjokwe LutheranHospital, Onandjokwe, NAMIBIA Ill patients referredtonearestclinicIll patients priortocART Stable: 2weekvisit, follow-up chempanelordered, medsrefilled b. a. Urine dippedforprotein: Sent backto ANC nurse c. b. a. Referred totestcounselorfor: b. a. clinicPatient presentstoantenatal visitandeither: iii. ii. i.

>1+ protein pack ≤ Patient CareBookletopened Adherence counseling Post-test counseling Currently on AZT forPMTCT Test positiveforHIVoris HIV and specialtydoctors,Antenatal nurses, pharmacists 1+protein-begunon TDF basedcART, 2weekstarter In 2013 WHO recommendedOptionB+topreventMTCT. 7 Rural NamibiaAfrica Effective RollOutofOptionB+in 1 , , JacqueswaNsendaKamangu Kathleen Jacobson urgent referraltoregionalvisitandchempanel week starterpack current orprevious AZT- begin ABC basedcART, 2 starter pack no previous AZT -begin AZT basedcART, 2week In twomonthsOptionB+wasrolledouttothe proceduresareeasytoimple These operating 4 , GodwinZishumba

(presenting)

5 , RayMulangMwinMat 2 , Okore Ogbonnaya 8

6 , 3 , -

105 POSTER ABSTRACTS 106 164

for programsintendingtoimprove ART adherence. grating ART intotheirlives. points These insightsprovidekeyintervention continuum of ART. PLWH wheninte strategies oftendeveloptheirown Conclusion: non-adherent. PLWH controlovertreatment, withoutcompletelyabandoningitorfeeling schedule, butwithouttheguidanceofaprovider. gives Self-regulation ART isoftenpracticed, or ormodifytheirdosage wherePLHIVregulate PLWH takeabreakfromtheroutineandre-energize. of Self-regulation asocialevent);or”vacations”(attending when ART issuspendedand suspended duringshortanddiscreteperiods, usuallyforspecificreasons overly strictandinflexible. Theseinclude: “permissions,” where ART is tives toadherence, ofteninresponsetoamedicalsystemperceivedas experiences, expectations, andevolvingneeds. PLWH developalterna construct ofadherenceisfrequentlyre-defined, dependingonPLWH’s Results: diagnosis, using55monthsasathreshold. and challengesovertimethesamplewassegmentedonsince in ART adherence. To successes documenttheexperienceoftreatment consensusregardingchallenges ence wascompromisedandtogenerate continuumwhenadher used toidentifykeymomentsinthetreatment POSTERfrom thegeneralpopulation. 61lifehistoriesand20focusgroupswere transgender women, femalesexworkers, riskandwomen andmenat ment oftheprogram’s keypopulations: sexwithmen, menwhohave Rica andPanama amongmaleandfemale PLWH, recruit withdeliberate Methods: forachieving strategies ART adherence. program, PASMO researchtoexplorebarriersand conductedformative care. In2012, prevention aspartoftheUSAID-fundedcombination structural, and andindividualfactorsalsoimpedeeffectivetreatment PLWH inCentral America fromreceivingthebenefitsof ART. Social, ABSTRACTSBackground: 3 2 1 Sussy Lungo Isolda Fortin Central America HIV Treatment AdherenceAmongPLWH in Population Services International,Population Services Washington, DC, USA International,Population Services NewOrleans, LA, USA Pan American SocialMarketingOrganization, Guatemala, GUATEMALA PLWH’s with relationship ART iscomplexandmutable. The wasconductedinNicaragua,The study ElSalvador, Costa The threats to treatment adherence vary throughoutthe adherencevary totreatment The threats 1

, DanaSievers Eligibility criteria and sub-optimal coverage inhibit many inhibitmany Eligibilitycriteriaandsub-optimalcoverage (presenting) Qualitative StudyonBarriersto ‘Sometimes We Take aVacation’: 1 3 , Jennifer Wheeler ,

2 , KimLongfield 3 ,

10th International Conference on 10th International - - - - 165 enhanced HIV/AIDSReportingSystem(eHARS). Gender, age, race/ethnic Methodology: Tennessee findings. in2012astheseresultsmaydifferfromnational inHIV-careengagement (EC)andviralsuppression(VS)amongPLWH in guidance fromtheCDC, wequantifiedracial/ethnicdisparitiesin importance ofreducingHIV-related healthdisparitiesby2015. Following Background: 2 1 Sten Vermund Shepherd Bryan Carolyn Wester Persons inTennessee in2012 Suppression AmongKnownHIV-Positive determinants areneeded. disparities. Annual monitoringandanalysesincluding additional health goals, planning, toreduce programmatic implementation andservice comes in TN. establishmentof areimportantforstatewide These data Conclusions: were lesslikelytoachieve VS comparedto Whites. 0.86; 95%CI: 0.83,0.89)andHispanics(PR=0.80;95%CI: 0.73,0.87) (PR =0.81;95%CI: 0.74,0.89)comparedto Whites. BothBlacks(PR= achieved VS. Inadjustedregression, HispanicswerelesslikelytobeEC White, 57%wereBlack, and4%wereHispanic;55%EC, and54% 37%were 37% hadheterosexualcontactasHIVexposurecategory; in TN: was45years;46%hadMSMand 73%weremen;medianage Results: both outcomesbyrace/ethnicity. (PR)for prevalenceratios wasusedtoestimate covariates all available <200 copies/mLachieved VS. Modified Poisson regressionadjustingfor results or VL HIV-1 viralloads(VL)from2012wereextracted. Individualswith ity, residentialcounty, exposurecategory, andreportedCD4counts Vanderbilt UniversityMedicalCenter, Nashville, TN, USA Tennessee DepartmentofHealth, Nashville, TN, USA As ofDecember31, 2012, PLWH 14,671known wereliving ≥ Racial/ethnicdisparitiesexistinimportantNHASout (NHAS)stressesthe HIV/AIDSStrategy The National 2 3 months apart wereEC;thosewith 3 monthsapart Cross-sectional data were obtained from the statewide wereobtainedfromthestatewide Cross-sectionaldata , April Pettit, April Engagement inCareandViral Racial andEthnicDisparitiesin 2

, ShanellMcGoy (presenting) HIV Treatment andPreventionAdherence 2

1 , Peter Rebeiro 1 , BennDaley 2 , Thomas Shavor , Thomas 1 , MelissaMorrison ≥ 1 VL andafinal VL 1 ,

≥ 1 , 2 CD4 -

- 166 10th International Conference on 10th International feasible andmayyieldpositiveresults. is focusingontheseservices approach gests usingacasemanagement toimprovingHIVoutcomes.mental illnessasapathway sug Ourstudy forsubstanceabuseand access tohousingassistanceandtreatment Conclusions: thetimeofanalysis. not reachedthe12-monthendpointat had patients 12-monthswasobserved, many 35% to46%at however <0.01). before to6-monthsafterenrollmentwasdetected(42%68%, p anHIVvisitwithin6-months having increase intheproportionofpatients and92%obtainedservices.substance abusetreatment A significant ed mentalhealthassistanceand93%obtainedservices. 48needed housing scoreimprovedfrom4.2to2.3afterenrollment. 60request and 89%successfullyobtainedhousingthroughourprogram. The mean the remainderswereunstablyhoused. 72requestedhousingassistance, Results: within 12-months. incare(HIVvisitwithin6-months)and engagement VL <200copies/mL focusing onhousing, substanceuse, andmentalhealth. Outcomeswere withdirecthand-offs approach consistedofacoordinated intervention = permanenthousingto6streethomeless). The case-management unmet needs. A housingscorewasassignedusinga6-pointscale(0 wereassessedforhousing,patients substanceuse, mentalhealth, and tion projectbetweenSeptember2013-February 2015. At enrollment, Significancedemonstra in aHRSA-fundedSpecialProjectsofNational care HIV-infected inHouston, homelesspatients TX whowereenrolled Methodology: couldimproveoutcomes.case-management of homelessHIV-positive patients, weexaminedwhetherintensive inHIVcareand engagement VL improvement. fromacohort Usingdata disorders, andunmetneeds. These challengespresentbarriersto becauseofsubstanceabuse,management mentalhealth untreated Background: 2 1 Charlene Flash Jessica Davila Among Out-of-CareHomelessWithHIV toIncreaseRetentioninCare Intervention Harris HealthSystem, Houston, TX, USA Baylor CollegeofMedicine, Houston, TX, USA improvementinA non-significanttrendtowards VL<200from 93 patients wereenrolled. 93patients 73%wereliterallyhomelessand Increased efforts among homeless are needed to facilitate Increasedeffortsamonghomelessareneededtofacilitate Many homelessHIV-positive strugglewithHIV Many patients This isanongoing, included that single-armstudy out-of- 1

, YasmeenQuadri Case-Management Based Implementation ofanIntensive (presenting) 1 , Pasalar Siavash 1 , Thomas Giordano , Thomas HIV Treatment andPreventionAdherence 2 , Nancy Miertschin 1

2 , - - - and afterreceptiveanalintercourse(RAI)and, 3)dailyoral Truvada™. rectally,daily useoftenofovir(TFV)gelapplied 2) before TFV gelapplied Methodology: Background: 4 3 2 1 Lama Javier Curtis Dolezal Alex Carballo-Diéguez MTN-017 Rectal MicrobicideGelbyParticipants in preferences, tobelower. thepotentialuseofagel dailyappears due tofamiliaritywithrectallubricantuseRAI. Incontrast, basedon oforalPrEPprobably withRAIwassimilartothat bicide gelassociated ofPrEP’sawareness protectiveeffect. futureuseofamicro Anticipated ed withRAI, toexperiencewithpilltakingandpotential probablyrelated quite high;preferencedidnotdifferbetweendailyuseandassociat Conclusions: other countries(90%). they wereinclined touse TFV geldailycomparedwithrespondentsin concerning productpreferences, fewerUSrespondents(59%)reported ly). age orsexualidentityemerged While nosignificantdifferencesby RAI, therewasclear (26%vs. preferenceforthelatter 74%, respective daily vs. 46%withRAI. Givenachoicebetween TFV geldailyorwith gel. Givenachoicebetween Truvada™ dailyorwithRAI, 54%preferred (89%). likelihoodofdaily use of fewer(76%)anticipated Somewhat TFV Truvada™ daily(88%), Truvada™ withRAI(92%), and TFV gelwithRAI and Perú). likelytouse beinglikelyorvery A highproportionanticipated eight sites(fourintheUS, twoin Thailand, andoneeachinSouth Africa 12% respectively), 31years(18-64, meanage SD=9.26), recruitedat Results: via computer-assisted baseline. at self-interview Likelihood offutureproductuseandregimenpreferencewereassessed University ofPittsburghMedicalCenter, Pittsburgh, PA, USA Magee-Womens ResearchInstitute, UniversityofPittsburgh, PA, USA Asociación CivilImpactaSaludyEducación, Lima, PERU Institute andColumbiaUniversity, New York, NY, USA Psychiatric NYState Studiesat HIV CenterforClinicalandBehavioral 168 Participants were195MSMandtransgenderwomen(88% 2 , IanMcGowan futureuseofPrEPintheformapillwas Anticipated Productpreferencesoftenexistpriortoactualproductuse. 1 , IvanBalán MTN-017comparesthesafetyandacceptabilityof1) Preference ofOralPrEPVersus Baseline Anticipateduse

(presenting) 1 , William Brown, III 3 , RossCranston 1 , RebeccaGiguere 4

1 , Cheng-ShiunLeu 1 ,

1 ,

- - -

107 POSTER ABSTRACTS 108 169

factors, suchascuestoaction, mayaffectadherence. other between perceivedcompetenceandadherencesuggeststhat (guilt) maybeapositivepredictorofadherence. The lackofassociation In contrast, inChina, ourresultssuggestthat introjected self-regulation petence andadherence, compared tocontrolledformsofself-regulation. withcom areoftenmorepositivelyassociated forms ofself-regulation Conclusion: between perceivedcompetenceandadherencewasweak. withadherence(r=-0.34, associated atively p<0.05). The association adherence (r=0.22, n.s.), whilefeelingexternallycontrolledwasneg with (guilt)waspositivelyassociated introjectedregulation found that perceived competence(r=0.76)(allp<0.01). adherers,Among low we and (r=0.50);andbetweenself-regulation autonomous self-regulation support fromprovidersandperceivedcompetence(r=0.41) Results: withadherence. and todetermineassociations amongvariables coefficientstoassessrelationships correlation culated others). Adherence wasmeasuredbyelectronicpilldispensers. We cal (feeling guiltyifadoseismissed)andexternalcompelledby goals) self-regulation, whilemorecontrolledformsincluded introjected adherencegoalswithotherlife (integrating ally important)andintegrated includedtypes ofself-regulation identified(valuing adherenceasperson autonomyindexmeasuredself-regulation:A relative moreautonomous competence, scales. weremeasuredusingvalidated andself-regulation POSTERMethodology: perceivedcompetenceandhigherlevelsofadherence. lead togreater medicines. tomanage ormotivation omous self-regulation This would from clinicians comparedtocontrolpatients, auton leadingtogreater support wouldperceivestrongertreatment patients intervention that of CATS, (SDT). theory self-determination Ourhypothesiswas applying ing. This sub-analysisexaminesfactorswhichmayexplainthesuccess remindersandcounsel using real-timefeedbackthroughtextmessage toincreaseadherenceamongHIV-positive inChina intervention patients Background: ABSTRACTS5 4 3 2 1 Lora Sabin Geoffrey Williams Taryn Vian FHI360, Beijing, CHINA Veterans Health Administration, Bedford, MA, USA University ofRochester, NY, USA Boston, MA, USA Center forGlobalHealthandDevelopment, BostonUniversity, Boston UniversitySchoolofPublicHealth, Boston, MA, USA betweentreatment robustcorrelations The analysisshowed 1

(presenting) suchasdiabetescare,With healthbehaviors autonomous The China Adherence through Technology testedan Study SDT’s support, constructsfortreatment perceived Predicting HIVAdherenceinChina The RoleofMotivation andGuiltin 3 , Allen Gifford , Allen 1 , BachmanDeSilva Mary 4 , ChristopherGill 1 , LiZhong 2 , Cabral Howard 5 , Wubin Xie , Wubin

10th International Conference on 10th International 1 , - - - - - 5 , - Background: 8 7 6 5 4 3 2 1 Jennifer Cohen (presenting) Tracey Wilson Women WithHIVInfection U.S. womenwithHIVinfection. further focusonthepotentialbenefitsofpromotingpositiveaffectamong causality betweenpositiveaffectandviralcontrol, thisanalysissupports Conclusions: symptoms ofdepression. ofbirth,country status, affective relationship andnegative andsomatic CI 1.02-1.94), aftercontrollingforHIVantiretroviraladherence, age, between highpositiveaffectandundetectableviralload(OR1.41, 95% a logisticregressionmodelwith948women, therewasanassociation with race/ethnicity, cocaineorheroinuse, orinterpersonaldifficulties. In symptomsofdepression(OR0.95,somatic 95%CI0.92-0.98), butnot 1.97), affect(OR0.96, negative lower 95% CI0.94-0.99), andfewer 1.05-1.85), beingmarriedorlivingwithapartner(OR1.52, 95%CI1.17- 95% CI1.00-1.03), (OR1.39, beingfromaforeigncountry 95%CI antiretroviral adherence(OR6.68, 95%CI4.44-10.61), (1.02, olderage withhighpositiveaffect(OR1.49,ciated 95%CI1.16-1.90), highHIV Results: plasma HIV-1 RNAviralloaddetection, thethirdwave. assessedat collection, ofdata positive affectovertwowaves andtheoutcomewas (10/11-3/13).Study predictorvariablewasself-reported The primary inthe women withHIVinfectionparticipating Women’s Interagency HIV Methodology: affect andviralloadamongwomenwithHIVinfection. University ofNorthCarolina, Hill, Chapel NorthCarolina, USA University ofCalifornia, SanFrancisco, CA, USA Albert EinsteinCollegeofMedicine, Bronx, NY, USA UniversityMedicalCenter,Georgetown Washington, DC, USA University ofSouthernCalifornia, Los Angeles, CA, USA Department ofPreventiveMedicine, KeckSchoolofMedicine, Baltimore, MD, USA Bloomberg SchoolofPublicHealth, JohnsHopkinsUniversity, Stroger HospitalofCookCounty, Chicago, IL, USA MedicalCenter,SUNY Downstate Brooklyn, NY, USA 172 In univariate analysis, Inunivariate anundetectableviralloadwasasso 3 Although furtherresearchisrequiredtodemonstrate 1 , JoelMilam This study assesses the relationship betweenpositive assessestherelationship This study , MichaelSzarek 7 Three waves of six month data wereanalyzedfrom1,264 ofsixmonthdata Three waves , BarbaraFredrickson With Viral ControlAmong Positive AffectisAssociated HIV Treatment andPreventionAdherence 4 , Mary YoungMary , 1 , MardgeCohen 8

5 , AdebolaAdedimeji 2 , Elizabeth Golub 6 ,

- 10th International Conference on 10th International their outcomes. eligible, andtotracelostpre-ART and ART tobetterunderstand patients mers, toreducetime andinZambiahasinformedstrategies ART once eligible, notyeton ART.” maybeusefulforprogram This information states, andpreviouslyunder-recognized suchas lossesfromstates “ART betweenpatient boththelinkages cascadedemonstrates and treatment Conclusions: period.follow-up and ofthoseinitiating ART, 69%wereretainedon ART theendof at on toinitiate ART. eachstepinthecascade, were<5%at rates Death pre-ART care. Ofthoseineligiblefor ART, 45%werelost, and30%went those ART eligiblewerelostpriorto ART initiation, and5%remainedin figure below, 57%meteligibilitycritieriafor ARTat enrollment. 14%of Results: periodoftime. reports ontheiroutcomesduringthat least6months ofpotentialfollow-up,the two-yearperiodwithat and analysis includes thesesitesduring enrollingincareat allpatients era (CD4<200, CD4200-350+ III,WHO Stage or IV).WHO stage Our 2011,2009 and31January andreflecttheeligibilitycriteriaof that in 71public ART facilities(40urban)in4provincesbetweenJanuary system, information national SmartCare. We include interactions patient Methodology: withsuboptimaloutcomes. of patients foreasytargeting wouldallow topresentingthecascadethat approach We andpractical workedwithpartnerstoconceptualizeaninnovative eachstepafterenrolment.comprehensively accountedforoutcomesat ers. not cascadeoutcomeshave to demonstrate Previousattempts andascarcityofhealthcareprovid severe infrastructurallimitations volumesand environmentwithlarge patient in achallengingoperating Background: 3 2 1 Elvin Geng Charles Holmes ProgrammaticDecision-Making Improved University ofCalifornia, SanFrancisco, CA, USA University ofCalifornia, Berkeley, CA, USA Centre forInfectiousDiseaseResearchZambia, Lusaka, ZAMBIA 173 98,331 patients wereenrolled, 98,331patients inthecascade andasshown 3 , IzukanjiSikazwe ofthecare presentation The comprehensivegraphical CIDRZsupportstheGovernmentofZambia’s HIVprogram programinZambiausesa The HIVcareandtreatment 1 , Nancy Czaicki Representation toFacilitate A MoreGranularCascade 1

(presenting) HIV Treatment andPreventionAdherence 2 , Mwanza 1 , -

- 178 to adherencefacedbyPLWH, including TW. examinesasubsetof This study Central America, PASMO toexplorethebarriers study conductedaqualitative Methods: care, stigma, greater andlimitedfamilysocialsupport. because estimates than existingnational TW faceadditionalbarriersto other groups. ART andadherence in coverage TW isassumedlower among rangebetween7.5%-28.6%andfarexceedestimates estimates mostaffectedbyHIV/AIDSintheregion.ulation prevalence Country-level Background: 2 1 Isolda Fortin Adherence AmongTWinCentralAmerica Barriers andMotivations toTreatment prior to or as part of a holistic treatment regimen. prior tooraspartofaholistictreatment mustbeaddressed that initiation andtreatment experience ofdiagnosis Conclusion: support, ofanimproved/maintainedappearance. andexpectation familiarity with withinthe AIDS death TW community, positivefamily interest inself-care. Factors adherenceinclude contributingtotreatment discrimination, lackoffamilysupport, andareducedself-efficacy or riers toadherenceordelaysindrop-outfromcarebecauseofprovider by boththeinternalandexternalstigmaof TW identity, leadingtobar or supersedeadherenceto ART asapriority. HIVstigmaisexponentiated work, orlossofhousing. This additionalburdenmay ofteninterferewith ing depression, genderidentitytransitions, lossoflivelihoodsfromsex processessuchasaddictionrecovery,parallel andoverlapping overcom Results: across 3countriesinNicaragua, ElSalvador andCostaRica. and2focusgroupsconductedwithHIV-positive interviews 10 lifehistory TW Population Services International,Population Services NewOrleans, LA, USA Pan American SocialMarketingOrganization, Guatemala, GUATEMALA initiation, andtreatment At thetimeofdiagnosis TW mayface To PreventionProgramin informaUSAID-fundedCombination identifiedchallengesfaced byThis study TWwithinthe

Transgender women(TW)inCentral America arethepop (presenting) Elegant, MuchBetterThanToday:” “In FiveYears IWillLookMore 1 , Jennifer Wheeler , 2 , SussyLungo 1

- - -

109 POSTER ABSTRACTS 110 180

population. Additional researchisneededonHIVtestingpreferencesinthisunique experiencing homelessnessincreasedaccesstoscreeningservices. women. In-sheltertestingprovidesauniqueopportunitytogivewomen acceptable, althoughconfidentialityisanexpressedconcernofmany Conclusions: 57.2%, 59.8%, respectively). or “extremely” importanttothemajorityofrespondents(58.4%, 59.7%, testing aspartofroutinecare, andgettingsamedayresultswere “quite” Receiving anHIVtestfreeofcharge, HIVtestconfidentiality, gettingHIV over theirHIVtestresultwouldnotaffectdecisiontogettested. theshelter.test resultsat concern The majority(70.1%)reported that POSTERlot” or deal”“a great ofconcerninregardstoconfidentialitytheirHIV theyshouldgettestedforHIV. feltthat surveyed 64.9%reported “quite a a strongpreferencetobetestedelsewhere. A minority (29%)ofthose theshelter wheretheystay;14.3%had they preferredtobetestedat Results: shelter. alsoaskedaboutgeneralHIVtestingpreferences. The survey the of74womenlivingat the residentsalsoliveweconductedasurvey acceptabilityandfeasibilityofHIVtestingina shelter where investigate the DepartmentofHealthandshelter’s staffandresidents. Inorderto student-run clinic LotusHouse at Women’s with Shelterincollaboration ABSTRACTSMethodology: tunity toimpacttheHIVepidemicinwomenexperiencinghomelessness. risk forHIVinfection. sheltersprovidesauniqueoppor HIVscreeningat Background: 1 Susanne Doblecki-Lewis Schwartz Bryanna Homelessness University ofMiamiMillerSchoolMedicine, Miami, FL, USA Of the surveyed women, Ofthesurveyed themajority(53.3%)reportedthat Offering HIV testing at awomen’s OfferingHIVtestingat shelterisfeasibleand Unstably housed and homeless women are at increased Unstablyhousedandhomelesswomenareat InJuly2013, HIVtestingwasestablishedinamedical Sheltered Women Experiencing HIV Testing PreferencesAmong

(presenting) 1 , Amelia Poquette, Amelia 1 , LarissaLester 1

1 ,

10th International Conference on 10th International - barriers to antiretroviral treatment adherenceamongadolescentsinGha barriers toantiretroviraltreatment sub-Saharan Africa. ofand wastoidentifyfacilitators The aimofthisstudy andmediumincomecountriesarein adults livingwithHIV/AIDSinlow among adolescentslivingwithHIV/AIDS. Morethanhalfoftheseyoung Background: 6 5 4 3 2 1 Hubert Leufkens Aukje Mantel-Teeuwisse Daniel Ankrah Adherence AmongAdolescentsinGhana HIV/AIDS status. wouldbeneededtoaddressadolescentdisclosuretorial approach of adherence.forgetfulness mayimproveantiretroviraltherapy A multi-sec adherence amongthissubgroup. Also, toreducepatient interventions support fromhealthcareworkersandparentsorguardiansmayimprove Conclusion: older adolescents. among wasaspecificfacilitator toadheretreatment Self-motivation afterdisclosurezation werethemostfrequentlymentioned barriers. from healthcareworkers, andforgetfulnessperceivedstigmati roviral therapy. wassupport The mostfrequentlymentionedfacilitator due todisclosure, financialinsufficiency, andadverseeffectsofantiret barriers wereforgetfulnesstotakemedicines, perceivedstigmatization parental support, andsupportfromhealthcareproviders. The identified ofdisease,knowledge productformulation, perceivedpositiveoutcomes, Results: total, wereconducted. 19interviews Analysis wasdonemanually. wasreached. wereused.therapy weredoneuntilsaturation In Interviews tal inGhana. toantiretroviral Predominantlyopen-endedquestionsrelating theadolescentsHIVclinic12-19 years)at theKorle-Bu at Teaching Hospi collectionwascarriedoutamongadolescents(aged fordata interviews Methodology: na, andmediumincomecountriesinsub-Saharan oneofthelow Africa. University ofGhanaSchoolPublicHealth, Accra, GHANA Noguchi MemorialInstituteforMedicalResearch, Accra, GHANA Utrecht University, Utrecht, NETHERLANDS University ofUtrecht, Utrecht, NETHERLANDS University ofGhanaMedicalSchool, Accra, Korle-Bu, GHANA Korle-Bu Teaching Hospital, Accra, Korle-Bu, GHANA 181 were emergedfromtheinterviews that The mainfacilitators Continuous information provisioninadditiontounflinching Continuousinformation tobedifficult isknown Adherence toantiretroviraltherapy usingsemi-structured study A crosssectionalqualitative

(presenting) 4 , MargaretLartey to Antiretroviral Therapy to Antiretroviral Facilitators andBarriers HIV Treatment andPreventionAdherence 4 , Daniel Arhinful , 1 , ErnestKenu 2

5 , Irene Agyepong , 2 , EllenKoster 3 , 6

- - - - - 185 10th International Conference on 10th International generalistpractitionersinPrEPprovisionareneeded. engage earlyadopterexperiencescanbeusedto Studies tounderstandhow caresettingsisfeasible. inprimary PrEPimplementation suggest that Conclusions: (10%), orHIVacquisition(3%). (16%),ence (19%)orfollow-up lababnormalities(13%), financialbarriers preference(58%),patient intolerance(19%), medication suboptimaladher PrEP. discontinuePrEPbecauseof Half(52%)ofrespondentshadpatients STIs (32%)ordecreasedcondomusewithanalsex(42%)afterinitiating 3months. every withmorefrequent Someprovidersreportedpatients viders performedHIVtesting(77%)andrisk-reductioncounseling(71%) prompted viralloadtesting. ConcordantwithCDCguidelines, mostpro symptoms ofacuteHIV(62%)orrecenthigh-riskexposures(39%)also STIs (90%), renalfunction(94%), B(75%), hepatitis andHIVviremia(16%); using PrEP. PrEP, Beforeinitiating clinicians routinelyperformedtestingfor from financialbarriershadpreventedpatients that providers indicated serodiscordant couples(84%), andpersonswithSTIs(77%). (61%) Many sexwithmen(100%),prescribed PrEPtomenwhohave membersofHIV range0-70).had prescribedPrEP(median20patients; Respondentshad and 50%identifiedasgay/homosexual. Nearlyall(97%)practitioners was37years;53%werefemale,spondents’ medianage 78%werewhite, all providedHIVcare(median50HIV-infected range15-130). patients; Re 91%); 59%werephysicians, 41%wereotherprescribingclinicians, and Results: calculated. initiation). intotalasofstudy were (500+ patients Descriptivestatistics assessingexperienceswithprescribingPrEP Boston completedasurvey health centerspecializinginthecareofsexualandgenderminorities Methodology: in additionalsettings. provided PrEP(“earlyadopters”)couldinformeffortstoimplement prophylaxis (PrEP). Assessing theexperiencesofclinicians whohave Background: 3 2 1 Kenneth Mayer Douglas Krakower Care Primary Prescribing HIVPre-ExposureProphylaxisin Health CenterDemonstratetheFeasibility of Harvard University,Harvard Boston, MA, USA Fenway Health, Boston, MA, USA Beth IsraelDeaconessMedicalCenter, Boston, MA, USA Among 35invitedpractitioners, (responserate 32participated Prescribing experiencesamongearlyadopterpractitioners Few clinicians prescribedHIVpre-exposure have 3 During January 2015,During January acommunity practitionersat Experiences ataCommunity “Early Adopters”:Clinician

(presenting) 1 , KevinMaloney HIV Treatment andPreventionAdherence 1 , ChrisGrasso 2 , - - - 186 Analysis ofthesample(n=367)wasrealizedwithModalisa©. questionnaire. werecollectedthroughananonymous data qualitative life. intoeveryday challenges areincorporated and Bothquantitative andits therapy adherencefromtheperspectiveofhow ing treatment fromJulytoOctober2014examin cross-sectionalsurvey a national Methods: lifeofPLWHIV.the everyday formevolutionsin dosage ART modified andtheiruseasprevention have (ART).around 90,000areonantiretroviraltherapy Pharmacologicaland Background: 1 Elisabete deCarvalho 2014: BetweenConstraintandAdherence regimens, issues. andaddressingstigmatization with HIV, livingonlimitedfinancialmeans), drug studiesonalternating targeting specificgroups(women,aging or peoplebeginningtreatment single-tablet regimentreatments, developmentand support information herence. areemerging: Someimprovementapproaches widerrangeof and thedoctor-patient relationship, consequencesonad with negative Conclusions: theirdoctor doesnotlistentothem. and 42.9%ofthemfeelthat side-effects allthetimedonotfeelsufficientlyinformedbytheirdoctor aboutcontinuing.feel discouraged 26.5%ofPLWHIV whoexperience doesnotbenefittheirhealthand23.8% treatment fects believethat (37.3%). 35.7%ofPLWHIV side-ef who oftenexperienceproblematic multi-tablet therapy), andthosewithinsufficientfinancialresources therapy,py (38.6%onmulti-dosecombination 30.7%ononce-daily 20 years(49.1%), women(40%), peoplenotonsingle-tabletthera Regular side-effectsconcernmoreoftenPLWHIV forlongerthan treated sideeffects,experience problematic ofwhom27.8%onaregularbasis. forlessthantwoyearsoutoffive.treated Two thirdsofparticipants fearofpossibleside-effectsremainshigh:of treatment fourPLWHIV side-effects, and33.8%ofthemwithouttellingtheirdoctor. At thestart forseveraldays,present treatment ofwhom39.5%toreduceadverse Results: SIS Association, Montpellier, Hérault, FRANCE 22% of participants had already voluntarily stoppedtheir 22%ofparticipantshadalready Sida Info Service –theFrench SidaInfoService HIV/AIDShelpline–conducted Problematic side-effectsalterperceptionofanti-HIVdrugs Problematic 150,000 peoplelivewithHIVinFrance (PLWHIV) and Adopting ofTreatment inFrance From AdaptingtoTreatment to

(presenting) 1 , Corbinaud Marjory 1

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111 POSTER ABSTRACTS 112 187

settings. inresourcepoor should guidecommencingantiretroviraltherapy These clinical CD4countinthisstudy withlow variablesassociated forthepresenceofdiarrhea.wasting andrashesshouldbeevaluated Conclusion: presence ofdiarrhea. presence ofpallor, dehydration, withthe wastingandrashescorrelated CD4countlevelswhilethe rashes weremorereliablepredictorsoflow CD4count. withalow associated Clinically, oralthrush, wastingand diarrhea, 14.6%harbouredgutparasites. The presenceofdiarrheawas while 21.5%harboredoneormoreparasites. Inthesubjectswith of 2.5to1. Those withdiarrhearepresented14.1.%ofthepopulation, (46.8%)oftestsubjectwithafemaleto maleratio highest population Results: CD4 countestimation. parasites, in flocytomery methodwasemployed whiletheautomated dover aperiodofthreemonths. Stoolsampleswereanalyzedforgut subjects wereenrolled. Their stoolandbloodsampleswerecollecte Methodology: POSTER clinicour specialtreatment werestudied. Diarrhea andgutparasitesamongstHIV- attending seropositivepatients in HIV- insuchsettings. seropositivepatients The clinical of correlates withoutCD4countestimation antiretroviraltherapy possible toinitiate of thesepatients, analgorithmmaybeprovidedwithwhichit betweenthelevelofCD4countandclinicala relationship state thepatients.to recognizeotherparametersevaluate Byestablishing insuchsettings physicians whocomeincontactwiththesepatients (ART).ing commencementofantiretroviraltherapy for Itisimperative most resourcepoorsettingsinNigeriaisanimportantindexdetermin Background: ABSTRACTS3 2 1 Ita Okokon Elvis Bisong Teaching HospitalinSouth-SouthNigeria Treatment ClinicoftheUniversityCalabar Seropositive Patients AttendingtheSpecial University ofCalabar, NIGERIA University ofCalabar Teaching Hospital, Calabar, NIGERIA Department ofFamily Medicine, UniversityofCalabar, NIGERIA Participants group25-34yearsconstitutedthe intheage 2 , EmmanuelMonjok HIV-positive presentingwithpallor, patients dehydration,

(presenting) CD4 count estimation which is not readily available in whichisnotreadilyavailable CD4 countestimation Three hundredandfortyconsentingHIV-positive adult and GutParasites AmongstHIV Clinical CorrelatesofDiarrhea 1 , NdifrekeUdonwa 3

2 , Abraham Gyuse , Abraham 2 , 10th International Conference on 10th International

- - 190 relation ofhealthliteracy inalogisticre relation wasevaluated toemployment withtheHIV-HL-2,was evaluated measure. apreviouslyvalidated The banking accounts, andamountofcreditcarddebt. Health literacy status,their currentemployment sourceandamountsofincome, 49.1years,age 12.9, SD8.9;meanyearsofeducation SD3.1)provided white non-Hispanics;361men, 158women, and7transgendered;mean (N=526;342blacksand184 were collectedaspartofalargerstudy Methodology: thisrelation. istoevaluate The purposeofthisstudy ence, ofhealthliteracy buttherelation isnotknown. tobeingemployed in personswithHIV. Healthliteracy withadher hasalsobeenassociated Background: 2 1 Raymond Ownby adherence interactiswarranted. healthliteracy, ofthewaysthat Further study status, employment and unemployment. canaccompany context ofthefinancialinsecuritythat Better healthliteracy eveninthe adheretomedication mayhelppatients of beingemployed, previouslybeenlinkedtoadherence. andbothhave Conclusions: to reportmostincomefromdisabilitypayments. andmorelikely orwages were lesslikelytoreceiveincomefromsalary 0.01, Wald =12.76, p<0.001). levelsofhealthliteracyThose withlower p =0.001, (B=-0.40, wasinverselyrelated respectively)whileage SE= 0.04, Wald =15.03, p<0.001andB=0.15, SE=0.04, Wald =11.96, andhealthliteracyeducation (B=0.17, predictedbeingemployed SE= Results: withchi-squareandt-tests. were evaluated andhighervs. betweenfinancialstatus Associations healthliteracy lower tookage,gression modelthat gender, race, intoaccount. andeducation Emory University,Emory Atlanta, GA, USA Nova SoutheasternUniversity, Fort Lauderdale, FL, USA After takingage, gender, race, intoaccount, andeducation Low healthliteracy likelihood Low withalower isassociated Being employed is linked to better medication adherence islinkedtobettermedication Beingemployed Data on participants’ employment and financial status andfinancialstatus onparticipants’employment Data Literacy inPersons WithHIVInfection Employment isRelatedtoHealth

(presenting) HIV Treatment andPreventionAdherence 1 , Drenna Waldrop-Valverde, 2

- 191 10th International Conference on 10th International ART adherence. treatment ofself-efficacy,these factorsmayimproverates of thusincrease rates side effectexperience. Treatment focuson adherenceprogramsthat Conclusions: atthep<.05level. All reportedfindingsweresignificant predictor variablesmettheselectioncriterionforinclusion inthemodel. ART apositiveeffectontheirhealth. couldhave For modelSELF_3, no troubled bysideeffects(2.0, 1.2-3.3)reportedhigherconfidencethat instructions. For SELF_2, Blackparticipants(1.9, 1.1-3.2)andthosenot effects (1.8, medication 1.1-3.0)weremoreconfidenttheycouldfollow school (1.8, 1.1-2.9)andthosewhoreportednotroublewith ART side (CI),interval 1.2-3.6]. Inaddition, beyondhigh thosewitheducation (AOR)2.0,Black participants[adjustedoddsratio 95%confidence higher confidencewithtakingtheir ART asdirectedthan medications Results: arenottakenasdirected(SELF_3). current medications health (SELF_2), and3. if theywilldevelopresistancetoHIVmedications directed (SELF_1), 2. apositiveeffectontheir ART willhave medications assessed theparticipant’s confidence: 1. intheirabilityto take ART as were utilized. The outcomevariableswere ART self-efficacy itemsthat logisticregressionmodels multivariate Three backwardelimination Virginia from2009-2011wereincluded inthisanalysis(N=485). Methodology: characteristics inasampleofHIV-positive in patients Virginia. are differencesin ART self-efficacy andbehavioral bysociodemographic characteristics.havioral The aimofthisanalysisistodetermineifthere ifself-efficacyyet itisunknown and/orbe differsbysociodemographic tions (i.e. ART self-efficacy) isasignificantpredictorof ART adherence; (ART) antiretroviraltherapy medica they canbesuccessfulinmanaging Background: 1 Celestine Buyu Jennifer Kienzle 2011 The MedicalMonitoringProject(MMP), 2009- in-Care, HIV-Positive IndividualsinVirginia: Therapy (ART) Self-Efficacy inaCohortof Virginia DepartmentofHealth, Richmond, VA, USA For SELF_1, White participantsweretwiceaslikelytoreport Findings suggest ART self-efficacy differsbyraceand ART Recentanalysesin apatient’sVirginia suggestthat belief MedicalMonitoringProject(MMP)participantsin 1

Differences in Antiretroviral Differences inAntiretroviral Sociodemographic andBehavioral 1 , Lauren Yerkes, 1 , Anne Rhodes(presenting) HIV Treatment andPreventionAdherence 1 ,

- - 192 persons treated forHIVinfection(N=526;342blacksand184white persons treated healthliteracy evaluating adherencein a largerstudy andmedication Questionnaire(TSRQ).Self-Regulation werecollectedaspartof Data Attitudes Toward HealthcareProvidersScale(ATHPS) andthe Treatment health literacy (theHIV-HL-2) were collected. Participants completedthe Methodology: viaRaschIRTpsychometric evaluation analysis. study, wereportonarevisedversion’s (HIV-HL-2) validityandprovide adherence. itpredictedpatients’ Scale (HIV-HL) that andshowed Inthis adherence. InapreviousprojectwedevelopedtheHIVHealthLiteracy andmedication tohealthstatus with HIVinfectionbecauseofitsrelation Background: 2 1 Raymond Ownby(presenting) tion fromtheauthors. literacy inpersonswithHIVinfection. foronlineadministra Itisavailable Conclusions: adherence motivation. of providersandpatterns literacy toward bothtoattitudes isrelated with multipleitemsfromthe ATHPS and TSRQ, health suggestingthat of theunderlyingconcept). significantly The totalscorewascorrelated 1.5, eachcontributedtomeasurement withmostnear1suggestingthat goodfit(infitandoutfitwithintherangeof0.5to All otheritemsshowed fromthescale.(infit andoutfitindices>1.5)theywereeliminated from CFA). twoitemshadsubstantialmisfit that Raschanalysesshowed unidimensional factorstructurefortheinstrument(insertfitindexes Results: sure’s toitemsofthe correlations ATHPS and TSRQ. using thejMetriksoftwarepackage. Validity wasassessedasthemea structure oftheHIV-HL-2 Raschanalysiswascompleted wasevaluated 49.1 years, 12.9, SD8.9;meanyearsofeducation SD3.1). The factor non-Hispanics; 361men, 158women, and7transgendered;meanage Emory University,Emory Atlanta, GA, USA Nova SoutheasternUniversity, Fort Lauderdale, FL, USA Exploratory and confirmatory factoranalysessupporteda andconfirmatory Exploratory The HIV-HL-2 isa validandreliablemeasureofhealth Healthliteracy isofinteresttothoseworkingwithpersons Data on participants’ demographic status aswell status onparticipants’demographic Data Concurrent Validity HIV-HL-2: RaschAnalysisand 1 , Drenna Waldrop-Valverde, 1

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113 POSTER ABSTRACTS 114

psychosocial supports. unique needsofadolescents, including educational, socioeconomic, and sustain adherence, mustbetailoredtothe HIVservices dedicated help strengtheneffortsforadolescentslivingwithHIVinRwanda. To Conclusions: 0.92; 95%CI=0.88-0.96;p<0.05). withvirologicalfailure(OR= Depression wassignificantlyassociated withviralsuppression.95% CI=1.08–2.52;p<0.05)wereassociated = 1.31-2.89;p<0.05)andnotbeinginboardingschool(OR1.80; provided.ic-services Self-reportedadherenceto ART (OR=2.1;95%CI withtheadolescent-clin theyweresatisfied (167 of198)reportedthat 85% orlesson VAS. depression. 49%(96of197)demonstrated 84.4% failure (>1,000copies/mL). 55.6%(79of142)reportedadherence viral suppression(viral-loadof<40copies/mL)and37%hadload value). pre-treatment crease tobelow 51.3%(73of142)had complete had immunologicalfailure(>50%decreasefrompeakCD4orde was 16yearsand89%(177of199)hadinitiated ART. 27%(47of175) Results: POSTER (BDI). using Beck-Depression-Inventory barriers tocare, withcareservices, satisfaction andpsychologicalstate adherence usingthe Visual-Analog-Scale (VAS), HIV-related knowledge, ducted. Included ontheirtreatment adolescentsweretheninterviewed andclinicalreview ofdemographic from[insertyears]wascon data and RuhengeriDistrictHospitalwereincluded. A retrospectivecase note in theadolescentHIVclinics CentreHospitalierUniversitairedeKigali at Methodology: inRwanda. service ABSTRACTSto adherenceforadolescentsenrolledinanewadolescent-friendlyHIV methods,qualitative toidentifypredictorsofpooroutcomesandbarriers living withHIV. We undertookastudy, and combiningquantitative Background: 2 1 Majdi Osman Simon PierreNiyonsenga Rwanda Harvard SchoolofPublicHealth,Harvard Boston, MA, USA Rwanda BiomedicalCenter, Kigali, RWANDA 194 199adolescentswereenrolled. ofenrollment The median-age 2 can toprovideusefullessonsthat These findingsserve Poor adherenceisdrivingpooroutcomesforadolescents , EricRemera leastoneyear Adolescents 15-19yearsenrolledforat Adolescents LivingWithHIVin Barriers toAdherenceAmongst

1 (presenting) , SabinNsanzimana 1 , MuhayimpunduRibakare 1

10th International Conference on 10th International 1 - , - - 195 and barrierto ART adherence? To tothesequestions, answer Rwanda importantly, depressionaskeyfactor tomanage arethestrategies what andcare?3)More symptomsforbettertreatment psychiatric diagnose ofPLWA,2) inroutinecareandtreatment cancareproviders how HIV testing, to double-stigmaaswelladherencetotreatment ART? conditionsconsidering inpsychiatric topatients to providetreatment for universalaccesstotreatment, newchallengesarerising;1)how outcomes. beenbeingscaledup programshave As careandtreatment impactonHIVcareandtreatment negative psychosocial conditionshave areon patients ART. This covers90.2%ofthoseinneed. and Psychiatric Background: 1 Sabin Nsanzimana Adolphe Majyambere Patients onART inRwanda medication. tools. toaddressadherence tobeapplied Various have strategies ART screening usingstandardizedandadapted routine HIVcareservices HIV-positive withmentaldisorderscanbeidentifiedthough patients depression shouldbedonepriorto up.ART andduringfollow initiation Conclusion: was5.7%. overall screenedpatients and receivedanantidepressanttreatment. amongthe Depressionrate referred inmentalhealthforcareand76(39.2%)caseswereeligible 405 patients, 193(47.7%)werescreenedpositivefordepressionand symptom(s),405 (12.1%)presentedoneormorepsychiatric Among collectedon3,349adultsHIV-Positivedata situation: thefollowing show Results: according toscores. and2)leveltwo:using SAMISS(adapted) screeningdepressionandcare twolevels;1)levelone:at screeningofgeneralmentalhealthdisorders conductmentaldepressionscreeningusingstandardized tools atically Description: HIV preventionandcareservices. mentalhealthand tointegrate ofHealthdevelopedastrategy Ministry Rwanda BiomedicalCenter, Kigali, RWANDA Inamentorshipsessiondonein12Rwandadistricthospitals, Diagnosis and management ofmentalproblemsespecially andmanagement Diagnosis strategy,Within Mentalhealth/HIVintegration wesystem InRwandaatotalnumberof128,553HIV-Positive Address Poor Adherencefor Depression Managementto 1 , Yvonne Kayiteshonga , Yvonne

(presenting) HIV Treatment andPreventionAdherence 1 , MuhayimpunduRibakare 1 1 ,

- 10th International Conference on 10th International support washighforwiderPrEPimplementation. clinic flow. Inthisgroupof clinic staffwithsubstantialPrEPexperience, providedanddidnotsubstantiallydisrupt complemented otherservices theclinicsat inthePrEP DemoProjectwasstrong. participating PrEP Conclusion: desire toensurecontinuedaccessPrEPamongtheirclients. theirsite,introduced at moststaffreflectedonthebenefitsofPrEPanda rollout. While somewereunsureregardingtheroleofPrEPwhenfirst PrEP intoclinical careandnotedtheimportanceofresourcestofacilitate suggestedeaseofincorporating Themes emergingduringinterviews staff intheseclinics weregenerallyhighlysupportiveofprovidingPrEP. risk. offeredtothoseat prevention packages Despitethesedifferences, prescribed PrEPtookitasdirected, PrEPshouldbepartof andthat forHIVprevention,PrEP beingaprovenstrategy people beliefsthat project emerged. onitemsabout staffhadhigherratings Project-related differences betweenthosedirectlyinvolvedandnotwiththe Although positivebeliefsaboutPrEPanditsefficacy werecommon, staff (nurses, workers, surveillance phlebotomists, andreceptionists). staff)includingnon-study 16counselors, 14clinicians and, 42other Results: onstaffexperiences.conducted toelaborate Francisco, and Washington, DC. with24staffwere In-depthinterviews enrolled 557participantsinMiami,a communityhealthcenter)that San the U.S. PrEPDemoProject(twosexuallytransmitteddiseaseclinics and thethreeclinicsregarding PrEPwasofferedtostaffat in participating Methodology: the project. portionof eachsiteduringthefollow-up andbeliefsofstaffat attitudes intothreediverseclinicalPrEP-services sites. We exploredPrEP-related Background: 5 4 3 2 1 TapiaGregory Stephanie Cohen Susanne Doblecki-Lewis Demonstration Project Clinics Participating intheU.S. PrEP Bridge HIV, SanFrancisco, CA, USA Whitman Walker Health, Washington, DC, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA University ofMichigan, Ann Arbor, MI, USA University ofMiami, FL, USA 196 Surveys were completed by 75 individuals (31 study staff, werecompletedby75individuals(31study Surveys 44 Supportforcontinuedclinic PrEPprovisionamongstaff From 2012-14theU.S. PrEPDemoProjectintroduced 1 , Albert Liu , Albert andbeliefs assessingattitudes A 23-itemsurvey 3 , MichaelKolber Implementation inThree Staff ImpressionsofPrEP 5

(presenting) 1 , RichardElion HIV Treatment andPreventionAdherence 1 , KRivet Amico 4 , MeganColeman 2 ,

4 , 197 Methodology: theintervention. methods utilizedtotrainthepeersfacilitate ment oftrainingmaterials, selectioncriteriaforinterventionists, and suppressed HIVviralload. willfocusonthedevelop This presentation a adherenceandwhodonothave incareandmedication engagement challengeswith experiencedrepeated have targets individualsthat viaanacademic-communitypartnership.intervention The intervention apeer-facilitated todisseminating adherence approach HIVtreatment “Peers isexamininganovel KeepItReal” that study isanintervention adherence. inHIVcareand medication are strugglingwithengagement targetpeoplewho that changestrategies and revolutionizebehavior adherence whocanmodelHIV treatment promise aschangeagents Background: 1 Maithe Enriquez health careproviders. ence toHIVtreatment. hasalsobeenwellacceptedby The intervention incareandadher challengeswithengagement experienced repeated population: asubgroupofindividualswhoarelivingwithHIVandhave care settings. hasbeenwellacceptedbythetarget The intervention Conclusions: mented inavarietyofcommunitysettings. study.phase oftheintervention iscurrentlybeing imple The intervention successfully completedthetrainingandwentontoimplementation to gender, andethnicitywereselectedasinterventionists. age Seven Results: treatment. Peers weretrainedoveraperiodof6months. inHIVcareandadherenceto HIV andstrugglingwithengagement collectedfromindividualslivingwith data developed fromqualitative specifically fortrainingthepeersonthisintervention. Vignetteswere werewritten was learnedprimarilyviarole-playsbasedinvignettesthat group activitiesanddiscussion, androle-plays. delivery Intervention University ofMissouri, Columbia, MO, USA EightindividualslivingwithHIVwhowerediverseregard Peers are effective as intervention facilitators inHIV Peers facilitators areeffectiveasintervention Peers (i.e. great layindividualslivingwithHIV)have Training consistedofthefollowing: didactic, readings, Interventionists Peers KeepItReal:Training ofPeer

(presenting) 1 , Jan Akright , 1

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115 POSTER ABSTRACTS 116 200

teams. However, wecannotexclude byself-report. overestimation inreferencecenters,both groupsbeingfollowed withspecializedcare data.contrast toliterature Suchfindingsmaybeexplainedbythefactof Conclusion: 100%, withextremesof34.3%-100%intheHIVgroup, p=0.09). (medians of100%, withextremesof40to100%intheFCgroup, versus of 40%-100%intheHIVgroup;p=0.08), orinthe7-dayinterval extremes of0to100%intheCFgroupversus100%, withextremes by self-report, (mediansof100%, eitherinthe24-hourinterval with andincome).age inadherence Nosignificantdifferenceswereobserved and US$167intheHIVgroup(nosignificantdifferencesbetweensex, incomeswereUS$267intheFC Median monthlyhouseholdpercapita range17.36±4.85,and 51withHIV(age wereevaluated. 28boys) Results: bytheinstitutionalInternalReviewBoard. The projectwasapproved Mann-Whithey test. wereconsideredsignificantifp Associations was performedwithSPSSsoftware, by wereevaluated andassociations prescribed medicines), expressedinpercentage. analysis Statistical POSTERAdherence wasmeasuredbytheproportion(administeredmedicines/ port ofmedicineintakein24hoursand7daysbeforetheinterview. inadolescentswithHIVinfectionandCFbyself-re ence wasevaluated selected. referencecenters. intertiary Bothgroupswerefollowed Adher between13and20yearswererandomly cents withCFandHIVaged Methodology: infection andCysticFibrosis (CF). adherence intwocohortsofadolescentswithdifferentprofiles, HIV theirbestpotentials.life preserving Inthisreport, weaimedtoevaluate caregivers. Treatment toreachadult adherenceiscrucialforteenagers ABSTRACTS inpersonal,tations and ofpatients emotionalandfamiliarorganization Background: 1 Antonio Ribeiro Aline Ernesto and CysticFibrosis Cohorts ofAdolescentsWithHIVInfection Campinas, SaoPaulo, BRAZIL inPediatrics, UniversityofCampinas-CenterforInvestigation State Ninetypatients, range16.47±2.32, 39withCF(age 22girls) High adherence rates were observed inbothgroups, wereobserved Highadherencerates in 1 Livingwithchronicdiseasesrequiressignificantadap , DaianaPires Observational, analytic, cross-sectionalstudy. Adoles 1 , Diseases –ComparisonBetween Treatment AdherenceinChronic Marcos DaSilva 1 , Poliany Souza

(presenting) 1 , JoséRibeiro 1

1 , Toro Adyleia ≤ 10th International Conference on 10th International 0.05. - - - 1 - , Methodology: withHIV/HCVcoinfection. among patients betweenhealthliteracyrelationship andmortality andlosstofollow-up historicallyhasbeendifficulttotreat.tion that assessedthe Thisstudy Cvirus(HCV)coinfected,particularly amongtheHIV/hepatitis apopula of healthliteracy onoutcomespertinenttoHIV-related careisunclear, eracy healthoutcomes, hasbeenlinkedtoanumberofnegative therole withadversehealthoutcomes. careisassociated lated While healthlit Background: 1 Terence Johnson Christine Oramasionwu Coinfection Mortality AmongPatients WithHIV/HCV the high rates of loss to follow-up andmortalityamongthesepatients. oflosstofollow-up the highrates al, given largerstudiesareneededtofurtherexploretheserelationships fected, healthliteracy witheitheroutcome. wasnotassociated Addition literacy andadverseoutcomes, amongtheHIV/HCVcoin inthisstudy Conclusions: 0.175; 95%CI, withmortality. 0.048-0.635)wereassociated (aOR=1.053;95%CI,age 1.002-1.107)andlackofinsurance(aOR= died. While healthliteracy outcome, witheitherstudy wasnotassociated health literacy (score=226–500), and27% 22%werelosttofollow-up (55%). oraboveintermediate hadintermediate Most(68%)patients with HCVgenotype1(94%)andhadsomeformofinsurancecoverage years (IQR, 39-48)andmostweremale(69%), African-American (79%), Results: determined bylogisticregression. group data. Factors andmortalitywere withlosstofollow-up associated utilizesU.S. viaapredictivemodelthat were estimated Censusblock inthecliniclost tofollow-up died. orthat Healthliteracy measures were that Medical recordreviewswereperformedtoidentifypatients previously. HCVtherapy 1/1/2004-12/31/2011 whohadnotinitiated hort. Analysis included witha coinfectedpatients enrolledintheUNCCenterfor diagnosis AIDS ResearchHIVClinicalCo The UniversityofNorthCarolina, Hill, Chapel NC, USA 202 Of 107 patients that met study criteria, metstudy that was45 Of107patients themedianage Despite prior studies demonstrating a linkbetweenhealth Despitepriorstudiesdemonstrating Research demonstrates that poor engagement inHIV-re poorengagement that Researchdemonstrates This was an observational study of patients withaHCV ofpatients study This wasanobservational 1 , LuMao on LosstoFollow-Upand The ImpactofHealthLiteracy HIV Treatment andPreventionAdherence

(presenting) 1 , Izabela Annis , 1 , Stacy CooperBailey 1 , GangFang ≥ 1 clinic visitbetween 1

1 ,

------10th International Conference on 10th International incare. needed toretainthosepatients evidence ofdisinterestfromproviders, whichwouldunderminethetrust more cautionandplanning, as asitmightbemisconstruedbypatients requires By contrast, self-management patient greater amovetoward tients’ trustintheirprovidersandtherebypromoteretentionservices. helpsreinforcepa andcarecoordination Improving accesstoservices care settings, andinfluencestheacceptabilityofvariedPCMHgoals. Conclusions: self-management. patient greater skepticismaboutthePCMHgoalofencouraging greater of providerscaringaboutpatients. Bycontrast, informantsexpressed andproviders/staffbecausetheyhelpedevoke asense both patients goalswereembracedby andimprovingcarecoordination to services gender trustthroughtheiractions. The PCMHgoalsofenhancingaccess Providers/staff, hadfaced, ofthestigmapatients aware soughttoen fromtheproviders. ofandattention evidence ofrespectintheavailability respectedthem.to receivecarefromprovidersthat They lookedfor Results: analysis. andweconductedathematic were transcribedverbatim n = 82providers/staff).with theprojects(n=53patients; Interviews Methodology: and itspotentialimpactonretentionincare. andprovider/staffperspectivesonthePCMHmodel we examinedpatient in Ryan White HIV/AIDSProgram-fundedHIVcaresettings. Inthisstudy, projects offivePCMHdemonstration andevaluation the implementation tosupport the CaliforniaHIV/AIDSResearchProgramfundedaninitiative medicalhome(PCMH). isthepatient-centered given attention In2011, likehospitalizations.for highercostservices Among thecaremodels reducetheneed that costpreventiveservices oflower mote thedelivery accesstocare,facilitate amongproviders, improve coordination andpro Background: 1 Wayne Steward Care Settings Needs ofPatients inRyan WhiteHIV/AIDS UCSF Centerfor AIDS PreventionStudies, SanFrancisco, CA, USA 203 Many patients hadfacedstigmaintheirlivesandwanted patients Many HIV stigma shapes the needs of patients in Ryan inRyan theneedsofpatients HIVstigmashapes White Interest has been growing in care delivery models that modelsthat incaredelivery Interesthasbeengrowing andproviders/staffassociated We patients interviewed 1 , KimberlyKoester Medical HomefortheUnique Shaping thePatient-Centered 1 , Shannon Fuller HIV Treatment andPreventionAdherence

(presenting) 1

- - - 207 prior totheinterview, inadditiontopharmacy dispensingrecords(PDR). ed. Adherence wasassessedbyself-report(SR)in24hoursand7days from7to20years-oldandtheircaregiverswererandomly select aged Methodology: referencecenter. inatertiary andtheircaregiversfollowed ed patients andpsychosocialfactorsofHIV-infectbetween adherencetotreatment Background: 1 Marcos DaSilva Maria Uehara Aline Ernesto Caregivers Adolescents WithHIVInfectionandTheir higher prevalenceofwomenamongcaregiversisnoticeable. to healthcare, ofcaregiverburden. especiallyinthemanagement The ofnewknowledge psychosocial factorsmayresultintheincorporation Conclusion: median =21, range=1-54;p0.05). scores inthePDRnon-adherentgroup(median=14, range=0-41vs 0.02). Regardingcaregiverdepression, thereweresignificantlyhigher SR (median=69, range=0-100vsmedian50, range=19-75;p range =0-100vsmedian50, range=19-94;p0.02)and24-hour 0-100 vsmedian50, range=0-94;p0.01), 7-daySR(median=72, WHOQOL socialdomain, eitheronPDRrecords(median=75, range= of adherentadolescents, significantly higherscoresinthe weobserved was 54%(PDR), 80%(24-hourSR)and67%(7-daySR). Incaregivers women, of46.6(±11.72). withameanage The prevalenceofadherence of17.36(±4.85)years.a meanage Ofthe44caregivers, 39%were Results: institutional InternalReviewBoard. were consideredsignificantifp usingtheMann-Whitneytest. evaluated the associations Associations scales. analysiswasperformedwithSPSSsoftware, Statistical and (WHOQOL)andBeck tion QualityofLifeInventory Anxiety andDepression Quality ofLifeInstrument-Research(YQOL)and World HealthOrganiza ≤ was SR (drugintake/drugprescription)andifdrugdispensinginterval were Individuals wereconsideredadherentifadherencerates 37 days. questionnaireswereused: Standardizedandvalidated Youth Campinas, SaoPaulo, BRAZIL inPediatrics, UniversityofCampinas-CenterforInvestigation State Fifty twoadolescentswereevaluated: 29(56%) male, with Knowledge of the factors associated withadherenceand ofthefactorsassociated Knowledge 1 1 theassociation wastoevaluate The objectiveofthisstudy , Poliany Souza , Maria Vilela , Analytical, observational, cross-sectionalstudy. Patients and PsychosocialFactors in Adherence toTreatment

(presenting) 1 , Paulo Dalgalarrondo 1 , DaianaPires 1

≤ 0.05. bythe The projectwasapproved 1 , Lemos Renata 1 ,

1 ,

≥ 95% on - - -

117 POSTER ABSTRACTS 118 208

in ordertoachievebetterqualityhealthcare. Conclusion: complexityof 0.01); greater ARV regimen(p=0.03). perceptionofadverseevents(p= (p=0.01);lower missed consultations (p=0.02);smallerproportionof 0.05); lesstimespentwithtreatment of householdmembers(p=0.04). For 7-daySR: higherCD4count (p= (p=0.02);smallernumber er (p=0.05);lesstimespentwithtreatment caregiv (p =0.002);bettereducated proportion ofmissedconsultations events (p=0.04). For 24-hourSR: marriedcaregiver(p=0.02);smaller perceivedadverse (p= 0.03) andlower portion ofmissedconsultations (p=0.03),spent withtreatment viralload(p=0.03);smallerpro lower withPDR: 3(p=0.013),associated immunologicalcategory lesstime 54% (PDR), 80%(24h)67%(7d). werepositively Significantassociations en, of46.6(±11.72). withameanage The prevalenceofadherencewas of17.36(±4.85)years.mean age Ofthe44caregivers, 39%werewom Results: bytheinstitutionalInternalReviewBoard. The projectwasapproved egorical variables. wereconsideredsignificantifp Associations Mann-Whitney testforcontinuousvariablesandchi-squarecat performed withSPSSsoftware, usingthe evaluated andtheassociations POSTER andsocioeconomicconditions.demographic analysis was Statistical variables wasevaluated: clinical, immunologicalandvirologicalcontrol, was on SR(drugintake/drugprescription)andifdrugdispensinginterval were Individuals wereconsideredadherentifadherencerates prior totheinterview, inadditiontopharmacy dispensingrecords(PDR). ed. Adherence wasassessedbyself-report(SR)in24hoursand7days from7to20years-oldandtheircaregiverswererandomly select aged Methodology: referencecenter. inatertiary caregivers followed ABSTRACTSbetween adherenceandclinical and factorsofpatients anddemographic Background: 1 Lemos Renata Aline Ernesto Infected AdolescentsandTheirCaregivers and DemographicFactors inaCohortofHIV- Campinas, SaoPaulo, BRAZIL inPediatrics, UniversityofCampinas-CenterforInvestigation State ≤ 37 days. betweenadherenceandthefollowing The association Fifty twoadolescentswereevaluated: 29(56%) male, witha factorsmustbecarefullyevaluated Adherence-associated 1 theassociation wastoevaluate The objectiveofthisstudy , Poliany Souza 1 Analytical, observational, cross-sectionalstudy. Patients , DeniseDaSilva Antiretroviral TherapyandClinical Antiretroviral Association BetweenAdherenceto 1 , DaianaPires 1 , Marcos DaSilva 1 , Ana Possa, Ana

(presenting) 1 , Maria Vilela , ≥ ≤ 95% 1 10th International Conference on 10th International 0.05. 1 , - - - - - 209 HAART framesfutureinterventions, morerigorous, standardized inter oncetheIMBmodelofadherenceto their medication. isthat Ourtheory withHIV/AIDSarestilllargelynon-adherentto patients interventions Active Antiretroviral (HAART).Therapy Despiteavarietyofadherence can beusedtounderstand, predictandpromoteadherencetoHighly information, skills. andbehavioral motivation ofthismodel Applications isdeterminedbythelevel oftheirHIVprevention HIV preventivebehavior was developedinresponsetotheHIVepidemic. apatient’s Itpositsthat Background: 1 Akesha Edwards Model Information, Motivation, BehavioralSkills - AReviewoftheApplication step towards curbingthisproblem. step towards isa ofinterventions oftheIMBmodeltoinformcreation ued application Conclusions: groupascomparedtotheircontrolgroup.in theintervention significantincreasesintheirmeasuredadherence outcomes statistically studies rangedfrom34.6yearsto47.1years. Onlytwostudiesreported African American population. oftheparticipantsforall Meanages literacy. withlow patients anexclusively investigated Onlyonestudy whileonealsoincluded withasubstanceabusehistory ed populations affected byHIV/AIDSaswelladditionaldisorders. Two studiestarget were that but someoftheresearcherswereinterestedinpopulations sults becauseitwasongoing. There werenogenderspecificpopulations From these, 8studieswereincluded. re didnotreportany Onestudy Results: Reviews/commentaries/editor’s noteswerenotincluded. aspectoftheirmethodology.to HAART theIMBmodelinany applying foradherence eligible forinclusion anintervention iftheyinvestigated searched forarticles during3/1/2014and4/15/2014. Studieswere Methodology: andidentifythedifferenttargetpopulations. interventions ventions willbecomeavailable. We aimtoexamineitsuseindifferent Nova SoutheasternUniversity, Fort Lauderdale, FL, USA Initial searches of electronic databases returned61citations. Initialsearchesofelectronicdatabases Poor adherencetoHAART isapublichealthissue. Contin SkillsModel(IMB) Behavioral Motivation The Information Electronic databases ofpeerreviewedjournalswere Electronicdatabases Therapy inDifferentPopulations Adherence toAntiretroviral

(presenting) HIV Treatment andPreventionAdherence 1 , SilviaRabionet 1

- - - - 10th International Conference on 10th International in HIVcareshouldtargetearliertesting. HIV carepromptly. toimproveFBengagement Publichealthinterventions vanced diseasethanUS-born. Oncetested, FBweremorelikelytolink Conclusion: within 90days. (OR2.31[95%CI1.17-4.56]wereriskfactorsfornotlinking history per decade), femalesex(OR1.97[95%CI1.25-3.10]), andopioidabuse (OR 0.43[95%CI0.25-0.72]). (OR1.21[95%CI1.00-1.48] Olderage 82-91%]). analysis, Inmultivariate timelylinkage facilitated FBstatus in US-born(77%[95%CI72-81%])comparedwithFB(87%, [95%CI <0.001). The proportionwholinkedtoHIVcarewithin90dayswaslower 144-559/µl) inUS-borncomparedwith258/µl(IQR87-482/µl)FB(p whom 36%(n=225)wereFB. BaselinemedianCD4was350/µl(IQR Results: age, sex, race, ofHIVdiagnosis). substanceabuseandlocation linking toHIVcare, controllingforhypothesizedconfounders(birthplace, We performedmultivariablelogisticregressionontheprobabilityofnot or infectiousdiseasephysicianwithin90daysoftheindexHIVtest. defined asthepresenceofanHIV-coded care encounterwithaprimary rank-sum test. toHIVcare outcomewastimelylinkage The primary an ICD-9-CMcode. We comparedbaselineCD4countsusing Wilcoxon and cocaineand/oramphetamines)wascharacterizedbypresenceof algorithm.validated (i.e. Substanceabusediagnosis alcohol, opioid, and 2012. Placeofbirth(USvs. FB)wasdeterminedusingapreviously (Boston, MA)aged Methodology: individuals. isdelayedinforeign-born(FB)comparedwithUS-born HIV diagnosis Background: 1 Julie Levison Metropolitan HealthSystem of LinkagetoHIVCareinaLargeUS Boston, MA, USA MedicalSchool,Massachusetts GeneralHospital/Harvard 211 We of identified619 individualswithanewHIVdiagnosis FBHIV-infected individualspresentedto carewithmoread We tocareafter soughttodeterminewhetherlinkage

We inthe identifiedpatients Partners HealthCareSystem (presenting) ≥ 18 years with a new HIV diagnosis between 2000 18 yearswithanewHIVdiagnosis Status asaPredictor The RoleofForeign-Born 1 , SusanRegan HIV Treatment andPreventionAdherence 1 , KennethFreedberg

- Background: 8 7 6 5 4 3 2 1 Xuemei Zeng and supportforcaregiver/adolescentrelationships. youth mustconsiderculturally-specificfactors, constructivedisclosure, context, particularlyaschildrenage. for Adherence supportstrategies represent importantchallengesforadolescentson ART in thisChinese Conclusions: become independentandself-disciplined. about children’s anddesiresforadolescentsto futurerelationships fromhome.in thisregionliveaway Caregiversalsoexpressedconcerns adolescents’ abilitytoadhereduringmiddleschool, whenmostchildren children’s tothem. HIVstatus wereparticularlyworriedabout Many in additiontoconcernsaboutfinances, stigma, todisclose andhow their givenschoolschedules, theirmedication-taking helping youthmanage toHIVstatus.challenges related Caregiversspokeaboutchallengesof medication, school;severalreporteddroppingoutdueto particularlyat bility. Mostadolescentsexpressedworriesaboutbeingseentakingtheir management,systems formedication withaspectrumofchild responsi (12/20).cation Bothadolescentsandcaregiversdescribedcollaborative (SD 11.2years), schooledu predominantlyfemale(12/20)withprimary majority (14/20)wereboys. 42.4yearsold Caregiverswereonaverage Results: toadherencechallengesinadolescence. related reports ofbarriersthat based onthefrequency ofspecifictopics, andexploredallunusual software, wesummarizedmajorthemes, prioritizedconcernsraised an at cent/caregiver dyads ART clinic inNanning, China. UsingNVivo Methodology: population, andtolearnaboutcaregivers’roleschallenges. caregivers, ofandbarrierstoadherenceinthis toexaminefacilitators explore viewstoward ART andadherenceamongadolescents their HIV-positive adolescents, inChinato study weconductedaqualitative developed forthisgroup. focusedon foralargerstudy As preparation been understudied, been have andfewevidence-basedinterventions Li Zhong BachmanDeSilva Mary Adolescents andTheirCaregiversinChina of AdherenceIssuesAmongHIV-Positive Boston UniversitySchoolofPublicHealth, Boston, MA, USA CDC ART Clinic, Nanning, CHINA Guangxi ProvincialCDC, Nanning, CHINA China CDC, Beijing, CHINA and Prevention(NCAIDS), ChinaCDC, Beijing, CHINA Division of Treatment andCare, Centerfor National AIDS/STD Control FHI360, Beijing, CHINA Veterans Health Administration, Bedford, MA, USA Center forGlobalHealthandDevelopment, Boston, MA, USA 212 Mean age ofadolescentswas12.3years(SD1.7), Meanage andthe 3 , FujieZhang 7 The complexitiesofpeer, school, andfamilyfactors (ART)Adolescent adherencetoantiretroviraltherapy has , ChristopherGill We (IDI)with20adoles conductedin-depth interviews 4 Stigma: AQualitativeStudy School, Disclosure, and ,Mu Weiwei

(presenting) 8 ,Li Yiyao 5 , YongzhenLi 1 , RachaelBonawitz 1 , Yen-HanLee 6 , Lu Hongyan 1 , LoraSabin 1 , Allen Gifford , Allen 7 ,

- 2 - , -

119 POSTER ABSTRACTS 120

due tointentionallyskippingdosesmayrequiredifferentinterventions. ited benefitforpeoplenotadherentonpurpose. adherence Inadequate skipping doses.lim focuson substanceusemayhave that Interventions withintentionally symptoms butnotsubstanceusewereassociated Conclusions: skipping doses. and drugusebyindividualclass withintentionally werenotassociated 95% CI: 0.1-0.4). At-risk alcoholuse, bingedrinking, overalldruguse, withdecreasedoddsofskippingdoses(OR0.3,load wasassociated 1.1-3.4), stigma(OR2.6, 95%CI: 1.0-6.8), whileanundetectableviral intentionally skippingdosesincluded panicsymptoms(OR1.9, 95%CI: nadir orsubstanceuse. Inadjustedanalyses, with factorsassociated pression, fatigue, fevers, nausea, stigma, recentCD4and VL butnotCD4 analyses, withanxiety, intentionallyskippingdoseswasassociated de among thosewhodidandnotintentionallyskipdoses. Inunivariate adherence.inadequate Mean30-dayadherencewas68%vs. 84% was45years.mean age Ofthese, 105(14%)reportedrecentintentional Results: skipped doses. for age, race, withintentional andsextoexaminefactorsassociated and currentpeakviralload. We usedlogisticregressionadjusting and individualsymptoms, riskbehaviors, stigma, currentandnadirCD4, POSTERalcohol anddruguse, depression/anxiety, qualityoflife, symptomburden andclinicalmographic withskippeddosesincluding factorsassociated 30 daysandavisualanaloguescaleofadherence. We examinedde completed anitemaskingaboutintentionallyskippingdosesinthelast depression/anxiety, measures. stigmaandriskbehavior Patients on ART screen-based assessmentincluding adherence, drug/alcoholuse, Methodology: adherence. intentional inadequate intentional. We examinedthefrequency with ofandfactorsassociated and substanceuse. andmaybe adherenceiscomplicated Inadequate ABSTRACTSBackground: 1 Heidi Crane Robert Harrington J Delaney Rob Fredericksen Among PLWH Therapy(ART)Adherence toAntiretroviral University of Washington, Seattle, WA, USA 213 766 patients wereincluded 766patients ofwhom85%were men, and 1 , RobinNance

(presenting) Inadequate adherencemaybeintentional. Inadequate Mentalhealth Inadequate adherence is associated withmentalhealth adherenceisassociated Inadequate Patients at UWMadisonHIVclinic Patients at completeatouch- 1 1 , Anna Church , Anna Shireesha Dhanireddy Intentional Inadequate Factors AssociatedWith 1 , JaneSimoni 1 1 , LaurieSmith 1 , JosephMerrill 1 , Paul Crane 1 , SharonBrown 1 , MariKitahata 1 ,

1 ,

10th International Conference on 10th International - 1 , - - 215 Drenna Waldrop-Valverde Mecation-Taking completed baselinemeasuresofhealthliteracy, numeracy, HIVspecific AAWH, wereenrolledfromHIVclinics inmetro-Atlanta. Participants Methodology: behavior.in actualandpotentialmedication-taking numeracy explainedpotentialdifferencesbetween AAWH andnon-AAWH health literacy. healthliteracy testedwhetherlow This study andhealth to errorsin ART drivenbyadditionaldisparitiesin medication-taking Living withHIV/AIDS(AAWH) persist. These disparitiesmayberelated Background: 2 1 Ying Guo *Supported byR01MH092284. with thisgroupmayimproverisk. healthliteracywith low ornumeracy. Programstoaidproblemsolving for tobemoreproblematic issuesappear or othermismanagement AAs However, inprescriptions lapses decision-makingimportantforavoiding for sometime, toraceorhealthliteracy. toberelated doesnotappear Conclusions: regimens. effectswerenotedforparticipant’sno mediation actualmedication well asnumeracy thesimulated mediated ART regimenscores;however, Findings bothgeneralandHIV-specific revealedthat healthliteracy as meracy bothactualandsimulated measuresmediated ART measures. were found. modelstestedwhetherthehealthliteracy/nu Mediation moreerrors.strating ofactualregimen Nodifferencesinknowledge regimen scoreswith non-AAs differedintheirsimulated AAs demon least6months.had beentakingtheircurrentregimenforat AAs and Results: coulddisruptadherence. events that andpotential knowledge regimen evaluating one measureofasimulated ofone’sone measureofknowledge actualprescriptioninstructionsand health literacy, takingability; andtwofunctionalmeasuresofmedication Nova SoutheasternUniversity, Fort Lauderdale, FL, USA University,Emory Atlanta, GA, USA Participants were 49 years of age on average (SD=8.8)and Participants onaverage were49yearsofage 1 , MarciaHolstad Knowledge ofone’s Knowledge regimenamongthoseprescribed own DisparitiesinHIVoutcomesamong African Americans A totalof382participants, 235 AAWH and 147non- Explains RaceDifferencesin Health Literacy andNumeracy HIV Treatment andPreventionAdherence 1

(presenting) 1 , RaymondOwnby 2 ,Dai Tian - - 1 , 217 10th International Conference on 10th International effectsoftheevent. theeventtodetermineany following these events. adherenceandhealthmeasuresinthemonths Lookat market Identify activitiesandeventstargetedtogirlsaggressively Recommendations: infuturegroupactivities. and openedtheirmindstoparticipating intheevent fortheyouthwhoparticipated lessintimidating appeared adherence, retentionincare, andsupportservices. A smallgroupsetting cerns. in theimportance ofpeerengagement demonstrated The retreat and benefits, disclosure, dating, issues/con andotherteengirlrelated sideeffects this younggirllearnedfromherpeersaboutmedication adherence.of medication Through herexperienceinthegirl’s day, nosed girlfurtherintocarewithabetterunderstandingoftheimportance birth. infectedat maternally onenewlydiag This experience engaged asteensandgirlswhowere event broughttogethergirlsdiagnosed accountswhileinteractingwithoneanotherintimately.Instagram The Lessons Learned: session.and meditation with HIVoranewdiagnosis. The dayendedwithaguidedimagery teem workshop, andawritingexerciseabouttheirexperiencesliving Sessions included: askincarelesson, facingfearsaboutHIV, aself-es girls livingwithHIV. Five oftheelevengirlswhowereinvitedattended. The dayincluded amixofrelaxation, fun, HIVeducation, andsupportfor 15to18years. girlsaged inOctober2014forteenage host aretreat Description: forsupport. health careproviderstoconnectpatients community. HIPAA, confidentialitylaws, andpoliciesmakeitdifficultfor inthe available intheexistingsupportgroupsand retreats to participate support andeducation. Inourexperience, beenlessinclined girlshave Introduction: 2 1 Laura Clarke-Steffen Amy Edmonds Care AdherenceandRetentionin and Improves Southwest CenterforHIV/AIDS, Phoenix, AZ, USA Phoenix Children’s Hospital, Phoenix, AZ, USA The Bill Holt Clinic and Southwest Center collaborated to The BillHoltClinicandSouthwestCentercollaborated It isdifficulttogetadolescentstogetherformutual

(presenting) Increased KnowledgeAboutHIV All DayGirl’s EventPromotes During theday, thegirlsexchangedphonenumbers, 1 , Megan Allen , 1 , TrayciPrince 1 , JanicePiatt HIV Treatment andPreventionAdherence 2 , KimberleyBickes 1

1 ,

- - - streamline timelyreceiptanduninterruptedaccesstoHIVmedications. acquired ART viaHarborPath, acentralizedweb-basedportalaimedto care. viralload(VL)outcomesforpersonswho Therefore weevaluated patients, clinical providers, pharmacy suppliers, andsupportstaffinHIV times, waitlists, programspresentchallengesto andpriorauthorization among uninsuredandunderinsuredclients to related ADAP processing and mortality. disparitiesinaccesstouninterrupted However ART ART offerpotentialforequivalentreductionsinHIV-related morbidity impacts marginalizedgroupsintheUnitedStates, advancesineffective Introduction: 1 Michael Mugavero Ranjith Kasanagottu Program AccessonViral Suppression with HIV. by providingeaseof ART accessforuninsuredandunderinsuredpersons follow-up. promiseforimprovingclinicalThis programshows outcomes at significantimprovementinvirologicsuppression demonstrated using theHarborPath portalforcentralprocessinganddistribution Conclusions: <.001) respectively. suppression increasedsignificantlyfrombaseline, from60%to81%(p up forwhombothbaselineandfollow 488 patients VL wereavailable, VL distributionwas4.0days. tomedication time fromapplication Ofthe was1.5days, toenrollmentapproval Median timefromapplication and uninsured. Nearlytwo-thirds(60%)hadsuppressed enrollment.VL at 39 years, 78%Male, 71%Black/African American, 8%IDU, and85% Results: enrollment. a year)following upafter6weeks(butwithin baselineversusfollow (<200 copies/mL)at intheprogramwasassessedbycomparing participation VL suppression to enrollment, upto1yearprior)wereincluded foranalysis. Effectof leastonefilledat ART prescriptionandaat baseline(closest VLvalue 2015. 2013-January toenrollwith January Patients whowereapproved post designwithinanacademicHIVClinicalCohortin Alabama from Methodology: University of Alabama, Birmingham, AL, USA 218 wereenrolled,A totalof594patients of withameanage Eligible patients whoenrolledinan Eligiblepatients ART drugprogram Though the burden of HIV prevalence disproportionately Though theburdenofHIVprevalencedisproportionately We retrospectively examined VL changesusingapre- 1 , JamesRaper 1 , AshutoshTamhane Centralized Portal forART Drug Evaluating theEffectsofa 1 , Anne Zinski 1 , Will Rutland , Will

(presenting) 1 ,

121 POSTER ABSTRACTS 122

has expandedtheprogramtoinclude C. hepatitis expanding theadherenceprogramtoallinterestedcontractedclinics and counselingandsideeffectreductionstrategies.disease state CCNis reminder programwasdeveloped, andpharmacistsincreasedfocuson To betteraddressadherencebarriers, atext, voice, andemaildosage usingtheprevioustwelvemonthsoffilldata.MPRs werecalculated to initiallybeadherent, tolessthan80%, theMPRwaslowered and Recommendations: period. theendof6-month at program and28werestillactivelyengaged effects andhealthliteracy. achievedadherencethroughthe 22patients common barriersreportedfornon-adherencewereforgetfulness, side ent and50werefoundtobenon-adherentintheinitialcall. The most targeted, ofwhich30wereneverengaged, 69werefoundtobeadher Lessons Learned: untilitwasdeterminedtheywereadherent. patient engage andIMBmodelswouldcontinueto interviewing through motivation POSTERso, plan thepharmacistwouldhelpdevelopacustomizedintervention riskfornon-adherence.were non-adherenttotheirmedicinesorat If would determineduringinitialcounselingsessioniftargetedpatients usingtheprevioussixmonthsoffilldata.were calculated Pharmacist torefilltheirmedicine(s).or morethan120%iftheywerelate MPRs (MPR)oflessthan90% possession ratio geted iftheyhadamedication werereactivelytar ortheirHIVregimenchanged;patients treatment Description: designed anddevelopedbyCCN. interventions, resultsandcommentsweretrackedbyasoftwaresystem ABSTRACTS adherence. toincreasemedication patients cally engaged All actions, an HIVadherenceprograminwhichclinical pharmaciststelephoni Introduction: 1 Nayli Ridener Patients Adherencein340-B Model toImprove WithintheIMB Motivational Interviewing Coordinated CareNetwork Coordinated America, LP, Pittsburgh, PA, USA 219 Patients wereproactivelytargetediftheynewtoHIV CCNPharmacy, a340Bcontractedpharmacy, piloted

(presenting) Duringthesixmonthpilotperiod, were 151patients Because a high percentage of patients werefound ofpatients Becauseahighpercentage Adherence Program–Using A PharmacistDriven 1 , Ashley Grassel , Ashley 1

10th International Conference on 10th International - - - 220 itatively examinedclients’itatively experienceswithhousing assistancesystems systems. ofhealthcareandotherservice and aidinnavigation We qual withclients; appointments services, attend referralsandappointments; out ofmedicalcare, incare. riskofdisengaging orat They coordinate support toindividualswhoarenewlydiagnosed, recentlyincarcerated, community-based organizations. They provideintensive, client-centered caseloads ofclients for6-9monthswithinHIVmedicalclinics and Background: 2 1 Michelle Broaddus Barriers toRetentioninCare Navigating Complex SystemstoAddress programs. systems, navigation whichsuggeststhecontinuingneedfor patient systems,service ofbureaucratic incontrastwithotherrepresentatives clients complex resultedinmany may have successfullynavigating Conclusions: themtotakecareoftheirhealth.support motivated in othersystemsofsupport. thisadvocacy that indicated and Many seen ascaringand “not justthereforajob,” incontrastwithindividuals clients that couldnotovercomeontheirown.services Specialistswere cialists as “advocates” whowereabletoovercomebarrierscareand ostensibly taskedwithaddressingtheseneeds, clients describedSpe managers, systems ofthesebureaucratic andotherrepresentatives rity. Incontrasttotheirexperienceswithparoleofficers, previouscase due tocomplexneedssuchashousinginstabilityandfinancialinsecu Results: incarceration, andpreviousexperienceswithcasemanagement. readings regardinghousingbarriers, withprevious barriersassociated for keythemesusingMaxQDAsoftwareandusedtoconducttargeted ed, andpastremainingbarrierstomedicalcare. werecoded Data former clients ofSpecialists, Specialistsprovid focusingontheservices Methodology: son withpreviousexperiencescasemanagers. thesesystemsincompari withnavigating address barriersassociated and DepartmentofCorrections, Specialistshelped how andinvestigated Baltimore, MD, USA Johns HopkinsUniversity, BloombergSchoolofPublicHealth, Milwaukee,USA WI, Center for Research,AIDS Intervention MedicalCollegeof Wisconsin, Many clients Many systems requiredencounterswithbureaucratic SmallcaseloadsandflexibilityonthepartofSpecialists Wisconsin’s toCareSpecialistsworkwithsmall Linkage In-depth interviews wereconductedwith30currentor In-depthinterviews Specialists: Successesin Wisconsin’s LinkagetoCare

(presenting) HIV Treatment andPreventionAdherence 1 , JillOwczarzak 2

- - - - - 221 10th International Conference on 10th International daily behaviors. theperformanceof skillsviatrainingcanfacilitate emotion regulation interventions. Futureresearchshouldaddresswhetherimproving is importantforpsychological performing frequentdailybehaviors forconsistently A betterunderstandingoftheroleemotionregulation thislink. affectmediates negative andthat performing dailybehaviors withmoreconsistently skillsareassociated higher emotionregulation underlying mediator. These resultsareinlinewithourhypothesisthat affect,effect vianegative affectasan highlightingtheroleofnegative taking.skills withmoreconsistentdailymedication We foundanindirect Conclusion: (z’=-3.13,ation p<0.01). thisassoci emotionalwell-beingmediated that The Sobeltestindicated takingamongparticipants. skillsanddailymedication emotion regulation Results: scale. days. affectwithanemotionalwell-being They alsoreportednegative takingforthepastfour reported theiradherencetodailymedication Scaleand 18-32)completedtheDifficultiesinEmotionRegulation (age Methodology: behaviors, affectcontributestoexplainingthislink. andifnegative withconsistentlyperformingdaily skillswereassociated regulation 1992). Therefore, aimedtodeterminewhetherhigheremotion thisstudy & Scheier, 2011;Klinger1975;Lewis, Sullivan, Ramsay, & Alessandri, orincentives(Carver frombehaviors withdisengaging often associated affectasanunderlyingprocessvariable.negative affectis Negative takinginyoungminorityMSMlivingwithHIVandexamines medication Background: 1 Gertraud Stadler Columbia University, New York, NY, USA Pearson correlations revealed a positive association between Pearson revealedapositiveassociation correlations We foundadirect effect linkinghigheremotionregulation anddaily onemotionregulation presentsdata This study As partofalargerstudy, 80BlackmenlivingwithHIV in DailyLife Emotion RegulationandAdherence

(presenting) 1 HIV Treatment andPreventionAdherence - 222 mented maincontentofsessionsincounselingnotes. tosex,risk reductionrelated substanceuse, andadherencedocu counseling. Staffconductedbrief, client-centered counseling, targeting MSM asa “toolkit”, whichincluded PrEP, condoms, HIV/STItesting, and Background: 5 4 3 2 1 Albert Liu Rivet Amico K. Gwen Ledford the PrEPDemoProjectinWashington, DC with brief medication adherencecounseling. with briefmedication tified. PrEPprogramsmightconsidercombining riskreductionefforts anxiety, proactivelycaringforoneselfwereiden towards andmotivation Conclusion: 5) discussedareturnoftheirHIV-related anxiety. Notably, (n= alloftheparticipantswho didnotcontinuePrEPpost-study reported feelingadecreaseinanxietyaboutHIVwhileonPrEP(n=18). ue PrEPaswellconcernsaboutaccess. Additionally, participants everbeen.”have To thisend, participantsdescribedplanstobothcontin wasthe inthestudy participation “most involvedinhealthcare[they] number ofpartners, andsubstanceuse. For some, counselorsnotedthat ed condomuse, sexualpositioning, disclosure ofHIVstatus, sexvenues, and takingcareof[themselves].” HIV-risk tomanage includ Strategies PrEP; theywereseenas risk”“lower becausetheywere “getting tested be healthy.” Discussionsincluded perceptionsofsexpartnersalsotaking participants weredocumentedassharing “[it] feelsgoodtotakesteps healthprotection, towards impactedoverallmotivation may have where “pioneering andhelpingthecause.” useofPrEP Notessuggestedthat PrEPadherenceandfeelingsof of accountability/commitmenttowards Across sessions, descriptionsofbeingintheprojectincluded asense management. extendedbeyondmedication wide rangeoftopicsthat Results: or-participant discussions. Using groundedtheory, researchersidentifiedmainthemesincounsel analyzed.ticipants covering52weekswerecompiledandqualitatively and itspotentialrolewithparticipants, counselingnotesfrom18par Methodology: Bridge HIV, SanFrancisco, CA, USA University ofCalifornia, SanFrancisco, CA, USA San Francisco DepartmentofPublicHealth, SanFrancisco, CA, USA University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA Whitman-Walker Health, Washington, DC, USA Counseling notes suggested that discussions focusedona Counselingnotessuggestedthat 5 , RichardElion Themes ofpreventionsynergies, reductioninHIV-related to The DemoProjectprovidedHIVpreventionservices 2 To betterunderstandthecontentcoveredincounseling

, StephanieCohen (presenting) Analysis ofCounselingNotesFrom Reflections onRisk:AQualitative 1

1 , MeganColeman 3 ,Matheson Tim 1 , JustinSchmandt 3 , OliverBacon 4 , 1

------

123 POSTER ABSTRACTS 124

address the dynamic nature ofretention. nature address thedynamic areneededto HIV treatment. interventions programmatic Collaborative with highlights anongoingefforttoimproveconsistentengagement supportedbycommunity-based intervention ASOs andDOHresources Recommendations: 73remaininoutreachwith31activeDOHreferrals.gap; (3%) died, 3(1%)areincarcerated, and11(8.5%)experiencedanother 253 withgaps, returnedtocare, 130(51%)have 38(15%)moved, 8 least once, thoughvirologicreboundoccurredfor80/405(20%). Ofthe Subsequently, 405(75%)individualsachievedvirologicsuppressionat for substanceuse/mentalhealth/housing, support. andpeeradvocate implementedincludeInterventions phone/letter/emailoutreach, referrals >9monthswereidentified.with PVL>200copiesand253gaps Lessons Learned: to reviewprogress. outreach wasunsuccessful. ICAREteammembersmeettwicemonthly of Health(DOH)ReturntoCareprogramforthosewhereclinic/ASO and3)referraltotheRhodeIslandDepartment services; management community based (ASO)foradditionalcase organizations AIDS service with outreach andbarrierassessmentbyICARE;2)coordination POSTER by:HIV plasmaviralload(PVL>200copies/mL)followed 1)clinic-based incare(>9months)ordetectable withgaps reviews toidentifypatients withquarterlyclinicICARE beganapractice-basedapproach database a baselineassessmentinconjunctionwiththeIn+CareCampaign, secretary, clinical psychologist, andpeerhealthadvocates. Following of physicians, adherencenurses, casemanagers, socialworkers, a The MiriamHospitalinProvidence, RI. team ICAREisamultidisciplinary Center Adherence andRetention(ICARE)Programwasestablishedat Description: anurbanHIVclinic incareat gaps inRhodeIsland. ABSTRACTSestablished resourcestoimproveHIVvirologicsuppressionandreduce using our experiencesofapractice-basedmultifacetedintervention toaddressmultiplebarriers tocare.requires thecapability We provide Introduction: 2 1 Brian Montague Aadia Rana(presenting) HIV Treatment Adherence The MiriamHospital, Providence, RI, USA Warren University, Brown Alpert MedicalSchoolat Providence, RI, USA 224 In January 2013, InJanuary theRyan White-funded Immunology Supporting consistent engagement with HIV treatment withHIVtreatment Supportingconsistentengagement 1 , Nicole Alexander-Scott, Between1/1/2013and1/1/2015, 542patients Ryan A multidisciplinary White fundedclinic-based Based Approach to Improving Based ApproachtoImproving ICARE ForYou: APractice 1 , RebeccaReece 1 , DanielZariczny 1 , Fizza Gillani 1 2 ,

10th International Conference on 10th International 226 women at riskofhomelessness. women at among careservices palliative needforlow-barrier address thegrowing mental wellness. The SueBujoldFlooropenedinSeptember2014to experiences ofviolence, poverty, socialisolation, and/orstruggleswith living in Vancouver’s Eastside(DTES)andmarginalizedby Downtown Resource Society(AWRS) womenandtheirchildrenwhoare serves settings, including shelters, prisons, andthestreet. Atira Women’s careintonon-traditional ofhospicepalliative prioritized theintegration Introduction: 3 2 1 Susan Burgess Dana Ramsay Low-Income UrbanCommunity palliative services. palliative womenwhoaremarginalizedandinneedof serve that organizations forusebyotherhealthandcommunity edge gainedshouldbetranslated incareandtheimpactofprogram.studies willidentifygaps Knowl care.experience withotherprovidersofhealthandpalliative Qualitative womenexclusively,serve andrecognizetheimportanceofsharingthis Recommendations: guidelines forcareprovisioninthissetting. tice improvements. AWRS residentfeedbackintoevolving incorporates Sue BujoldFloorareexpertswithwhomwecandeveloppolicy andprac virtue oftheirlivedexperiences, onthe thewomenaccessingservices healthbenefits. caremodelsanddeprivedofassociated palliative By experiences ofhomelessnessandpovertyareexcluded fromtraditional Lessons Learned: social, emotional, andpracticalsupports. painandothersymptomsofillness,managing andprovidingarangeof iting disease. adherence, isgiventosupportingmedication Consideration chronicillnesses,deteriorating including HIV, hepatitis, andotherlife-lim of theprogrampromotescomfortandensuresrespectforwomenwith plansforeachresidentofthefloor.management Thesupportivefocus with healthcareprovidersinthecommunitytodevelopappropriate floorofaDTEShousingdevelopment;theprogram staffworks dedicated Description: University ofBritishColumbia, Vancouver, BC, CANADA Simon Fraser University, Burnaby, BC, CANADA Atira Women’s ResourceSociety, Vancouver, BC, CANADA AWRS caresuitesona maintainseightindividualpalliative The CanadianHospicePalliative Care has Association 1 , 3 , Janice Abbott , Cathy Puskas Women-Centred Palliative Careina The SueBujoldFloor:Providing Chronicallyillwomenwhoaremarginalizedbytheir We ofcomparableprogramsthat arenotaware HIV Treatment andPreventionAdherence

1 (presenting)

2 , JaniceRadford 1 ,

- - - 227 10th International Conference on 10th International in developingcountries. households outofproject. indifferentcontexts These canbereplicated handout.constraining any 3)Focus the onsustainablygraduating size-fits-all packages. 2)Emphasisonhouseholdresilience, severely which “fit theprojecttopeople”, thanstandardizedone- rather features.three maininnovative 1)Family centered, tailoredinterventions, Recommendations: or slightlyvulnerable, toslightlyvulnerable. andfrommoderately one,ty brackettoalower is;fromcriticallyvulnerableto moderately that 14%. Overall, movedfromavulnerabili 71%ofSCOREhouseholdshave from 74.96%to85.25%, andschoolabsenteeismfallingfrom33.07%to abuse reducedfrom38.09%to13.43%, schoolenrolmentincreased doubled from41,840to87,200UgandaShillings, theoccurrenceofchild regard toarangeofdriversHIV/AIDSinUganda. income Average improvementwith received economicstrengtheningactivitiesshows Lessons Learned: leastonememberlivingwithHIV/AIDS. at AIDS; have households currentlyunderSCORE, 19%(3,379)areaffectedbyHIV/ increaseHIV/AIDSrisk.AIDS orarecompoundingfactorsthat Ofthe areeitheraresultofHIV/ headed familiesamongotherfactorsthat incomes, arecharacterizedbylow households that education, child strengthening. andcriticallyvulnerable SCOREworkswithmoderately strengthening, foodsecurityandnutrition, childprotectionandfamily include arethemedunderfourobjectivesthat economic Interventions a varietyofinterventions, targetingmorethan25,000households. Description: years ofprogramming. three households affectedbyHIV/AIDSin35districtsofUgandafollowing on3,379 their families)socio-economicstrengtheninginterventions (Sustainable ComprehensiveResponsesforvulnerablechildrenand Introduction: 1 Patrick Walugembe Project inUganda Households inUganda;ACaseoftheSCORE FHI360, Kampala, UGANDA SCORE isamulti-sectoral, fiveyearprojectimplementing The abstract demonstrates theimpactofSCORE project’sThe abstractdemonstrates Vulnerabilities inHIV/AIDSAffected Mitigating SocialandEconomic The analysis of outcomes in SCORE households that The analysisofoutcomesinSCOREhouseholdsthat

SCORE introducedtoOVCprogramminginUganda (presenting) 1 , Joshua Thembo , HIV Treatment andPreventionAdherence 1

- 228 2 or more no-show visitsinthepastyear(mild),2 ormoreno-show 7monthsormoresince were characterizedaccordingtotheseverityoftheirout-of-carestatus: Methodology: barriers. barriers andthoselessseverelyoutofcarewouldreportmorestructural wouldreportmorepsycho-social moreseverelyoutofcarepatients that toself-reportedbarriersHIVmedicalcare,relationship hypothesizing Background: 2 1 Michael Mugavero Ashutosh Tamhane William Anderson Out-of-Care Status tions such as transportation assistance. tions suchastransportation mightderivemorebenefitfrompractical interven in-care patients addressingstigmaissues. aimedat intervention Conversely, tenuously who couldpossiblybenefitfrom for longertermoutofcarepatients impact greater personalbarrierssuchasstigmamayhave suggest that ofparticipantsreportingtheother12barriers,centages theseresults Conclusions: p =.02). as abarriertocare(2-noshow: 75.8%, 7-month: 59.3%, HRSA: 53.8%; ofparticipantsreportinga and inthepercentage “lack oftransportation” 62): 17.7%, 7-month(n=27): 11.1%, HRSA(n=80): 30.0%;p=.06) theclinic” beingseenat “to avoid (n= asabarriertocare(2-noshow of participantswhoreportedwanting the threegroupsinpercentage White: 19.5%, Other: 3.0%), thereweresignificantdifferencesamong Results: whetherdifferencesexisted. square analysiswasusedtoevaluate transportation, inabilitytopay, denial, stigma). withchi- Cross-tabulation responses toaseriesof14(yes/no)barrierscarequestions(e.g. of beingincare(severe). Across thethreegroups, wecompared (moderate),last appointment orfailingtomeettheHRSA-HABdefinition Birmingham AIDS Outreach, Birmingham, AL, USA University of Alabama, Birmingham, AL, USA (Male:Among 169patients 65.0%; African American: 77.5%, Although therewerenosignificantdifferencesinper We examinedthree “out-of-care” criteriaandtheir Patients recruited for a re-engagement in HIV care study inHIVcarestudy Patients recruitedforare-engagement HIV Careand “Severity” of Self-Reported Barriersto 1

1 , JamesRaper (presenting) , DnikaJoseph 1 , Batey David 1

2 , KarenMusgrove 1 , JeremiahRastegar 2 ,

- 2 , -

125 POSTER ABSTRACTS 126 229

referral and treatment system. referral andtreatment structure andstaffingtoprovideaseamlessmentalhealthscreening, programs aresuccessful, infra mustinvestinthenecessary agencies to continuousHIVmedicalcare. To ensurementalhealthscreening menting routinementalhealthassessmentstoaddresspotentialbarriers Recommendations: time periodif<200copies/mL. suppression wasmeasuredasthelastviralloadwithin12-month least60daysapart. wereat tion) withinthe12-monthperiodthat Viral markers (CD4orviralloadtest, HIVcarevisit, orantiretroviral prescrip 2013. RetentionincarewasmeasuredasevidencetwoormoreHIV 2013 andviralsuppressionincreasedfrom54.7%in2012to69.6% 8/31/2014 andretentionincreasedfrom62.4%in2012to79.0% tion clients. from9/1/2013- 181clients bytheintervention wereserved and viralsuppressionamonginterven 12-month retentionincarerates Lessons Learned: 6months. every are repeated viral loadresultsaremonitoredovertime, andthescreeninginstruments POSTERcounseling andotherpsychologicalservices. RetentioninHIVcareand prescription abuse. Screeningresultsareusedtoreferpersons for depression, anxiety, cognitivefunctioning, substanceabuseand publicly mentalhealthscreeninginstrumentstoassessclients available Description: Health ResourcesandServices (HRSA). Administration Signficance(SPNS)grantfromthe through aSpecialProjectsofNational alargeuniversitymedicalcenterinRichmond,implemented at Virginia health barriersamongPLWHA. wasdesignedand The intervention prehensive screeningandreferralprocesstoidentifyaddressmental ABSTRACTSmedical care. The Virginia DepartmentofHealth(VDH)developedacom inHIV andengagement can presentasasignificantbarriertolinkage HIV/AIDS (PLWHA) aremorelikelytodevelopmentaldisorderswhich Introduction: 1 Gilmore Kate Care Outcomes Health ScreeningProgramtoMaximizeHIV Virginia DepartmentofHealth, Richmond, VA, USA 1 involvestheuseoffivevalidated,The intervention , Lauren Yerkes, Comparedwiththegeneralpopulation, personslivingwith Use ofaComprehensiveMental Screen, Refer, Treat, Repeat:The Preliminary results demonstrate improvementsin resultsdemonstrate Preliminary Programs serving PLWHA Programsserving shouldconsiderimple 1 , Anne Rhodes , Anne 1 , Steven Bailey

(presenting) 10th International Conference on 10th International - - - - - 1 ART adherence. Littleisknown, however, aboutthedistinctpsychosocial positive healthoutcomes, andadherenceself-efficacy to (ASE)isrelated (ART)Optimal adherencetoantiretroviraltherapy isakeypredictor of intheworld,morbid patients with65%of alsoHIV-infected.TB patients Background: 3 2 1 Robert Remien Michelle Henry Kelly Sherman South Africa Comparison ofHIV-TB ComorbidPatients in on AdherenceSelf-Efficacy: ABaseline Distinct targetedclinical maybeneededforeachgroup. approaches whether oneisHIV-infected orHIV-TB co-infectedwheninitiating ART. may exertdifferenteffectsonone’s perceived ASE for ART dependingon Conclusions: ASE (p=0.05)thanthosewithout. (p =0.04), high butthosewithchildrenwere7.49timesaslikelytohave those without. Women low were4.35timesaslikelymentohave ASE low problems were2.61timesaslikelytohave ASE (p=0.03)than Among HIV-only patients, thosewithpresenceofsubstance/alcohol low creased theoddsofhaving ASE, significant. but werenotstatistically ASE (p=0.04). householdincomealsoin andlow status Unemployed those without. Women high were5.04timesaslikelymentohave low health issuewere5.78timesaslikelytohave ASE (p=0.04)than Results: werealsoincluded status and employment inthemodels. perceived highandlow ASE. Gender, householdincome, children having riskfactorsfor logisticregressionswereusedtoevaluate multivariate were TB-comorbid, and73%female. by After stratifying TB status, health, andpresenceofsubstance/alcoholproblems. Twenty-two percent pleted baselinequestionnairesassessingperceived ASE for ART, mental ART RCTinSouth fromanongoingadherenceintervention Africa com Methodology: influence theirself-efficacy for ART adherence. extentdepressivesymptomsandcurrentdrugabuse problems to what characteristics of inSouth TB andHIVco-infectedpatients Africa and HIV Center for Clinical and Behavioral Studies,HIV CenterforClinicalandBehavioral New York, NY, USA University ofCape Town, Cape Town, SOUTH AFRICA Columbia University, New York, NY, USA 230 Among TB-comorbid patients, thosewithpresenceofamental Demographic factors, Demographic mentalhealthanddrugproblems South Africa hasthehighestburdenoftuberculosis-co Four hundredfifty-eightHIV-positive adultscommencing 3 2

, YoliswaMtingeni (presenting) Symptoms andDrugAbuse Effects ofDepressive HIV Treatment andPreventionAdherence 1 , ReubenRobbins 2 , JohnJoska 2 1 , ClaudeMellins , HettaGouse 2 , 1

- - - 231 10th International Conference on 10th International for PLHIV. better retentionandadherence, improvingthequalityoflife ultimately toachieve shouldstrengthencoordination community organizations while strengtheningreferralandcaresystems. and Healthservices strategy,must identifyanearlydiagnosis particularlyforkeypopulations, promote increasedadherenceandimprovedqualityoflife. Countries ing treatment. Byestablishingabaseline, themonitoringsystemcan Conclusions: respectively. viralloadslessthan1,000and50copies/ml,and 32%28%have 63% arelinkedtocare, stayedincare, 55%have 50%arereceiving ART, In Panama (17clinics, 15,423PLHIV), theirstatus, most(82%)know copies/ml, respectively. treatment, viralloadslessthan1,000and50 and18%16%have stayedincare, 35%have that analysis indicated 31%arereceiving numbers diagnosed, ofresults, withknowledge orlinkedtocare. The (17clinics,In Guatemala 52,784PLHIV), therewerenorecordsof than 1,000and20copies/ml, respectively. care, 31%arereceiving ART, viralloadsless and22%16%have infection status, 49%werelinkedtoHIVcare, remainedin 34%have Results: focused onHIVclinics in2013. viral suppression)inElSalvador, Guatemala, andPanama. The analysis cascade(diagnosis,treatment to/retentionincare, linkage ART initiation, a guidetotrack ART adherenceusingviralloadandtodocumenttheHIV Methodology: intheregion. strengthen analyticcapabilities and of CareMonitoringforHIVmodeltoharmonizemonitoringindicators USAID|Central Project(CAMPLUS),America Capacity usedtheContinuum American HealthOrganization, withtechnicalassistancefromthe and DominicanRepublicHealthMinistersCouncil(COMISCA)Pan (ART)roviral therapy programsindifferentways. The Central America Background: 1 Roberto León Central America Guatemala City,Guatemala GUATEMALA USAID|Central Project(CAMPLUS),America Capacity In ElSalvador(20clinics, 23,000PLHIV), their 69%know

In thethreecountries, 30%-50%ofPLHIVarereceiv Central implementedantiret American countrieshave (presenting) The CAMPLUSProject, withregionalexperts, developed and theHIVTreatment Cascadein TreatmentAntiretroviral Adherence 1 HIV Treatment andPreventionAdherence

- - 7 6 5 4 3 2 1 Constantin Yiannoutsos Elizabeth Bukusi Mwebesa Bwana Wendy Hartogensis Elvin Geng Up FromHIVCareinEasternAfrica Engagement AmongPatients LosttoFollow- among patients whoalsofacestructuralbarriers. among patients ing retentionincareshouldfocusonpsychosocialbarriers, particularly forincreas with shorterlapses. interventions Ourfindingssuggestthat incare,more durablelapses whilestructuralbarrierswereassociated Conclusions: structural barrier. in thepresenceofastructuralbarrierascomparedtoabsence (95% CI: 1%to24%;p=0.04)largerabsolute effectonre-engagement reporting onlyapsychosocialbarrier. Psychosocialbarriershada12% (i.e., neitherastructuralnorpsychosocialreason) and9%inpatients with psychosocialandstructural, withonlyclinic-based 22%inpatients 90dayswas47%amongthosewithonlyastructural,at 23%inthose age, sex, CD4level, andclinical barriers, theincidenceofreengagement 23% clinic-based and12%nospecificbarriers. Afteradjustment for years and67%female), 59%reportedstructural, 46% psychosocial, Results: analyses. usingsurvival barriers andre-engagement was self-reported. We betweenpatient-reported analyzedassociations clinic-based (e.g., waitingtimes)dimensions. ofre-engagement Date tion, livelihoodresponsibilities), psychosocial(e.g., stigma, denial)and andgroupedintostructural(e.g.,into categories lackoftransporta were solicitedwithopen-endedquestions, andresponseswerecoded inthecommunity. forlastappointment) late Reasons fornon-return We intensivelytracedarandomsampleofLTFU ART (>90days patients toEvaluate EpidemiologicDatatbases AIDS (IeDEA).in theInternational Methodology: ment afterLTFU ineastern Africa. withre-engage barrierstocareandtheirassociations patient-reported anddriversofre-engagement. abouttherate known We assessed (LTFU) in onantiretroviraltreatment amongpatients Africa, butlittleis Introduction: Indiana University, Indianapolis, IN, USA Mbarara UniversityofScienceand Technology, Mbarara, UGANDA USAID-AMPATH Program, Eldoret, KENYA Infectious DiseasesInstitute, Kampala, UGANDA National AIDS ControlProgram, DarEsSalaam, TANZANIA Program, Services Education Kisumu, KENYA MedicalResearchInstituteandtheFamilyKenya AIDS Careand University ofCalifornia, SanFrancisco, CA, USA 232 LTFUAmong 364patients 33 tracing(medianage andaliveat

(presenting) PsychosocialreasonsforLTFU with tendtobeassociated Enrollment at a new site is common after loss to follow-up anewsiteiscommonafterlosstofollow-up Enrollmentat In14clinics inUganda, and Kenya Tanzania participating 2 6 , Kara Wools-Kaloustian, , Paula Braitstein 1 , Alice Nakiwogga-Muwanga , Alice Clinic-Based BarrierstoRe- Structural, Psychologicaland 7 , Eric Vittinghoff , 1 , Thomas Odeny , Thomas 7 , GeoffreySomi 1 , JeffreyMartin 7 , Glidden David 2 , RitaLyamuya 4 , LameckDiero 3 , Andrew Kambugu , Andrew 1

1 3 , ,

5 , - 4 - - ,

127 POSTER ABSTRACTS 128

who becomepregnant. forthecareofyoungminorityfemaleHIVpatients potential implications period.pregnant womenduringthestudy Findings fromthisworkhave era, of fortreatment accountingforchangesinrecommendations outcomes), bytreatment separately andwillexaminetheserelationships bypregnancywill examinemediation outcome(i.e., livebirthsvsadverse more childrenwerelesslikelytoadhere ART. Subsequentanalyses bysixmonthslater.discontinued therapy Blackwomenandthose with pregnancy wasonly72%, pregnantwomenhad and23%of treated notwithstanding,dations theprevalenceof ART thetimeof useat Conclusions: p =0.01)andthosewhodrankalcohol(vs. abstainers;p=0.03). visitwereblackrace(vs. thisfollow-up optimal adherenceat non-black; analysis, index+1;inbivariate adherent at significantpredictors ofsub 144 women pregnancies,for treated (p<001). 30(26-35)yearsforuntreated Among women wereon ART index. at was33(29-38)years Median(IQR)age women, and47%had Sixty-two percentofpregnanciesoccurredamong African-American Results: for predictorsof ART with pregnancy. adherenceassociated (PR) prevalenceratios toestimate equations with generalizedestimating regimen wereconsideredadherent. We usedlog-binomialregression dex+1). Participants reporting self-reported pregnancy (in outcome(indexvisit)andsixmonthslater 2013 wereincluded. We assessedadherenceto ART thetimeof at POSTERMethodology: with pregnancy inacohortofHIV-infected women. comes. We soughttocharacterizechangesin ART adherenceassociated pregnancy. Suboptimal ART adherencecanleadtoadversehealthout Background: 7 6 5 4 ABSTRACTS3 2 1 Minkoff Howard Roksana Karim Elizabeth Golub Women’s Interagency HIVStudy Pregnant USWomen: ResultsFromthe Maimonides MedicalCenter, Brooklyn, NY, USA University ofCalifornia, SanFrancisco, SanFrancisco, CA, USA Albert EinsteinCollegeofMedicine, Bronx, NY, USA Northwestern University, Chicago, IL, USA University ofSouthernCalifornia, Los Angeles, CA, USA UniversityMedicalCenter,Georgetown Washington, DC, USA Baltimore, MD, USA Johns HopkinsBloombergSchoolofPublicHealth, 233 A totalof502pregnanciesoccurredamong297women. ≥ InthiscohortofHIV-infected USwomen, recommen (ART)Antiretroviral therapy ishighlyrecommendedduring 95% adherent at index,95% adherentat 20(14%)weresub-optimally Self-reportedpregnanciesbetween 2002andMarch April 3 , SusanCohn 7

(presenting) Antiretroviral TherapyAmong Antiretroviral Use andAdherenceto ≥ 3 priorchildren. For 363(72%)pregnancies, 4 , Rodney Wright , 1 ≥ , BinLiu 95% adherencetotheirprescribed ART 1 , SebleKassaye 5 , DeborahCohan

2 ,

6 ,

10th International Conference on 10th International - - - - 234 on engagement incare,on engagement including accesstohealthcareandadherence security leadstohighermorbidityandmortalityamongPLHIVviaeffects people livingwithHIV/AIDS(PLHIV)inresource-richcountries. Food in Background: 3 2 1 Sheri Weiser Shirley LemusHufstedler Whittle Henry Qualitative Study Individuals inaResource-RichSetting:A Clinic Visits AmongLow-IncomeHIV-Infected dressing foodinsecurityasanessentialpartofcomprehensiveHIVcare. resource-rich setting. These findingsemphasizetheimportanceofad ment incareandworsenmentalhealthoutcomesamongPLHIVa mechanisms throughwhichfoodinsecuritymayundermineengage Conclusions: participants. symptoms ofdepression, which alsounderminedadherenceamong care ofoneself(epitomizedbyfoodinsecurity)contributedtostressand physical effectsofhungerandachronicfeelingbeingunabletotake foodassistancesitesduetoHIVstigma.food at Furthermore, boththe with procuringfood;and(4)concernsaboutbeingseentaking ART with worsened sideeffectsof ART intheabsenceoffood;(3)preoccupation ART. These included: (1)feelingsofhunger, fatigue, andanxiety;(2) andnon-adherenceto contribute tomissinghealthcareappointments effectsoffoodinsecuritycould severaldownstream described how on physicalhealth, mentalhealth, incare. andengagement Participants Results: approach. according tocontentanalysismethodsusinganinductive-deductive and transcribedverbatim. Codingandanalysisoftranscriptsproceeded and hospitals, andadherenceto ART. wereaudio-recorded Interviews perceived effectsonphysicalhealth, mentalhealth, clinics at attendance Bay Area. Topics included experienceswithfoodinsecurityandits PLHIVreceivingfoodassistanceintheSan Francisco34 low-income Methodology: methods. aimed toexplorethesemechanismsusingqualitative effects occurinresource-richsettingsarepoorlyunderstood. Herewe (ART).to antiretroviraltherapy The mechanismsthroughwhichthese University ofSouthCarolina, Columbia, SouthCarolina, USA San Francisco, CA, USA Center for Vulnerable SanFrancisco Populations at GeneralHospital, University ofCalifornia, SanFrancisco, CA, USA Participants foodinsecurityhaddirectimpacts perceivedthat 1 1 Our study extendspreviousresearchbydescribingthe Ourstudy Food insecurityishighlyprevalentamonglow-income , We with conductedsemi-structured in-depthinterviews Kartika Palar Antiretroviral Therapy,Antiretroviral andMissed Food Insecurity, Non-Adherenceto HIV Treatment andPreventionAdherence 1 , TessaNapoles

(presenting) 1 , EdwardFrongillo 1 , Seligman Hilary 3 2 , ,

- - - 235 10th International Conference on 10th International supports toutilize ity ofnecessary Wisepill effectively. costs canbeprohibitive. Further researchisneededtoexaminefeasibil monitoring.and data This mayprovechallenginginLMIC, wheredevice topreparation,infrastructure related training, participantengagement, adherence thanself-report. However, EMDslike Wisepill requireastrong for routineclinical care, picture of they likelyprovideamoreaccurate Recommendations: supporting caregivers, andlay, medical, andresearchstaff. required considerabletimefortraining/ Improving deviceimplementation monitoring oftheirchild’s adherence, assuming Wisepill didthat. by Wisepill, pillboxes. preferringtheirown Somecaregiversreduced reminders torechargebatteries. Somelostinterestinorfeltburdened (5%), orlackofcellularnetworkconnection(52%). Families alsoneeded SIMcards(43%); least1dayhadde-activated for at “dead” batteries least1dayand27%for5ormoredays.a signalforat Devicesoffline emerged.the study Inthefirstmonth, 39%ofthedevicesdidnotsend of numerous barrierstoimplementingitcorrectlyandfortheduration Lessons Learned: rechargedregularly.batteries eachtimeitisopened.to aserver mustberefilledand Medications Africa. Wisepill storesthepatient’s ARVs andsendsreal-timesignals HIV-infected 9-14;n=119)inSouth vention forperinatally youth(ages to assessadherenceinanRCTofafamily-basedriskreductioninter Description: numbers ofHIV-positive youth. countries(LMIC)withstaggering particularly inlow-to-middle-income measure. Yet, reportedonitsusewithadolescents, fewstudieshave toring device(EMD), increasinglybeingusedasanobjectiveadherence highriskfornon-adherence.at Wisepill isareal-timeelectronicmoni potential ofantiretrovirals(ARVs)especiallyamongadolescentswhoare Introduction: 3 2 1 Inge Petersen Shezi Sindiswa Latoya Small in theVUKATrial inSouthAfrica Among Perinatally HIV-Infected Adolescents Durban, KwaZulu-Natal, SOUTH AFRICA School of Human Sciences,Applied UniversityofKwaZulu-Natal, Columbia University, New York, NY, USA Silver SchoolofSocial Work, New York University, New York, NY, USA We presentthefeasibility andexperienceofusing Wisepill

3 Adherence isasignificantbarriertoactualizingthefull (presenting) , ClaudeMellins 3 , ReubenRobbins of WisepilltoMeasureAdherence Challenges andBarrierstotheUse While mostparticipantslearnedtouse Wisepill, While EMDsareexpensiveandresource-intensive 1 , DanielleNestadt 2

2 , Arvin Bhana , Arvin HIV Treatment andPreventionAdherence 2 , SphindileMachanyangwa 3 , McKay Mary 1 ,

- - 3 - , 236 herence, anddetectableviralload(DVL, >400copies/ml)overtimein disorders, amongpsychiatric to examinetherelationships ARV non-ad highriskfornon-adherence. at population This isoneofthefirststudies HIV-infectedresearch inthisareaamongperinatally (PHIV+)youth, a non-adherenceinHIV-positiveARV medication adults, thereislimited Background: 4 3 2 1 Elaine Abrams Rebecca Chad Amelia Bucek Perinatally HIV-Infected Youth Adherence OverTime inaCohortof addressing bothmaybecriticaltowell-beinginthispopulation. adherenceovertime.der andmedication Evidence-basedinterventions ence, disor betweenpsychiatric aswellthebidirectionalrelationship disorderandnon-adher should considerco-occurrenceofpsychiatric Conclusions: • • and 53%hadDVL. disorder including substanceabuse(PDSA);60%werenon-adherent, Results: age, sex, time, andthe Time1 outcome. points. Multipleregressionanalysisfor Time2 outcomewasadjustedfor disorderand1)non-adherenceor2)DVLwithin across time atric betweenpsychi and multiplelogisticregressionexaminedassociations of lastmisseddosewithinpastmonth)andDVL(medicalcharts). Simple included disorder(DISC-IV), psychiatric ARV non-adherence(self-report ofHIV-affectedlongitudinal study youthinNYC, wereanalyzed. Variables 13-24 at from PHIV+youth(N=165;ages Time1) ina participating Methodology: this population. Albert EinsteinCollegeofMedicine, New York, NY, USA Columbia University, New York, NY, USA College,Bates Lewiston, ME, USA Studies,HIV CenterforClinicalandBehavioral New York, NY, USA mood disorder(OR=4.95, p=0.045). only onesignificantassociation: Time1 non-adherenceand Time2 Time1 non-adherenceorDVLand found Time2 diagnoses psychiatric PDSA and Time2 non-adherence(OR=2.52, p=0.035). Analyses of non-adherence orDVLfoundonesignificantassociation: Time1 Multiple logisticanalyses only PDSAat Time2 (OR=2.40, p=0.022). Time 2(OR=5.77, p=0.035). with Non-adherencewasassociated 1.96, p=0.037), andPDSA(OR=1.93, p=0.037)], andonlyBDat (BD) (OR=3.09, p=0.008), disorder(PD)(OR= psychiatric any at diagnosis ofpsychiatric disorder Time1categories behavioral [any Simple regressionanalyses At Time1, psychiatric criteriaforany 53%metdiagnostic Clinicians treating PHIV+youthtransitioningtoadulthood Clinicianstreating disorder hasbeenpredictiveof Although psychiatric 3 1 Data from two time points (approximately 2.5 years apart) 2.5yearsapart) fromtwotimepoints(approximately Data

, AndrewWiznia , Elkington Katherine (presenting) Antiretroviral Medication Antiretroviral Psychiatric Disorderand

of and Time1 diagnoses psychiatric Time2 1 , Cheng-ShiunLeu . withthreeofseven DVLwasassociated 4 , ClaudeMellins 1 , CurtisDolezal

3 1

, StephanieBenson 1 , Patricia, Warne 3 2 , , - - - -

129 POSTER ABSTRACTS 130 238

inform the development of PrEP interventions fortransgenderwomen. inform thedevelopmentofPrEPinterventions differences indruglevelsascomparedtoMSM. Suchfindingswillthen women isneededtodeterminethefactorswhichunderlieobserved Conclusion: inconsistentlevels(61%vs36%)(p= .031).were foundtohave detected(13%vs32%)whilemore NTW subjectshaddruglevelsalways significantlyfewer that demonstrated Tthan the courseofintervention severalpointsintimeover armmeasuredat subjects intheintervention NTW subjects. analysisofdruglevelsinarandomsample303 However druglevelswasdetectedbetween in prevalenceoftherapeutic T/W and arm.random samplingof470subjectsintheintervention Nodifference Results: or plasma(N=3)analysis. iPrEx trial, nonehaddetectible TDF orFTClevelsbyintracellular(N=9) tion =0.08). Ofthe12 T/W/H subjectswhoseroconvertedduringthe POSTER efficacylower (FTC/TDF: 3.63 v. Placebo3.29per100PY, pforinterac atrendtoward taking feminizinghormones(H)totheanalysisshowed per 100person-years, p=.17). Combining TW participantswiththose of FTD/TDFfailedtoreachsignificance(3.54vs. 2.06seroconversions identifying as Transgender or Woman). A testfordifferenceinefficacy and 2.06v. 3.98per100PY(p=.001)seeninNTWsubjects(thosenot 3.54 v. Placebo: 3.57HIV-positive years[PY])p=.97) per100patient Transgender (T)or Woman (W)failedtoreachsignificance(FTC/TDF: Methodology: gender identityonthetransgenderspectrum. ABSTRACTSsex withmen(MSM)andsubjectsamalebirth-assigned FTC/TDF forHIVpreexposurechemophylaxis(PrEP)inmenwhohave intheiPrExtrial-arandomized controlledtrialof subjects participating Background: 1 Glidden David Jae Sevelius Women San Francisco, CA, USA Center for AIDS PreventionStudies, UniversityofCalifornia, 8weeksina TDF andFTCdruglevelsweremeasuredat Further study ofHIVchemoprophylaxisintransgender Furtherstudy

A subgroupanalysiswasperformedoftransgender 1 (presenting)

By an intention-to-treat analysis,By anintention-to-treat efficacy ofPrEPin for HIVPreventionInTransgender Preexposure Chemoprophylaxis 1 , MadelineDeutsch 1 , RobertGrant 1

10th International Conference on 10th International - 239 Methodology: be explored. effective andacceptabletoHispanics, theroleofculturalfactorsmust Hispanic MSM. For suchas PrEPtobe HIVpreventioninterventions among toHIVpreventionstrategies asitrelates the roleofacculturation sexwithmen(MSM).among menwhohave regarding Littleisknown compared tonon-Hispanicswiththemajorityofnewinfectionsoccurring Background: 2 1 Cardenas Yannine Estrada Miami MSM inthePrEPDemonstrationProject- priate prevention strategies indiverseHispanicpopulations. preventionstrategies priate isneededtoimplementappro nuanced understandingofacculturation risk perception, andPrEPefficacy beliefsamongPrEPusersinMiami. A Conclusion: spoke bothEnglishandSpanish(3.13%, p=0.048). non-Spanish speakingparticipants(2.63%)andwhoequally PrEPwascompletelyeffectivecomparedto that pants (21.7%)indicated same scale(p=0.01). ofSpanishspeakingpartici A higherpercentage alikelihoodof27onthe and non-HispanicEnglishspeakersindicated 0-100, alikelihoodof34 whereasHispanicEnglishspeakersindicated their likelihoodofHIVacquisitioninthenextyearas41onascale participants (p=0.01). SpanishspeakingHispanicparticipantsranked discussions withalloftheirpartnerscomparedto34.6%U.S. born ed. Among participantsbornoutsideoftheU.S., 59.7%hadserostatus disclosure behavior, riskperception, andPrEPefficacy beliefswerenot preferred Spanish, 50%preferredEnglish). Significantdifferencesin and bornoutsidetheU.S. preferencewasevenlyspilt(50% Language Results: analysis. about PrEPefficacy usingchi-square werecomparedacrosscategories disclosureregarding serostatus discussions, riskperception, andbeliefs preference,language oforigin. andcountry responses Baselinesurvey byself-reportedethnicity, Projectwerecategorized PrEP Demonstration Bridge HIV, SanFrancisco, CA, USA University ofMiami, FL, USA The majorityofparticipantswereHispanicorigin(73.9%) 1 , Gregory TapiaGregory , disclosure, mayimpactHIVserostatus Acculturation HIV HIV incidence is three times greater amongHispanics HIVincidenceisthreetimesgreater Miami-siteparticipants(n=157)intheopen-labelU.S. Related Factors AmongHispanic The RoleofAcculturationandHIV

(presenting) HIV Treatment andPreventionAdherence 1 , Albert Liu , Albert 1 , SusanneDoblecki-Lewis 2 , MichaelKolber 1

1 , Gabriel - - - 240 10th International Conference on 10th International settings. and low/middle-resource the impactofpeer-based tocareinbothhigh onlinkage interventions resource-limited settings. Additional researchisneededtodemonstrate improving adherenceto ART andretentioninHIVcare, particularlyin Conclusions: outcomes. staff burdenwhilemaintainingpatient compared tostandardcare, settingshelpedtooffset peersinlow-resource effectswerenon-inferioritytrials, with nointervention that demonstrating improved adherenceto ART andretentioninHIVcare. Severalstudies in sub-Saharan Africa. peerinterventions that Overallfindingsindicated tocare.only onefocusedonlinkage Twelve studies(60%)wereconducted primarily focusedonimprovingadherenceorretentioninHIVcare, with full textreview. Twenty mettheinclusion criteria. Included studieswere recordsandreviewingabstracts,duplicate 49studieswereincluded inthe bases, with25additionalarticles fromothersources. After removing Results: totheheterogeneityofoutcomesmeasured. ble owing Peers wererequiredtobeHIV-positive. poolingwasnotpossi Statistical English, design. regionorstudy withnorestrictionsongeographical through hand-searching. Studieswererestrictedtothosepublishedin withrelevantoutcomes.interventions Additional studieswereidentified CINAHL between1996-2014usingsearchtermstoidentifypeer-based Methodology: HIV-positive peerstobolsterlinkage, retention, and/oradherence. for research, employed reviewofstudiesthat weconductedasystematic order tosummarizethecurrentevidenceandidentifyfuturedirections intermsofquality. comefromhigh-incomecountriesandvary many In tention toHIVcare. beenimplemented,While anumberofstudieshave toimproveadherence represent onestrategy ART andlinkage/re (ART)maximizing theimpactofantiretroviraltherapy worldwide. Peers Background: 4 3 2 1 WachiraJuddy Becky Genberg Cascade: ASystematicReview Indiana UniversitySchoolofMedicine, Indianapolis, IN, USA AMPATH Consortium, Eldoret, KENYA The OntarioHIV Treatment Network, Toronto, Ontario, CANADA University,Brown Providence, RI, USA Intotal8,344studieswereidentifiedthroughthethreedata Sufficientevidenceexiststosupporttheuseofpeersfor Improving patient engagement HIVcareiscriticalfor engagement Improvingpatient We searchedarticles indexedinPubmed, PSYCinfo, and 3 , Paula Braitstein Engagement intheHIVCare Peer toImprove Interventions

(presenting) 1 , SylviaShangani 4 , DonOperario HIV Treatment andPreventionAdherence 1 1

, BethRachlis 2 ,

- - - among womenlivingwithHIVinresource-poorsettings. However, few outcomes including (ART) suboptimaladherencetoantiretroviraltherapy Introduction: 5 4 3 2 1 Sergio Terrero Kartika Palar Dominican Republic:AQualitativeStudy in CareAmongWomen WithHIVinthe and optimize HIV outcomes among women in low-resource settings. and optimizeHIVoutcomesamongwomeninlow-resource informal foodsupportnetworks, areneededtoreduceemotionaldistress toimprovefood security,Interventions including accesstoformalor HIV-related outcomes, especiallyforwomenwithdependentchildren. impacted throughwhichlackoffoodnegatively lient andakeypathway Conclusions: such support. healthcare, andbetter ART accessandadherence thanwomenwithout described lessdistress, fewercompeting demandsbetweenfoodand family,they couldtap institutionsforfoodsupport neighborsorstate totheclinicand transportation tofeedtheirchildren. Women whofelt including copingstrategies in negative sacrificingfoodforthemselves theirHIVduetofoodinsecurityandengaged their abilitytomanage access andadhereto ART, theyalsodescribedmorehopelessnessabout to caring foryoungchildrenexpressedparticularlyhighmotivation was particularlyevidentforwomenwithdependents. While women Emotional distresscausedbyanuncertainorinsufficientsupplyoffood shortages, aswellpoordietqualityduetotheinabilityaffordfood. Results: on acodebook, whilepermittingemergentthemes. Content codingprocedureswereusedtoidentifysalientthemesbased staff,conducted bylocaltrainedstudy audio-recordedandtranscribed. insecurity anditsimpactonHIV-related outcomes. were Interviews ART (n=30). exploredthelivedexperienceoffood In-depthinterviews Republic amongurban-dwellingwomenlivingwithHIVandreceiving Methodology: compromises HIV-related outcomes. throughwhichfoodinsecurity thepathways been publishedtoelucidate studies,qualitative andnoneinLatin America andtheCaribbean, have and theCaribbean, Panama City, PANAMA United Nations World Food Program, RegionalOfficeforLatin America DOMINICAN REPUBLIC Universidad IberoamericanaUNIBE, SantoDomingo, Office, SantoDomingo, DOMINICANREPUBLIC United Nations World Food Program, DominicanRepublicCountry RAND Corporation, Santa Monica, CA, USA University ofCalifornia, SanFrancisco, CA, USA 242 currentorrecentfood Almost allparticipantsreportedhaving Emotionaldistressduetofoodinsecuritywashighlysa Food withpoorHIV associated insecurityisquantitatively

4 wasconductedintheDominican study A qualitative (presenting) , HugoFarias Distress andEngagement Food Insecurity, Emotional 1 5 , Derose Kathryn

2 , Altagracia Fulcar , Altagracia

3 ,

131 POSTER ABSTRACTS 132 243

care toachieveimprovedhealthoutcomesforwomenlivingwithHIV. and improvethelongstandingRyan HIV White modelofmultidisciplinary care. fromthecaseseriestobuildupon Ourgoalistouseinformation ofanevidence-basedmodeltoaddresstrauma inprimary plementation mental health, violence, substanceabuseormedicalcauses;andim highriskofmortalityfrom at meeting toproactivelyidentifypatients ofaquarterly for traumaandPTSD;implementation “risk ofdeath” ing elementsofthecaremodel. Nextstepsinclude: increasedscreening careteam, arobustmultidisciplinary having suggestmiss thesedeaths frompotentiallypreventablenon-medicalcauses.risk ofdying Despite Recommendations: (2/19). unknown abuse (5/19), cancer(2/19), lungdisease(1/19), caraccident(1/19), or to: wereattributable deaths violence(2/19), suicide(3/19), substance causes,AIDS related mostlyduetonon-adherence ART. Remaining near thetimeofdeath. toHIV/ werelikelyattributable Only3/19deaths nosed withschizophrenia. or 6/19haddocumentedsubstanceabuseat POSTER ofdepression,carried adocumenteddiagnosis 2womenwerediag often. 8/19womenwerenottakingantiretroviraltherapy. 6/19women least2visitsperyearandmostseenfarmore incarewithat engaged women died. werenewtoclinic,Three patients allothershadbeen theUCSF at active patients WHP. Between2004–2014, nineteen Lessons Learned: en’s HIVprogram(UCSF-WHP). ofHIV-positive theUCSF surrounding deaths womencaredforat Wom Description: ABSTRACTS hundredthousandwomen. every of1.3per causesintheU.S. rate AIDS related low arelatively occursat causesremainshigh,due toHIV/AIDSrelated duetoHIV/ femaledeaths Introduction: 2 1 Jennifer Cocohoba San Francisco, CA, USA University ofCaliforniaSanFrancisco Women’s HIVProgram, San Francisco, CA, USA University ofCaliforniaSanFrancisco, SchoolofPharmacy, The goalofourcaseserieswastodescribecircumstances Unlike for other countries where rates of female deaths offemaledeaths Unlikeforothercountrieswhererates Woman: ACaseSeries Mortality andtheHIV-Positive During any givenquartertherearetypically130 Duringany

HIV-positive women engaged in care remain at high HIV-positive incareremainat womenengaged (presenting) 1 , BethChiarelli 2 , EdwardMachtinger

10th International Conference on 10th International - - - 2 -

limitations oftraditionaladherencemeasures,limitations regarding data however real-time data. ofthe Wisepill hasthepotentialtoovercomemany rural U.S.are logisticallyprohibitiveinmany clinics anddonotprovide the UnitedStates. Traditional formsofelectronicadherencemonitoring, tested for ART adherencemonitoringin Africa buthaslimitedusein totransmitreal-timedosing behaviors,and internettechnology hasbeen Background: 2 1 Jessica Haberer Kristi Stringer States Using WisepillTechnology intheUnited in RuralAlabama:AProofofConceptStudy to evaluate its power topredict clinical itspower to evaluate outcomes. to longitudinal ART adherenceprotocolsintheUSshouldbeconsidered and immediate ART adherenceanalysis. The potentialforadding Wisepill between self-reportand Wisepill data, formoredetailed whichallows limited duetocellsignalloss. Significantdiscrepanciesseemtoexist use inruralU.S., settings, real-timemonitoringseemstobe however Conclusions: visit. seen fortheirfollow-up However, were themajorityofeventswererecoveredwhenpatients orcellularfailures,of battery causingalossofreal-timeevents671. Cronbach’s Alpha coefficient=0.224. Technical problemsconsisted concordance between Wisepill adherenceandself-reportwas14.7%, = .005). 90%daily,After dichotomizingadherencetoaboveorbelow self-report (Intraclass correlation, ICC=.265, 95%CI.-.004–.462, P between degreeofconcordancewasobserved A low Wisepill and Results: were conductedusingintraclass analysis. correlation Adherence Questionnaire). Comparisonsofthetwoadherencemeasures was measuredby Wisepill andself-report( AIDS Clinical Trials Group U.S. foratotalof127personmonths. DeepSouthfollowed Adherence months of Wisepill ART inthe adherencemonitoringamong18patients Methodology: is currentlylacking. the feasibilityandacceptabilityofusing Wisepill inruralareasoftheUS. Massachusetts GeneralHospital, Boston, MA, USA University of Alabama, Birmingham, AL, USA 245 Mediandailyadherencewas72.0%asmeasuredby Wisepill. Wisepill adherencemonitoringseemstobefeasiblefor Wisepill, utilizes mobile phone a wireless pill container that fromthefirst6 presentsproof-of-concept data This study

(presenting) 2 , Mirjam-ColetteKempf Therapy AdherenceMonitoring Real-Time Antiretroviral HIV Treatment andPreventionAdherence 1 , CorilynOtt 1 1 , StevenSafren 2 ,

246 10th International Conference on 10th International adherenceandhenceimprovedhealthconditions. areas willfacilitate insupportgroupsshouldbepartoftreatment.pation inthese Synergy this sense, medicalappointments, andpartici psychologicaltherapy ence to ART willbecomemoremeaningfulanddesirableforpatients. In cho-social). isredefinedasaholisticprocess, Oncetreatment adher Conclusions: providers, counselorsandsupportgroups. amongmedical three areasofcarewithlittleevidencecoordination social support. However, amongall identifiedalackofsynergy thestudy receivednotonlymedicalattention,having butalsopsychological and in PLWH supportgroups. MSM reportedbetteradherenceto ART when providers, psychologicalsupportwithcounselors, andsocialsupport Results: bringing newmeaningtothem. MSM. foranemicaccountofthefacts allowed approach The lifehistory From those, 19lifehistoriesand7focusgroupswereconductedamong consensus regardingthekeychallenges.compromised andtogenerate continuumwhenadherencewas identify keymomentsinthetreatment to approach and 20focusgroupswereconductedwithalifehistory (MAR) andwomenfromthegeneralpopulation. 61in-depthlifehistories (MSM), transgenderwomen(TW), femalesexworkers(FSW), risk menat Rica andPanama amongPLWH included–men sexwithmen whohave Methodology: adherenceamongPLWH.treatment forachievingholistic researchtoexplorebarriersandstrategies mative preventionprogram,USAID-funded combination PASMO conductedfor PLWH abandon ART withinoneyearofinitiation. In2012, aspartofthe and care. Across Central American countries, between13-46%of Social, structural, andindividualfactorsalsoimpedeeffectivetreatment PLWH inCentral America fromreceivingthehealthbenefitsof ART. Background: 3 2 1 Kim Longfield Isolda Fortin Adherence AmongPLWH inCentralAmerica Population Services International,Population Services Washington, DC, USA International,Population Services NewOrleans, LA, USA Pan American SocialMarketingOrganization, Guatemala, GUATEMALA Some study participantsreportedreceiving Somestudy ART frommedical

Treatment shouldberedefinedinaholisticway(bio-psy Eligibility criteria and sub-optimal coverage inhibit many inhibitmany Eligibilitycriteriaandsub-optimalcoverage 3 (presenting)

conductedinNicaragua,A study ElSalvador, Costa Study onBarrierstoHIVTreatment ‘The ART Qualitative ofSynergy’: 1 , Jennifer Wheeler , HIV Treatment andPreventionAdherence 2 , SussyLungo 1 ,

- - - - 247 online survey evaluating DPCclient evaluating characteristics,online survey including mental 2011. Eligibleparticipantscompletedapeer-administrated quantitative pants 19yearsandoverwhoenrolledintheDPConorafterFebruary 27, Methodology: ofoptimalHAARTcorrelates adherenceamongasampleofDPCclients. and healthbarriers. prevalenceand This analysisaimstoinvestigate carefacilityforPLHIVexperiencing multiplesocial non-profit integrative for somePLHIV. The Dr. Peter Centre(DPC), in Vancouver, Canada, isa HIV (PLHIV). Achieving and maintaining HAART adherence may be difficult improvedmorbidityandmortalityforpeoplelivingwith has dramatically Introduction: 1 Saranee Fernando FacilityHealthcare Service and emotionalneedsofmarginalizedpeoplelivingwithHIV. to meetthecomplexclinical, arenecessary ed healthservices mental, support needsofindividualswhoarenon-adherent. HIV-relat Integrated Conclusions: health(29%versus67%;p=0.034).charge oftheirown oftaking andcapable participants expressedfeelingcompletelyready fore andafteradmissiontheDr. Peter Centre, fewernon-adherentsurvey versus 97%;p=0.027). participantperceptionsbe Comparingsurvey viralloadsuppression(78% lower participantshave non-adherent survey facility(10%versus31%;p=0.027).from apsychiatric Inaddition, regular physician(49%versus77%;p=0.027)oreverreceivingsupport participantsreportreceivinglessmentalhealthsupportfroma survey participants (34%adherent, 63%non-adherent). Overall, non-adherent no currentmentalhealthsupport(25%versus0%;p=0.003)outof92 Results: (adherent) vs. <95%(non-adherent). intheprevioustwelvemonths,for treatment dichotomizedat overthenumberofdaysanindividualwaseligible prescribed medication data.survey Adherence toHAART wasdefinedasthenumberofdays the BCCentreforExcellence’s Drug Treatment Programandlinkedtothe adherence.health andtreatment wasascertained through Clinicaldata BC CentreforExcellenceinHIV/AIDS, Vancouver, BC, CANADA participantsreportreceiving A quarterofnon-adherentsurvey Particular needstobepaidtheuniquemental attention The adventofhighlyactiveantiretroviral(HAART) therapy Enrolment in the study waslimitedtoHIV-positive Enrolmentinthestudy partici With HIVUsinganIntegrative HAART AdherenceinPeople Living

(presenting) 1

≥ 95% - - -

133 POSTER ABSTRACTS 134 248

adherenceto ART. groups andcommunityliaisonvolunteers toreducestigmaandpromote Recommendations: with OVC focusedCBOshasresultedinadditionservices.and linkages anearlystage, intocareat partners hasensuredthefamilyisinitiated amongpatients.seeking behaviors Partnership withCBOsandPMTCT adherence to ART, reduced stigma, andpromotedearlytreatment Lessons Learned: in ruralsettingswereinitiated, andRCEsprovideQCfordistricthospitals. mobilize patients. Decentralizedtrainingopportunitiesforhealthworkers programs. Communityleaderswere trainedtoaddressstigma, and to ensureruralareashadaccess ART andcomprehensiveadherence the message. RegionalCentresofExcellence(RCEs)wereestablished parentsgot inlaunchactivitiestoensuretheirstigmatized participated to reducestigmawasrolledoutinallregionsofUganda. Schoolchildren ”TREAT For Life”, toreduceHIVstigma andpromoted ART literacy and tion withleadingUSinstitutions. A unique ART campaign communication levels, andleadershipcourseswereofferedincollabora management ment, trainingOVCsandcaretakers. all JCRCtrainedhealthworkersat ofachildfriendlyenviron focusedtrainingtoensurecreation pediatric Northern Uganda, highriskgroups(themilitary, fishingcommunities), andhardtoreachcommunitiesinIDPcamps vulnerable populations system. drugmanagement the national toincreaseaccess Strategies sured allfacilitieshadconstantsupplyof ART. The systemsupplemented extensions of ART clinics andtraining. A robustdruglogisticssystemen health facilitiestodeliverquality ART throughrenovations, services JCRC adoptedasimplifiedmethod, ofthepublic bybuildingthecapacity stigma. andfindlocalsolutionstoHIVrelated ing communitiestoown support groups, danceanddramatogiveanewface ART, empower sector,and theprivate solutionsincluding introducedinnovative peer Description: to ART. addressing keyrootcausesofStigma, adherence andaffectingpatient POSTER getaccessto OVCsandothervulnerablepopulations ensure that ART, by fishing communitiesandvulnerablepopulations. Themodelwasto addressingHIVstigma,at increasingaccesstoOVCcaretakers, widows, Program called THALAS (June2010-June2015). The JCRCmodelaimed program called TREAT (Dec2003-Sept2010), on5year andafollow stigma, ART adherence, buysuccessfullyimplementinga7yearPEPFAR toHIVrelated addressissuesrelated support wasabletorapidly intheprovisionof a pioneerorganization ART in Africa, withPEPFAR werefailingon and many ART. JointClinicalResearchCentre(JCRC), children wereenrolledon ART, Patients werenotkeepingappointments adherenceto facilities werehinderingpatient ART inUganda. Very few ABSTRACTSoverwhelmed infrastructure, trainedstaffinpublichealth inadequately tooffer fewfacilitieswereready very ART adherenceservices. The Introduction: 1 Rose Byaruhanga Michael Kabugo Limited Setting AdherencetoARTImproved inaResource Joint ClinicalResearchCentre, Kampala, UGANDA JCRCworkingclosely withpublichealthfacilities, CBOs When thePEPFAR programwasrolledoutinUganda, HIV RelatedStigmaResultedin Innovative StrategiesTo Address

1 (presenting) , SamuelKiirya campaignincreasedpatient The IECcommunication Moreinvestmentsarerequiredinpeer support 1 , Peter Mugyenyi 1

1 , Francis Ssali 1 ,

10th International Conference on 10th International - - - - Charlene Flash Among Treatment NaïvePatients were analyzed for antiretroviral naïve patients startingregimenswhose were analyzedforantiretroviralnaïvepatients Methodology: dosed oncedaily. regimens (STR)yieldbetteroutcomesthanmulti-tablet(MTR) thus clinical outcomes. existtoprovedailysingletablet Limiteddata adherenceand decreasingpillburdentoimprovepatients’ toward Background: 3 2 1 Thomas Giordano clinical outcomes. improved suggestcomparablyeffective STRsmayfacilitate data vational and betterretentionvirologicsuppressionthanMTRs. These obser Conclusions: modeling. ate 0.053). All other differencespersistedinpropensityadjustedmultivari inpropensityanalysis(OR1.24;95%CI1.00-1.54;p= attenuated 80% ofprescriptions(OR1.31;95%CI1.06-1.61;p=0.011), though and oninitialregimen, filledover proportionofSTRpatients agreater pressed (OR1.40;95%CI1.15-1.72;p=0.001). incare Among patients were morelikelytobeontheiroriginalregimenandvirologicallysup 1.40; 95%CI1.04-1.89;p=0.027). givenquarter, Inany STRpatients vs.occurred among81%ofSTRpatients (OR 72.9%ofMTRpatients (OR 1.51;95%CI1.12-2.03;p=0.007). Virologic suppressionyearone vs.one wasachievedin80.7%ofSTRpatients 72.4%ofMTRpatients and64.6% ritonavir TDF/FTC/darunavir/ritonavir. Retentionincareyear the 410MTRsubjects, 35.4%wereprescribed TDF/FTC/atazanavir/ jects, 94.4%wereprescribedcoformulated TDF/FTC/efavirenz. Among white non-Hispanicand0.5%other. Among the674(62.2%)STRsub men (72.5%), 59.8%wereBlacknon-Hispanic, 31.2%Hispanic, 8.5% Results: scores. sion, duringthefirstyear. modelsadjusted forpropensity Multivariate by HRSA, fromoriginalregimen, timetoswitch andvirologicsuppres >80%dayscovered,assessed adherenceashaving retentionasdefined Street HealthCenterinHouston, TX, between2008and2011. We backbone included tenofovir(TDF)andemtricitabine(FTC)at Thomas Harris HealthSystem, Houston, TX, USA Houston,USA TX, Texas SouthernUniversity, SchoolofHealthSciences, Baylor CollegeofMedicine, Houston, TX, USA 249 Of1,084subjects, was41.4yearsand786were meanage Inanon-clinical trialsetting, STRsyieldsimilaradherence ofHIVhastrended The pharmacologicmanagement Pharmacy results filldata, andlaboratory demographics

(presenting) 1 , TeddyZerai Facilitate Outcomes Improved Single Tablet HIVRegimens HIV Treatment andPreventionAdherence 1 ,Hemmige Vagish 3

1 , JosephineCarter

2 , - - - - - 250 10th International Conference on 10th International andretention. initiation ly diagnosed.effectivefor tocarebyPCMshasbeenvery Linkage ART forfindingPWIDwithHIVinfection,strategy including thosenotprevious Conclusions: enrolled3,745uniquePWIDsoverthefourtimewaves. now have and 1died. Thus 98%wereretainedincare(49/50retained). Intotalwe 50 initiated ART, 49successfullycontinuedon ART, 0stoppedtaking ART, ticipants wereeligibletobeassignedaPCMandinitiate ART. Ofthose, byourstudy.with HIVinfection(n=213)werenewlydiagnosed 54par 213 of1,293(16.5%)wereHIV-positive. About 14.1%(n=30)ofthose ranged from18to82years. firstinjectionwas 27years. at Medianage enrolled participantsweremale(88.2%). was32years;age Medianage tion periodwith1,293foundtobeeligibleandenrolled(96.1%). Most Results: for PWIDadherencetoHIVcarevisits[RETAIN]. [TREAT]. BothPCMsandPWIDreceivesmallconditionalcashtransfers (PCMs) tothosewithCD4<500copies/μLlink ART withadherence forHIV-positives,determination andassignmentofpeercasemanagers collectedusingtablets, data havioral HIVtesting[TEST], rapid POCCD4 sitesrollout,in additionaltimeperiodsasPWIDservice including be [SEEK].prevalence andviralloaddetermination We data collectstudy usesrespondent-driven-sampling(RDS)toreachPWIDs forHIV-1ation Methodology: Kenya. toimprovetesting,study andretentioninHIVcareofPWID linkage level startingin2013. science We fromanimplementation presentdata at acountry-wide isamongthefirsttoimplementNSP though Kenya (NSPs) andPWID-specific-ART beennearlynon-existent, supporthave among people-who-inject-drugs(PWID). Needle-and-syringe-programs Background: 2 1 Peter Cherutich John Lizcano Study in Kenya: AnUpdateofthisSteppedWedge Ministry ofHealth-Kenya, Nairobi,Ministry KENYA New York University, New York, NY, USA 1,346individualswerescreenedduringthethirdinterven 1 testingisaneffective ofRDSandrapid The combination HIVinfectionsinsub-Saharan Africa increasinglyoccur , CharlesCleland This stepped-wedgecluster-randomized-design evalu 2 for People WhoInjectDrugs(PWID) Seek, Test, Treat andRetain(STTR)

1 , AnnKurth HIV Treatment andPreventionAdherence

(presenting) 1 ,

- - - - - 251 specialist (LTC-S), afterwhichLTC increasedfrom70%to90%. rates tocare(LTC)linkage goals, tocare theLGBTCenterhiredalinkage testing andcarefacilities. HIV/AIDSStrategy InresponsetotheNational Introduction: 4 3 2 1 Robert Bolan Steve Leyva Rhodri Dierst-Davies Care SpecialistProject Newly HIV-Infected Patients: theLinkageto service providers. service improve LTC and isacceptabletobothpatients ina mannerthat rates a programs maybenefitfromincorporating LTC-S intotheirprogramsto Recommendations: populations. individuals maybebestsuitedtodeliverLTC-S todiverseurban services baseline.levels ofstigmaandfearat Inaddition, bilingualandbicultural while mostclients aboutHIV, areknowledgeable reportmoderate many istaken. approach that as apatient-centered resultsindicate Preliminary participants incareclose isfeasibleandacceptable, todiagnosis aslong activities. tolinkage dedicated enrolling that This project demonstrates of22.5days(SD=13.7),average with2.3hours(SD=1.1)ofstafftime linking tocarewithin3monthspost-disclosure. hastakenan Linkage bisexual). (45%)or MostareLatino White (32%), with91%(n=73) sexwithmen(93%gay,participants aremaleandreporthaving 7% Lessons Learned: domains offear, stigma, knowledge, attitudes, andsupport. post-disclosure follow-up, andat exploresearlyreactionsbyfocusingon A newassessmentdesignedforthisstudy, administeredwithin2weeks withimplementingtheproject.nosis anddeterminethecostassociated diag individuals seeanHIVmedicalproviderwithin3monthsfollowing providing referrals. The purposeoftheLTC-S projectistotrackwhich This involvessettingadditionalmeetings, upwithclients, following and basedonindividualneed. andtailorshisintervention nosed patients LTC strategy, inwhichtheLTC-S meetsone-on-onewithnewly-diag Description: University ofCalifornia, Los Angeles, CA, USA University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA Los Angeles GayandLesbianCenter, Los Angeles, CA, USA Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, 2 , K. Rivet Amico 2 this projectprospectivelyevaluates This demonstration

The L.A. LGBTCenterisoneoftheregion’s largestHIV Enhanced Linkage Intervention for Enhanced LinkageIntervention Real-Time Evaluation ofan At present, beenenrolled. 80individualshave All Current HIV testing facilities and social service CurrentHIVtestingfacilitiesandsocialservice

(presenting) 3 , William Cunningham , William 1 , JesseBendetson 4 , Amy Rock-Wohl, Amy

1 , RisaFlynn 2 , - 1 , -

135 POSTER ABSTRACTS 136 252

gagement inHIVcareandimprovetheproportionvirallysuppressed. gagement caneffectivelyidentifylostHIVclinicapproach patients, promotere-en Recommendations: <0.01). (63%)comparedtotimeofenrollment(50%;p 12 monthsoffollow-up 12months.in careat virally suppressedwashigherat The percentage to obtainingcare. Among thoseenrolled, 82%(n=60)wereretained (17%)weremajorbarriers financial assistance(26%)andtransportation (35%) andmentalhealth(27%)services. Competing needs(50%), =4.8) fororalhealth(n=60%),needing multiplereferrals(avg nutrition withinsixmonthsoffirstcontact.re-engaging Respondentsreported tocare, beenre-engaged (94%)have of 73patients withmost(85%) patients.and 11.6hoursofstafftimewasneededtore-engage A total male (78%)anduninsured(57%). of4.8appointments An average and enrolled(n=78). (71%), wereLatino The majorityofpatients 4%declined29% hadinvalidcontactinformation; and7%werelocated (i.e., in-careelsewhere, deceased, notLACresidentsorincarcerated); Lessons Learned: eligibility andtrackretention. POSTER wasusedtoverify to promotere-engagement. data HIVsurveillance bases. Oncelocated, amodified ARTAS wasadministered intervention was obtainedviaHIV/STDsurveillance, clinic recordsand publicdata provider. HIVcarestatus, residency, andcontactinformation vitalstatus withnoregular not linkedwithin3months;ord)recentincarceration months withmostrecent and VL >200copies/ml;c)newly-diagnosed measures intheprevious12months;b)noreported VL orCD4in7-12 ofthefollowing: 18andolderwithany aged a)noreported VL orCD4 Description: sevenLACclinics. at lost patients ABSTRACTS andre-engage tolocate intervention strengths-based casemanagement techniques andamodified Antiretroviral Treatment (ARTAS) AccessStudy (DIS)locator Services ofDiseaseInvestigation used acombination County (LAC)wereretainedincare2011. Program The Navigation Introduction: 1 Rhodri Dierst-Davies Re-Engaging LostHIVClinicPatients Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth,

Eligiblelostclinic included patients HIV-infected persons 47%ofHIV-infectedAn estimated personsinLos Angeles Innovative MethodsforFindingand The NavigationProgram: Among 1,139lostclinic patients, 60%wereineligible acombinedDISand suggestthat These data ARTAS

(presenting) 1 , AllaVictoroff 1 , Amy Rock-Wohl, Amy

10th International Conference on 10th International 1

- - Michael Kallen Out-of-Care Persons LivingWithHIV? atSixMonthsinHospitalized,Improvement Predict RetentioninCareandHIVViral Load (IMB) Modelof “Retention inHIVCare” We testedwhethermeasurementsfromIMB-RetentioninHIVCareat motivation, skills, andbehavior hasbeen developedandevaluated. tion inHIVcare” measure, information, retention-related operationalizing has onlyrecentlybeenextendedtoretentioninHIVcare. An IMB “reten Background: 3 2 1 Jeffrey Cully on outcomes. theimpactof3-monthand6-monthIMBstatus being usedtoevaluate 6-month outcomes. The IMB-RetentioninHIVCaremodeliscurrently ses, skillsplayedimportantrolesinpredicting andbehavior motivation Conclusions: 39.7, p=0.14, RMSEA=0.03). ment. The overall PA (chi-square= modeldisplayedgoodfittothedata retention incarehadasignificanttotaleffectonHIVviralloadimprove had anear-significant totaleffectonHIVviralloadimprovement, and skills, retentionincare, andHIVviralloadimprovement. skills Behavioral patients. InthePA hadsignificanttotaleffectsonbehavioral motivation sixmonthsontwooutcomevariables,variables andat included N=251 Results: model variables’covariancestructure. inexaminingcomplexrelationships.equations For PA weanalyzedthe PA’s multipleregression strengthisitsabilitytosimultaneouslyestimate total effectsofbaselineIMBmodelcomponentson6-monthoutcomes. analysis(PA)conducted apath toidentifysignificantdirect, indirect, and acrossmodelvariables(Spearman’s relationships bivariate rho)and predicted retentionincareandHIVviralloadimprovement. We assessed was developed: skills, predictedbehavioral Motivation bothofwhich cacy, lifechaos, coping. andpositivenegative A conceptualmodel support, generalself-efficacy, self-effi appointment andmedication sures ofbeliefincare, accesstocare, trustinphysician, stigma, social baseline,completed IMB-RetentioninHIVCareat mea withIMB-related Methodology: six months. baseline predictedretentionincareandHIVviralloadimprovementat Baylor CollegeofMedicine, Houston, TX, USA University ofMichiganSchoolPublicHealth, Ann Arbor, MI, USA Northwestern University, Chicago, IL, USA 253 Oursample, baselineon13predictor withmeasurementsat 3 , JessicaDavila ConsistentwithIMB-RetentioninCaremodelhypothe Modeliswell-known,Although theIMBHealthBehavior it English-speaking, out-of-care, HIV-positive individuals

(presenting) Motivation-Behavior Skills Does aBaselineInformation- HIV Treatment andPreventionAdherence 3 , Thomas Giordano , Thomas 1 , K. Rivet Amico 2 , MelindaStanley 3

3 ,

- - - - - 254 10th International Conference on 10th International efforts. OOC HIV-positive toHIVcare personsandcriticalforsupportinglinkage and directrecruitmentiseffectiveforfindingseverelymarginalized Recommendations: Program acceptabilitywashigh. of thoseenrolledforsixmonths(n=55), 75%wereretainedincare. staff time. Among OOCpersons, 75%(n=59)were linkedtocare, and of31daystolinkaparticipantHIVcareand7.2hours an average (mean=121,582copies/ml). data enrollment perHIVsurveillance Ittook partners (previous6-months)and34%hadasuppressed VL priorto were on ART enrollment. at of9sexual Participants reportedanaverage average, OOCpersonshadnotseenaproviderfor13monthsand24% inexchangesex(28%).homeless (78%)andrecentlyengaged On can (38%), MSM(67%), uninsured(48%), (52%), recently incarcerated sampling.snowball OOCpersonsare The participating African-Ameri (35%) wereenrolledthroughdirectrecruitmentand51(65%) recruiters and79OOCpersonslivingwithHIV. Among OOCpersons, 28 Lessons Learned: barriers. tocareandhelpednegotiate linkage data. wasverifiedusingHIVsurveillance for Staffadvocated OOC status OOC personsreceived$40whenareferredpersonlinkedtocare. were incentivized$40forcompletingabaselinesurvey. Recruitersand HIVprovider.released fromjailwithnoidentifiedprimary Participants andnotlinkedwithin3months;or4) recently 3) newly-diagnosed 2) noHIVcarefor7-12monthsandmostrecent VL >200copies/ml; HIV-positive individualwitheither: 1)noHIVcarevisitsin>12months; through theuseofoutreachworkersandflyers. OOCwasdefinedasan sampling, usingtrainedrecruitersfromlocalHIVclinics anddirectly Description: out ofcare(OOC)HIV-positive personsandlinkthemtoHIVcare. Introduction: 1 Amy Rock-Wohl Rhodri Dierst-Davies Persons inLosAngelesCounty Marginalized OutofCareHIV-Positive Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, Recruitment strategies included Recruitmentstrategies ofsnowball acombination Project Engage (PE)wasdesignedtofindhard-to-reach ProjectEngage 1 Technique forFindingandLinking Project Engage:AnInnovative

Currently140participantsareenrolledincluding 61 sampling ofsnowball A combinedmethodology

(presenting) 1 , Ludwig-Barron Natasha HIV Treatment andPreventionAdherence

1 ,

- 256 time (Broadhead, etal., 2002). given any 10-15% ofHIV-positive at drugusersarein drugtreatment outcomes (Wood, Kerr, Tyndall &Montaner, 2008);andonlyanestimated ofaccessandadherenceamongIDUsleadtosub-optimal clinicalrates andmorelikelytodiscontinueHAARTmedications outright. Lower hasbeeninitiated,Once treatment IDUsarelesslikelytoadhere (Broadhead, population from HAART otherat-risk thanany etal., 2002). benefit derivedlesstherapeutic other HIV-positive andhave patients likely toreceiveHighly Active Anti-Retroviral Treatment (HAART) than population.hard-to-reach andhard-to-treat Active drugusersareless Introduction: 1 Gisele Pemberton (presenting) HIV/AIDS Continuum forSubstanceUsersLivingWith to HIV-positive drugusers. are specific determinantsofriskthat Discussthebehavioral intervention; makesPSYMEDauniquecognitivebehavioral the boostersessionthat ments andkeycharacteristicsofPSYMED; Identifythesixsessionsand the researchandtheoriessupportingPSYMED; Describethecoreele andretainthemincare; Identify provide supportforantiretroviraltherapy identify HIV-positive drugusers, linkthemtocareandhealthservices, components: Explaintheoverallgoal andmajorobjectivesofPSYMED-to Recommendations: among community/clinical practitioners. isreserachdrivenandfoundtobeeffective targeting drugusersthat testedHIV-positive.have specifically PSYMEDisoneoffewinterventions afteroncethey active drugusersinhealthcareandmedicaltreatment orreengage of thisresearch]hasbeensuccessfullyusedtoengage needles. Incommunitypracticesettings, version PSYMED[thepackaged likely topoolmoneybuydrugs;andlessthanhalfasshare increasedself-efficacyas likelytohave less inneedle-sharingsituations; continuedinjectiondruguse;almosttwice lesslikelytohave treatment; participantswere:intervention Twice entered drug morelikelytohave drug treatment, services. andpsychiatric up,At six-monthfollow all in theexperimentalgroupwereHIV-positive andlinkedtohealthcare, Lessons Learned: HIVriskbehaviors. sex-related and increasetheirself-efficacy inidentifyingandmodifyingdrug andthehealthcaresystem, intodrugtreatment theirentry facilitate injectiondrugusers, techniquestoengage interviewing motivational and readinessstaging usedbehavioral that intervention ment behavioral to testtheeffectivenessofacombinedcounselingandcasemanage InstituteofDrug Funded bytheNational Abuse, was thegoalofstudy Caribe- SchoolofMedicine, PuertoRico, injectiondrugusers. withLatino conducted byRoblesetal., 2004, fromtheUniversidadCentraldel risk-takingbehaviors.drug related PSYMEDisderivedfromresearch in HIVcareand ART adherence, andassisttheminreducingsex intohealthcareanddrugtreatment,linkage supportparticipant retention strategies. their activedrugusersandfacilitates PSYMEDengages support, referralfordrugtreatment, change andindividualbehavior counseling, interviewing which combinesmotivational clinical care foractivedrugusers intervention management, navigation andpatient Description: PROCEED Inc., Elizabeth, NJ, USA PSYMEDisanevidence-basedintensivecounseling, case Substance users have beendeemedanotoriously Substanceusershave Facilitating CareAlongthe The PsychoMedicalModel- 15%(n=37)ofthe285participants Approximately This presentation will focus on the following willfocusonthefollowing This presentation 1 , SarahjaneRath 1

- -

137 POSTER ABSTRACTS 138 257

procedures, tasks, standardsandregulations. um. reviewofpersonnel, asystematic processfacilitates The Mapping partnershipintheHIVCareContinu ofcollaborative the coordination tocaremodelandprovidesapictorialreference analysis ofalinkage opportunities forimprovement. isamethodofvisual ProcessMapping beenusedtoidentify methodologieshave andotherdiagnostic Mapping componentoftheHIV the Linkage-to-Care Treatment Cascade, Process tocareprotocol.linkage toimproveoutcomes in Inbuildingthecapacity variables andeffectivenessofthe analysis wasconductedtolookat activities andcommencedHIVpositiveswereidentified, aprocess tocareprogram.installing anewHIVtestingandlinkage After testing buildingassistancepartnershiptoassistChildren’scapacity with throughaCDC(CentersforDiseaseControland Prvention) facilitated opportunities forimprovement. was buildingintervention A capacity tocaremodelidentify strengths andweaknessesinthelinkage Medical Center, Washington, DC, wasutilizedtoassess processmapping Children’s foradolescentsandyoungadultsat to-care services National Description: to informeddecisionsonimprovement. modelandlead tothestrengthsandweaknessesofalinkage awareness of toolsandtechniques, including canbringcritical processmapping POSTERway toperformobjectiveprocessanalysis. The effectiveapplication utilizingprocessmethodologiesisasystematic improvement initiatives protocols. andlackofadherencetolinkage agreements service Process to caremodels, processes, inefficientlinkage poorlyconstructedmedical including:could impactinitiallinkage-to-care poorlyconstructedlinkage cascade including tocare. initiallinkage There areseveralfactorsthat ofthetreatment difficultymakingitthroughtheearlystages uals have HIV-positive newlydiagnosed individ many It hasalsobeennotedthat undetectable viralloadsuppressionthrough ART (Antiretroviral Therapy). inthefullspectrumofHIV engaged Treatment Cascadetoachieve 19%ofHIVinfectedindividualsare onlyanestimated been notedthat ABSTRACTS beenlinkedtocarewithinafour(4)monthperiod.results have Ithas nosis, only72%ofthosewithpositiveHIVtest that ithasbeenestimated ment isahighpriorityintheHIVCareContinuum. Following anHIVdiag Introduction: 1 Jeffrey Blanchard Quality andResults Continuum: MappingforLinkage-to-Care PROCEED Inc., Elizabeth, NJ, USA In a case study ofnewlyinstalledHIVtestingandlinkage- In acasestudy Effective and sustainable linkage toHIVcareandtreat Effective andsustainablelinkage Methodologies intheHIV Utilization ofProcessImprovement

(presenting) 1 10th International Conference on 10th International - - - - is recommended that aworkgroupbeformedtoschedule,is recommendedthat implement, intotheprotocol, thisprocessimprovementinitiative to fullyintegrate it analysis. pointsforsystematic entry integration Inorder and services tovisuallyidentifyprocesses,process mapping processgroups, tasks providers adoptandutilizeprocessimprovementmethodologieslike itive individualslinkedtocareafterdiagnosis. Itisrecommendedthat protocoltoincreasethenumberofHIV-posimprovement inthelinkage modelstoassessstrengths andoportunitiesfor revisit Linkage-to-Care and clinic tofrequently basedprovidersofHIVpreventionservices outcomes ofpersonsinfectedwithHIV, itisimportantforcommunity Recommendations: medical outcomesofprogramclients. Children’s forhealthand ofimprovementinitatives openedafirstwave Department. implementedwith The ProcessImprovementmethodology data,patient withtheSocial andstrengthingpartnerrelationships Work including ofenhancedperformanceindicators, incorporation capturing tocaremodelandidentify areasofimprovement ements oftheirlinkage Children’s MedicalCenterwasabletobetterunderstand theel National critical elementintheimprovementprocess. Through processmapping isthefirstandmost factorthat heightenedtheawareness intervention Lessons Learned: analyze and incorporate change in the linkage tocaresystem. changeinthelinkage analyze andincorporate Facilitation of the Linkage-to-Care Process Mapping Facilitation ProcessMapping oftheLinkage-to-Care In ordertoimpactlong-termhealthandmedical HIV Treatment andPreventionAdherence - - 258 10th International Conference on 10th International possible consequencesofnon-adherence. be cured, toemphasizetheneedforstrictadherencetimeand HIVcan needforadditionalcounselingtocorrectthebelief that however site isaboveaverage.of theadolescentsinthistreatment There is Conclusion: feeling uncomfortablearoundfriends. itshould.their drugsarenottakenwhenandhow Most(84%)admitto they should. However, theycandevelopresistanceif only27%know ofnottakingtheirdrugswhenandhow ideaoftheimplication average byforgetfulness(11%).things’ (18%)followed Almost all(99%)have (35%). The mainreasonsformissingdrugswere; ‘being busywithother as remindersweresettingofalarms(47%)andusefamilymembers was 84%whileadherencetotime19%. The twomaintoolsused can becompletelycured. Self-reported7daysrecalldoseadherence the namesoftheir ARVs. HIV Thirty-five oftherespondents believethat of therespondentswereon AZT, 3TC & NVPcombination. They allknew with HIVcanbepreventedwhencondomisproperlyworn. Most(88%) was17.9 the meanage Results: version 17. site inLagos. andanalyzedusingSPSS obtainedwerecollated The data atreatment of questionnairesadministeredto100adolescentsattending Methodology: tion, andadherence. management ofHIVpreven withregardstheirknowledge adolescents ontreatment Background: 1 Roseline Aderemi-Williams Site inLagos, Nigeria Positive AdolescentsAttendingaTreatment University ofLagos, NIGERIA Morethanhalf(66.0%)oftherespondentswerefemalesand ofprevention,The knowledge andadherence management InNigeria, asregardsHIV-positive thereispaucityofdata carriedoutwiththeuse This wasacross-sectionalstudy Adherence to Antiretroviral byHIV-Adherence toAntiretroviral Knowledge ofPreventionand ± 2.8years. infection One-third(75%)knewthat

(presenting) HIV Treatment andPreventionAdherence 1 , OluwabunmiOgunsanwo - 1

260 Rebecca Dillingham Methodology: care beyondclinic. strategies, extends andsocialsupportwithresponsivestaffthat tools, andmanagement deliversHIVeducation that wellnesspromotion bypairingatailoredsmart phoneapplication promotes engagement clinical care, butothersremainunmet. The Positive Links(PL)program inHIVcare.engagement ofthesearepartiallyaddressedduring Many Background: 4 3 2 1 Tabor Flickinger Lena Waldman Ava towards improvedclinicaltowards ofPLWH. outcomesinahigh-riskpopulation promisingtrends incareandshowed nificantly increasedengagement withcarecoordination.ing atailoredmobile-basedapplication Itsig Conclusions: 0.05). board,for highuseofthecommunitymessage toviralsuppression(p= adherence(p=0.02)and, appointment interaction byquartiletogreater (p <0.001). levelofapp relating A dose-responseeffectwasobserved the past12months. 87%(45/52)achievedthis At sixmonthfollow-up baseline, by90 days in 2visitsseparated 44%(23/52)hadattended Mean numberofinteractionsin180dayswas297(range: 0-598). At (37%) wereidentifiedaschallenges. app regularly.Participants usedthe line. Housinginsecurity(21%), (19%), transportation andfoodinsecurity is 55%. Participants base reportedhighlevelsofstigmaandstressat sexwithmen.who have is35, Meanage andmeanfederalpovertylevel Results: medical records. is18months. The totalperiodofparticipation arecollectedcontinuously.use data werecollectedfrom Clinicaldata in-person. Participants completedbaselineandsixmonthsurveys. App and throughtheapplication accesstothePLcarecoordinator also have plan,with avoiceanddata loadedwiththePLapp. The participants provider referrals. The PLteamprovidedparticipantswithasmartphone School ofOrientaland African Studies, London, England, UK Wake Forest UniversitySchoolofMedicine, Winston Salem, NC, USA Health Decision Technologies, Sheboygan, Wisconsin, USA Uniersity of Virginia, Charlottesville, VA, USA 70%ofparticipantsaremale. 44%areblack. 46% aremen The PLprogramprovides “warm technology” bycombin People livingwithHIV(PLWH) facecomplexchallengesto The PLprogramhasenrolled52individualsbasedon 1 Improves EngagementinCare Improves Positive Links:Tailored MobileApp , ErinPlews-Ogan 1 , ColleenLaurence

(presenting) 1 1 ,Cohn Wendy , KarenIngersoll 3 , Erin Wispelwey , 1

1 , GeorgeReynolds 4 ,

- - - 2 ,

139 POSTER ABSTRACTS 140 262

support isneeded. as apossiblemarkerofrisktoidentifyparticipantsforwhomenhanced outcomes. As such, contacttimemaybeused initialintervention greater increased risk for poor clinicalmore time-intensive encounters may be at VL suppression. womenwhoearly onrequire This findingsuggeststhat tive, withless contacttime wasassociated initialintervention greater Conclusions: 95% CI: 0.86-0.99). contact timewerelesslikelytoachieve VL suppression(aOR=0.93; 0.20- 1.38). analysis, Inmultivariate intervention womenwithgreater contact timeduringthe2-weeksamplingperiodwas0.5hours(IQR use behaviors, and33.3%had VL suppression. Mediantotalintervention 35% reportedcurrenthigh-risksexualbehaviors, 10.6%high-riskdrug years, 60.6%werenon-HispanicBlack, and32.3%Hispanic. At baseline, Results: pression andtimefrombaselinetothe2-weeksamplingperiod. controlling forage, race/ethnicity, high-riskbehaviors, baseline VL sup contacttimeto intervention year,VL suppressionoverthefollow-up oftotal analysiswasconductedtodeterminetherelationship equations withinindividuals,for clustering ofobservations generalizedestimating enrollment.for a2-weekperiodwithin6monthsafterstudy To account ticipants, contacttimeperparticipantwasmeasured totalintervention POSTERnizations), design. eachwithadifferentintervention For asampleofpar sites(clinicsU.S.-based demonstration and/orcommunity-basedorga 9 inHIVmedicalcareat levelsofengagement women withvarying Methodology: suppression. contacttimeandHIVviralload(VL) betweenintervention relationship Therefore, amongacohortofHIV-positive women, weexaminedthe withrespecttoHIVclinical aboutthisrelationship is known outcomes. withhealthoutcomes. maybeassociated intervention However, less Background: ABSTRACTS4 3 2 1 Quinlivan EByrd Oni Blackstock Load Suppression Tufts UniversitySchoolofMedicine, Springfield, MA, USA North Carolina, Hill, Chapel NC, USA Institute forGlobalHealthandInfectiousDiseases, Universityof New York UniversitySchoolofNursing, New York, NY, USA Bronx, New York, USA Montefiore MedicalCenter/AlbertEinsteinCollegeofMedicine, Among ouranalyticsample(n=406), was41.4 medianage Among HIV-positive womenenrollinginamultisiteinitia Prior studies suggest that theamountofexposure toan Priorstudiessuggestthat The multisiteSPNS Women recruited ofColorInitiative is AssociatedWithLessHIVViral ContactTimeGreater Intervention

3 (presenting) , Thomas Lincoln , Thomas 1 , Arthur Blank , Arthur 4 , ChinazoCunningham 1 , JasonFletcher 1 2 ,

10th International Conference on 10th International

- - - - 263 functioning in treatment naïve functioning intreatment YLWH. Comprehensiveneurocogni versus standardofcare(SOC;CD4<350cells/mm Methodology: clinical outcomesin YLWH. ever, betweenthesetwoimportant abouttherelationship littleisknown non-adherence;how for bothneurocognitivedisordersandmedication Background: 4 3 2 1 Patton Doyle Patricia Garvie Behaviorally AcquiredHIV tobacco userisk, requirefurtherstudy. processes acrossverbalandvisualdomains,memory andtheroleof however, betweenadherenceandepisodic thediffering relationships predictedadherence; initiation functioning measuredpriortotreatment health issuestosustainoptimaladherenceamong YLWH. Memory adherence andhealthoutcomes, highlightingtheneedtoaddressmental 144 emphasizesthepotentialimpactofmentalhealthconcernson baselineandweek functioningmeasuredat and emotional/behavioral Conclusions: week adherence. tobetterpast tobaccouserisk(p=0.021)related 0.033) andlower week144.predicted betteradherenceat At week144, onlyGSI(p= <0.001), baseline globalsymptomindex(GSI;p=0.017)at andlower recall(p=0.035),poorer visualmemory depressionseverity(p lower included inanalyses. Betterverballearningrecognition(p=0.049), months sincediagnosis, post-enrollmentwere treatment whoinitiated male, 65%Black/African American, 24%Hispanic, withmean16.5 Results: and continuousscaleanalysis, respectively. Fisher’s exactand Wilcoxon Rank-Sumtestwereusedforcategorical days precedingthevisit, using>90%criteriontodefineadherence. week 144. Adherence wasassessedviaself-reportedrecallforthe7 baselineand substance usescreeningmeasureswereadministeredat symptoms)and (depressionandemotional/behavioral brief psychiatric functioning, memory, motorskills, attention, andexecutivefunctions), tive assessments(including globalintellectualfunctioning, adaptive University ofCalifornia, SanDiego, CA, USA University ofHouston, TX, USA Westat, Rockville, MD, USA Children’s & Diagnostic Treatment Center, Fort Lauderdale, FL, USA N = 111 treatment-naïve N=111treatment-naïve YLWH, 21years, meanage 87% 1 , SharonNichols betweenadherence observed The significantrelationship Youth acquiredHIV(YLWH) withbehaviorally areat-risk Longitudinal study oftheimpactearly(i.e., Longitudinalstudy CD4>350)

of AdherenceinYouth With Neurocognitive Correlates (presenting) HIV Treatment andPreventionAdherence 1 4 , SueLi

2 , JamesBethel 3 ) onneurocognitive 2 , Steven Woods, - 3 , - 264 10th International Conference on 10th International with careprovidersormortalityreminderssupportivesurrogates. wards improvementovertime, potentiallybecauseofincreasedcontact arm,increased; forregardlessoftreatment viralsuppressiontrendedto in self-reportedadherencemayreflectincreasedhonesty, astrust to findsignificantdifferences(ceilingeffects). Theincongruentdecline adherence andundetectableviralloadswerehigh, makingitdifficult There wasnotenoughvarianceinthedata, i.e. overallhighlevelsof Conclusions: range invariance, pvaluescouldnotbecalculated. to 85%andforcontrolfrom100%94%. Becauseoftherestricted adherence at (from 74%to81%)andcontrolgroup89%94%). Self-reported The proportionofundetectable group VL increasedforbothintervention (p=0.6877)inGEEmodel.interaction betweentimeandintervention 0.5472). effectonviralload(p=0.2114),There wasnointervention nor (p= eitherbaseline(p=0.3636)or3monthpost-intervention at related unknown. Self-reportedadherenceand VL werenotsignificantlycor sexually infected;9%viainjectiondruguse;30%congenital/iatragenic/ heterosexual; 58%lessthan300%ofFederal povertylevel. 61%were Results: effects. (GEE)examinedintervention Equations Generalized Estimating Undetectable VL wasdefinedasplasmaHIV-1 RNA VL<50copies/mL. persons prescribed ART wereincluded inthisinterimanalysis(n=45). at 3-monthspost-intervention.and chartverifiedviralload(VL) Only adherence(Visual medication tion onpatient-reported Analog Scale) clinical trial, betweenan weexploredtherelationship ACP interven Methodology: andhealthcareproviders. chosen surrogates shared decisionmakingregardingendoflifedecisionsamongpatients, asreminderofmortality.influence adherencebyserving ACPinvolves Background: 1 Maureen Lyon Among HIV-Positive Adults? Children’s National, Washington, DC, USA Meanage, 51years;55%male, 86% African American, 70% The analysisdidnotidentifyasignificanteffectfor ACP. withHIV advancecareplanning(ACP)may Among patients ≥ 2-armrandomizedcontrolled As partofanIRB-approved

90% decreased in both groups for intervention from93% 90% decreasedinbothgroupsforintervention (presenting) Increase MedicationAdherence Does Advance CarePlanning(ACP) 1 HIV Treatment andPreventionAdherence - - - 266 Method: WiLLOW participation. theirliveswereimpactedasaresultof women valuedandhow targetingHIVtransmissionriskreduction) dence-based interventions aspectsof tive womentoassesswhat WiLLOW (agroupCDCevi Introduction: 5 4 3 2 1 Alyssa Ursillo Sannisha Dale Evidence-Based Intervention factors that buildpositivegroupdynamics. factors that thesharingofstoriesintheircurriculumsand benefit fromincorporating specific targetedoutcomes. forHIV-positive Interventions womenmay beyondthe mayhave an intervention HIV andthebroadinfluencesthat amongwomenwith contribute totheacceptabilityofanintervention Conclusions: andintheircommunities. aboutissueswithinrelationships advocate status, gainedanoptimisticoutlookonlife, andlearnedtospeakup image, joinedothergroups, changedoldbehaviors, acceptedtheirHIV asaresultof also sharedthat WiLLOW theyembracedastrongwoman trust, openness, gettingfeedback, bonding, andsocializing. Women consistingofsafety,told byeachotherandpositivegroupdynamics Results: identified asage was48. African-Americanandtheirmean analyzed usingGrounded methods.Theory Ofthe31women, 80.6% wasaudiorecorded, that completed a1-hourinterview transcribed, and Eight womenwereunreachableandoftheremaining32, 31women women whocompleted alargehospitalintheBostonarea.WiLLOW at Boston UniversitySchoolofPublicHealth, Boston, MA, USA Boston MedicalCenter, Boston, MA, USA William JamesCollege, Newton, MA, USA The UniversityofGeorgia, Athens, GA, USA MedicalSchool,Harvard Boston, MA, USA Findings womenvaluedthepersonalstories revealedthat Forty HIV-positive womenwererandomlyselectedfromalistof 4 may findingsemphasizefactorsthat These qualitative wasconductedamongHIV-posi study A qualitative , Mari-Lynn Drainoni

(presenting) Women’s Perspectives onan “In OurStories”:HIV-Positive 1 ,Grimes Tiffany 5

2 , LaurenMiller 3 ,

- -

141 POSTER ABSTRACTS 142

have sufficientresourcestoobtainthefullspectrumofneededservices. have services. substanceusers Providersshouldfocuseffortstoensurethat stance usersaremorelikelytoreportlackingresourcesobtainneeded reported.stimulant useaffectedthenumberofgaps Additionally, sub gaps, increasedriskofreportingservice butwithinthisgroup,only at Conclusion/Implications: Findings substanceuserswerenot suggestthat barriers. compared tothosereportinginformation-based (RR=1.62) increasedriskofreportingadditionalgap(s) barriers wereat bybarriertype,stratified stimulantusersidentifyingresource-based health status, inmedicalcare. femalesandthosereportinglapses When werealsoreportedbymental al gaps. gaps Increasedrisksforservice ers (RRrange: riskofreportingaddition 1.54-1.75)reportedanelevated less robust(RRrange: 0.89-1.30). Among substanceusers, stimulantus bysubstanceusers(Poissonreporting additionalgaps regression)were (RRrange: gap(s) service 2.87-3.45)amongsubstanceusers. Risks of Results: gap(s), reported. aswellthenumberofgaps withbothreportingservice analysis determinedfactorsassociated reported recentsubstanceuse. NestedPoisson andlogisticregression 30%(119unweighted,Approximately 5,743weighted)ofrecipients period. systemduringthesurveillance the 19,915recipientsinRW adjust theeffectivesamplesizefrom400to18,951persons, similarto POSTERsample ofagencies/clients. Individuallevelsweightingwasusedto portional-to-size samplingdesignwasusedtoidentifyarepresentative Needs Assessment wereutilized. A two-stage, stratified, probability-pro Methodology: California. recipientsinLos sampleofRW a representative Angeles County, among gaps service examines theeffectsofsubstanceuseonancillary through programsfundedbytheRyan Care White (RW) Act. This study income HIV-infected accessedservices personsintheUnitedStates withincreasedmorbidityandmortality.correlated Historically, lower ABSTRACTSBackground: 2 1 Rhodri Dierst-Davies Los AngelesCounty Substance- UsingRyan WhiteRecipientsin Los Angeles, CA, USA University ofCaliforniaLos Angeles, Fielding SchoolofPublicHealth, Los Angeles, CA, USA Los Angeles CountyDepartmentofPublicHealth, 267 Logistic regression revealed an elevated riskforreporting Logisticregressionrevealedanelevated SubstanceuseamongHIV-infected individualsisstrongly Data fromthe2011Los Data HIV/AIDS Angeles Coordinated

Among HIV-Infected Services Gaps inAncillary (presenting) 1 , LindaBourque 2

, Amy Rock-Wohl, Amy 10th International Conference on 10th International - 1

- - - 271 herence vs. QoL). Viral loadwasabstractedfrommedicalrecord(codedas<90%ad assessedQoL,Inventory range0-100(thehigherthescore, thebetter six urban, hospital-basedclinics. Varni’s 1998Pediatric QualityofLife with HIVfromtheFAmily-CEntered Advance CarePlanningtrialfrom Methodology: care. regimentsandguidepatient oftreatment evaluation measures inconjunctionwithbiologicalendpointsmaybeusefulthe well-being.a comprehensiveunderstandingofpatient UseofQoL Background: 1 Maureen Lyon Allison Kimmel(presenting) Adolescents LivingWithHIV study isneededtobestunderstandthisrelationship. study had slightlyhigherscores, similartopreviousadultstudies. Longitudinal endpoints, viralload althoughthosewithbetteradherenceandlower Conclusion: <90% (83vs. 68, p=0.0019). nificantly highermedianofemotionalscorethanthosewithadherence infectedparticipantswithadherence Non-perinatally higher meanscoreinSchoolfunctioning(73.3vs. 66.1, p=0.0864). 400 copies/mL(Total 85vs. 83, p=0.3862)andmarginallysignificantly had non-significantlyhighermeanscoresthanthosewithviralload <90% (Total 85vs. 84, p=0.7599). Participants withviralload<400 had non-significantlyhighermeanscoresthanthosewithadherence had viralload<400copies/mL. Participants withadherence 14-20). Fifty-one percentreportedadherence Hispanic/Latino, 77%perinatally-infected, 18years(range meanage = 94). Participants were: 54%male, 95% African-American/black, 7% Results: bythesourceoftransmission. was usedtotestthesamerelationship of adherenceandviralloadwithQoL. An exactmediantwo-sampletest Children’s National, Washington, DC, USA Only adolescentsprescribed ART wereincluded inanalysis(N ≥ Quality ofLifescoreswerehighregardlessbiological 90% adherence). T-tests wereusedtotesttherelationship 1 Quality of Life (QoL) is an important measure to capture Quality ofLife(QoL)isanimportantmeasuretocapture

Baseline data werecollectedfrom105adolescentsliving Baseline data Self-Reported Adherencein Quality ofLife, Viral Load, and HIV Treatment andPreventionAdherence 1 , YaoCheng 1 , Jichuan Wang, ≥ 90%. Sixty-twopercent ≥ 90% hadsig 1 ,

≥ 90% - ≥

- 272 10th International Conference on 10th International care practices. PrEP inprimary andimplementing understand theproviderbarrierstodisseminating aswell.apply tootherstates findings may Moreresearchisneededto everprescribedPrEP.physicians inNorthCarolinareporthaving These carephysicians.prescribing practicesamongprimary Few care primary Conclusion: heterosexuals and8%(2/25)forinjectiondrugusers. sexwithmen,reported prescribingitformenwhohave 36%(9/25)for practice settings. OfthosewhoreportedprescribingPrEP, 56%(14/25) of thesePrEPprescribersweremalephysicianswhoworkedinurban scribed pre-exposureprophylaxis(PrEP)totheirpatients. Most(16/25) Results: participants (n=584)responded(59%responserate). for whomPrEPwasprescribed. Fifty-nine percent(n=327)ofeligible they hadeverprescribedPrEP. They werealsoaskedtodescribepatients tions regardingtheiruseofPrEP. Physiciansspecificallywereaskedif focused onHIVscreeningpractices, physicianswerealsoaskedques 2015.method duringOctober2014-April mainly Although thesurvey usingtheDillmantotaldesign and mailedaself-administeredsurvey carephysicians(definedhereasfamilyandinternalmedicine) primary Methodology: physicians. care todeterminetheuptakeoftheseguidelinesamongprimary survey inNC,among providersiscurrentlyunknown weconductedastatewide adults. Becausetheextentofadoptiontheserecommendations a preventionoptiontoinjectiondrugusersandhighrisksexuallyactive providers considerofferingPrEPas These guidelinesrecommendthat health careprovidersontheuseofPre-ExposureProphylaxis(PrEP). Prevention releasedcomphrehensiveclinical practiceguidelinesfor Background: 2 1 Prianca Reddi Becky White CarePhysicians North CarolinaPrimary of 2014-2015: ResultsofaStatewideSurvey North Carolina, USA Gillings GlobalSchoolofPublicHealth, Hill, Chapel University ofNorthCarolina, Hill, Chapel NC, USA Only 25 of 327 respondents (7%) reported having everpre Only25of327respondents(7%)reportedhaving To ofPrEP ourknowledge, survey thisisthefirststatewide

InMay2014, theCentersforDiseaseControland 1 (presenting) , DonaldPathman We ofNC randomlysampled 10%oftheentirepopulation Among Health Care Providers in Among HealthCareProviders Low AdoptionofPrEPGuidelines 1 , AshleyAppiagyei 1 , AdaoraAdimora HIV Treatment andPreventionAdherence 1 , JuliaHill 1 , CarolGolin

2 ,

- - 277 Description: urban jurisdictionsintheUS. impacted officialsfromheavily department representatives/government of partnershipspeoplelivingwithHIV/communityleadersandhealth frameworkuponwhichitisbased--involvestheestablishment strategic Urban CoalitionforHIV/AIDSPreventionServices, UCHAPS--andthe fromtheUSCentersforDiseaseControlandPrevention,services the andlocalgovernmentofficialsfundedtoprovideprevention sentatives Background: 1 Marsha Martin Metropolitan Areas Model forUrbanJurisdictionsand of evidence-informedbestpracticesinpublichealth. andexchange achievedreductionsinincidencethroughapplication have andagovernmentofficial.society representative UCHAPSjurisdictions theresponsetogether.managing The coalitionisco-chaired byacivil making authority, sharingtheburdenofimplementation, and creating thesametable,and governmentat inequalnumber, withequaldecision and betterimplemented.response canbebettermanaged Community byworkingtogetherinpartnership,on thebeliefthat thelocalHIV Conclusions: challenges, andlessonslearnedfromthefield. usingknowledge jurisdictions areoftenontheleadingedgeofrespondingtoHIVprevention ing andimplementingHIVprograms. As HIVpreventionpioneers, UCHAPS tion, from thedaytorealitiesofmanag ideasandresourcesgathered discuss atopicofparticularinterest, orpressingneed: sharinginforma tween itsmemberdelegations, thecoalitionmeetsquarterlytoreviewand Results: and leadersinHIVlocally. efficacy. membersrepresentthebestthinkers Jurisdictionaldelegation anddemonstrating theforefrontofpilotingnewinterventions are oftenat jurisdictions areamongtheepicentersofurbanHIVepidemicand in equalnumber, electedfrom selecturbancenters. UCHAPScities/ ofmembersfromccommunityandgovernment comprised ofdelegations tion andparity, is theUrbanCoalitionforHIV/AIDSPreventionServices Washington, DC, USA Urban CoalitionforHIV/AIDSPreventionServices, Usingapeertobasedmodeloftechnicalassistancebe Operating underthephilosophyofinclusion,Operating representa Begun as an informal collaborative ofcommunityrepre Begunasaninformalcollaborative The UCHAPS collaborative strategic frameworkisbased strategic The UCHAPScollaborative

Practices StrategicCollaborative ABest Scale UpofHIVServices: (presenting) 1 , SamRivera 1

- - - - -

143 POSTER ABSTRACTS 144 278

amplify HIVrisk. diseases interact, orindividuals, thelevelofpopulations eitherat to Conclusions: (13/28 [46%]vs. 0/9[0%];c2=6.44, P=0.01). about incorrectlanguage others toincorporate “synergy” or “interaction” tween psychosocialproblems, thesestudiesweremuchmorelikelythan abouttheextentofinteractionbe cannotprovideinformation approach to thetotalcountofpsychosocialproblems. Although thecountvariable to testthediseaseinteractionconceptwassumscorecorresponding scale.a multiplicative (28[76%]) The mostfrequentlyusedspecification tointerpretinteractionbothonanadditiveand sufficient information of aproductterm, withlessthanhalfofthese(5/11[45%])providing the diseaseinteractionconcept, 11(30%)studiesusedsomevariation (28[76%])orHIVinfection(9[24%]).transmission riskbehaviors To test [73%]); whilethemostfrequentlystudiedoutcomevariableswereHIV mental health(31[84%]), substanceabuse(32[86%]), andviolence(27 to The mostfrequentlystudiedpsychosocialproblemswererelated (29 [78%]), sexwithmen(20[54%]). andfocusedonmenwhohave POSTERbased onacross-sectionaldesign(30[81%]), conductedintheU.S. articles, 5dissertations, and1conferenceabstract. Moststudieswere Results: ofsyndemics. withthetheory associated tohighlycitedpublications andtrackedcitations databases bibliographic Methodology: for theconceptofdiseaseinteractionremainsunclear. field ofHIVprevention, buttheextenttowhichthereisempiricalsupport health (diseaseinteraction). haswidespreadadherentsinthe This theory ABSTRACTSand individuals, withmutuallyenhancingdeleteriousconsequencesfor thelevelofpopulations andinteractat conditions (diseaseconcentration) contextsduetoharmfulsocial in particulartemporalorgeographical Background: 1 Alex Tsai Disease InteractionConcept Systematic ReviewofEmpiricalTests ofthe Massachusetts GeneralHospital, Boston, MA, USA Ofthe784records, included weultimately 31publishedjournal

(presenting) Moreevidenceisneededtoassesstheextentwhich ofsyndemics,According tothetheory diseasesco-occur In January 2015 we systematically searchedseven 2015wesystematically InJanuary Problems andHIVRisk:A Syndemics ofPsychosocial 1 , BridgetBurns 1

10th International Conference on 10th International - 284 experiences withpatients. sharedexperienceto They canleverage cancer screeningandtreatment. sharecommonmedical Peer navigators obstacles. hasbeenmostprominentin navigation The useofpatient orcircumventpotential to reducedisparitiesincareandevenavert which caninclude healthcareprofessionalsandlayworkers, canhelp delivery.and culturalcompetenceofhealthcareservice Navigators, andimprovethequality accesstoservices tofacilitate and patients asoneofthecriticallinksbetweenproviders serve Patient navigators Improvements inretentioncareareexpectedtoreduceHIVincidence. notbeenretainedinHIVcare. orhave oftheirdiagnosis either unaware topeoplelivingwith HIV (PLWH)infections areattributable whoare Introduction: 1 Rupali Doshi Successes andChallenges order toimprovehealthoutcomesforPLWH andreduceHIVtransmission. incareoutcomes, onretentionandre-engagement HIV peernavigation in Recommendations: confidentiality. certification, humanresourcesdevelopment, andmaintenanceofpatient care team. include Challengestoimplementation funding, training, withthehealth andimprovedengagement to medicalappointments programs include improvementsinretentionHIVcareandadherence Lessons Learned: Charleston. describe successfulprogramsimplementedinNashville, Chicago, and programs fundedbytheRyan White HIV/AIDSProgram(RWHAP). We will Description: programsremainslimited. for HIVpeernavigation result inimprovementsretentioncare. However, theevidencebase could of stigma), useofHIVpeernavigators that ithasbeenpostulated treatment, needed, multiplemedicaltestsandappointments andhistory Given thesimilaritiesbetweencancerandHIV(complexityofdisease aboutresourcesandcopingstrategies,mation andbuildhealth literacy. asustainableforumforseekinghelp,foster trustandcreate shareinfor Health Resources and Services Health ResourcesandServices Administration, Rockville, MD, USA beenmultiplemodelsofHIVpeernavigation There have

Recent data demonstrates that over90%ofnewHIV that demonstrates Recentdata (presenting) White HIV/AIDSProgram:Models, Peer NavigatorsintheRyan Successes of the RWHAP-funded peer navigation peernavigation SuccessesoftheRWHAP-funded More research is needed to examine the effects of Moreresearchisneededtoexaminetheeffectsof HIV Treatment andPreventionAdherence 1 , Ameila Khalil , Ameila 1 , TraceyGantt 1

- 285 10th International Conference on 10th International prisonrelease. following these services HIV-positive ex-offenderscanbeprovided medicalcareandlinkthemto needs. These findingscanhelpindesigningaprogramthroughwhich addressbasicsurvival ferral forassistancetocommunityprogramsthat treatment, forHIVandothermedicalconditions, appointments andre andreferral,mental illnesstreatment substanceabuseassessmentand Conclusion: with careservices. SMSmay beusedforestablishinglinkages peer outreachandanimated onpartofprisonadministration,which willincreaseownership anda as anNGO, prisonstaffmaybetrainedandassignedtoprovidetesting insteadofanoutsidepartysuch providersthat consensus amongservice that shouldbeprovidedwithoutinterruptions.VCT services There was are providedfreeofcostbythegovernment. All providers suggested inoroutsideofprisoneventhough available preventive services ARVs the HIVinfection, aboutthecareand andwerealsonotfullyaware Results: testing andlinkingtocareprogram. providers inMarch2015toassessthefeasibilityofestablishingafree Method: because ofonereasonoranother. areprovidedbyanNGOwhichfrequentlyinterrupted testing services moment thereare2,200prisonersinthefacility. CurrentHIVcareand inthecountry.houses oneofthehighestnumbersinmates At the particularlyforriskgroups.and HIVtestingservices DistrictprisonMalir healthcare Confinement providesanopportunitytoaccessprimary were HIV-positive, 5.9%hadHBVand15.2%weresufferingfromHCV. nodeficiency virus(HIV)infection, 2% that inDPMshows arecentstudy Background: 1 Anees Siddiqui (DPM), Karachi, Pakistan Linkage PrograminDistrictPrisonMalir District PrisonMalir, Karachi, Sindh, PAKISTAN Majority of the prisoners had very limited knowledge about limitedknowledge Majority oftheprisonershadvery We conducted in-depth interviews of inmates and service andservice We ofinmates conductedin-depthinterviews mayinclude andcareservices thefollowing:The treatment Prisoners are at increasedriskofacquiringhuman immu Prisoners areat

Establishing HIVTesting and Assess theFeasibility of (presenting) 1 HIV Treatment andPreventionAdherence - - 286 agnosis, immunoassays as astheycombinethird-andfourth-generation initiation.treatment earlierHIVdi The thirdandfourthalgorithmsallow early andallowing oral fluid(OF)–henceexpandingaccesstodiagnosis tests-fingerprickor The firsttwoalgorithmscombinetheuseofrapid one forscreeningandasecond, morespecific, toconfirmtheresult. Methodology: consistently inseroconvertingindividuals. HIV-1 that assayreactivityprogressed sequentiallyandhighly observed conceptdevelopedbyFiebig staging etalwho based onalaboratory indifferentsettings.testing implementation These algorithmswere aswellenable toincreaseaccessdiagnosis alternatives create on HIV-1 inBrazil. diagnosis Five algorithmswereproposedaimingto Background: 1 Ana Pires serological status. their so astoenableaccessalltheindividualswhowantknow choiceofthealgorithmaccordingtotheirlocalreality,make anadequate STDs, AIDS, and professionalsandservices expectsthat Viral Hepatitis Conclusions: supportedbyCivilSocietyOrganizations. key populations infrastructure, itsuseenabledthescreeningtestpilotingprojectswith early diagnosis. doesn’trequirelaboratory As theOFimplementation as prevention(TasP) improvementsaimingat whichrequirescoverage recentlyadoptedinBraziloftreatment meetsthestrategy diagnostic reducing thebiologicalrisk. ofrapid ofthistechnology The incorporation increases testingaccessibilitywhile in Brazilsincethistechnology Results: test. a confirmatory bythe immunoassayscreeningfollowed third-generation Western blotas proposed, thefifthalgorithmisroutinelymostusedandcombinesa being lesscost-effective, whencomparedwiththeothersalgorithms results. forconfirmatory screening andviralloadquantification Despite Ministerio daSaúde, Brasília, DistritoFederal, BRAZIL The decreeisgroundbreakingintheuseofOralFluidtests

(presenting) ofthisdecree,With thepublication theDepartmentof In2013, ofHealthpublishedthenewdecree theMinistry Serological diagnosis is conducted with at leasttwotests, isconductedwithat Serologicaldiagnosis the DiagnosisofHIV-1 Infection forExpansionof Brazilian Strategy 1 -

145 POSTER ABSTRACTS 146 291

services andtaskshiftingtoimprovecontinuumofcare. services ize the withgeneralhealth integration ART programmebyitsappropriate Conclusions: success, cascade. ofleakytreatment haslimitation limited numberofstandalone ART centersinIndia, despiteitssignificant Lessons Learned: could notbeachieved. ever, variousstepsofthecascade least90%retentionat thedesiredat and “Pre-ART” LTFU declined rates to9.4%and7.4%, respectively. How National AIDS ControlProgramme(NACP-III;2007-2013), and “On ART” adoptedin improvementthroughstrategies 2014 showed Third Phaseof respectively. The retentioncascadeoflastyearfrom 2013toMarch April and “Pre-ART” LTFU inthelastdecadewas15.5%and45.2%, rate fromcarewhile1.2%haddied.disengaged After ILT overall “On ART” to 2009. tracked,Amongst patients 1.5%werealive, 0.24% had POSTER prior onenrolmentintoHIV-careproof ofpatients wasnotmandatory LTFU clients sinceaddress duetoincompleteaddresses/ormigration 2013 throughMarch2014wasnotsuccessfulintracking97%pre-ART Results: wereinactivepre-ARTOnly 27.4%patients careduring2013. inpre-ART thanthoseinitiated the patients carewas3timeslower ART. step-4werewithin1styearand80%2years.at The retentionof tolifelong step-4 (initiation ART) ofretentioncascade. About 2/3rdlosses eligibility), of step-3(eligibilitytoinitiation 23.7%at ART), and16.6%at (testing toenrolmentintoHIV-care), step-2(enrolmentto 7.8%at ART ABSTRACTS (LTFU)24% HIV-positive werelost-to-follow-up patients step-1 at Description: morbidity &mortalityandpreventemergenceofdrugresistance. of Anti Retroviral Treatment (ART) programmetoreduceHIV-related Introduction: 1 Anil Gupta Experience ofaDecadeandWay Ahead Deep ChandBandhuHospital, GovtofDelhi, NewDelhi, Delhi, INDIA The intensified LTFU tracking(ILT) undertakenduring November

(presenting) In last decade in Delhi (April 2004toMarch2014), InlastdecadeinDelhi(April overall forpolicy hasimplications The study makerstodecentral Retention of patients inHIV-care Retentionofpatients iscriticalforsuccess in ContinuumofHIVCareDelhi- Challenges inRetentionofPatients National policy National ofdelivering ART through services 1 10th International Conference on 10th International - - 292 children living with HIV/AIDS enrolled for at least one year at PSSH. leastoneyearat children livingwithHIV/AIDSenrolledforat of outcomes anddeterminingtheprescriptionpattern ARV drugsin andtreatment data existedbetweendemographic association out ifany outcomes in children (0 – 15years),geria by measuring treatment finding specialistHospital(PSSH), State of antiretroviraldrugsinPlateau Jos, Ni management. wastodeterminetheeffectiveness The aimofthisstudy ti-Retroviral (HAART) globallyacceptedforHIV/AIDS Therapy istreatment 3 millionchildrenarelivingwithHIV/AIDS(WHO, 2013). Highly Active An which occursduringpregnancy, labour, delivery, orbreastfeeding. About Background: 1 Comfort Sariem Nigeria HIV/AIDS inaTertiary HealthInstitutionin prolong their lives if treatment is initiated before the age of2years. beforetheage isinitiated prolong theirlivesiftreatment Conclusion: the olderchildren(6-15)years. progressed frombaselineamongtheunder- fiveyearolds, comparedto a significantincrease(p<0.05)inweightandCD4countastreatment ofthechildren. andCD4countacrossallages data There washowever There wasnosignificantdifference(p>0.05)betweendemographic ole. age progressed. inweightas A significantdifferencewasobserved enrollment from2006to2013. Majority(90%)weregivenco-trimoxaz dren. About 54%werelessthanfiveyearsold. Therewasanincreasein orefavirenz.nevirapine There weremoremales(60%)thanfemalechil most frequentlyprescribedwaslamivudineandzidovudinewitheither Results: fromthestudy. outcomesweregenerated andtreatment data percentages, meanandstandarderrorof(SEM)demographic science (SPSS)softwareversion20.0foranalysis. Descriptivestatistics, forthesocial packages collectedwasenteredintostatistical data permission fromthehealthresearchandethicscommitteofhospital, design wasutilizedforthestudy. obtainedethicalclearance Having and Methodology: Jos, NIGERIA Department ofClinicalPharmacy andPharmacy Practice, Universityof A totalof200childrenwereinvolvedinthestudy. The HAART Antiretroviral drugscanimprovechildren’s healthand HIV inchildrenismainlyduetoverticaltransmission A cross-sectional retrospective hospital based study A cross-sectionalretrospectivehospitalbasedstudy Therapy inChildrenLivingWith Effectiveness ofAntiretroviral

(presenting) HIV Treatment andPreventionAdherence 1 - - - - 10th International Conference on 10th International Nova SoutheasternUniversity 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 University Institute/Harvard 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 Dazon DixonDiallo, MPH 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 Boston, MA, USA MedicalSchool Harvard of AIDS Care of AIDS KENYA SWITZERLAND SOUTH AFRICA CANADA

147 ACKNOWLEDGEMENTS 148

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 Dazon DixonDiallo, MPH ACKNOWLEDGEMENTSAberdeen, of Aberdeen University Marijn deBruin, PhD Denver, CO, USA University ofColorado, Denver Marla A. Corwin, LCSW, CAC III 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 SCOTLAND

Bethesda, MD, USA Instituteof National and Allergy Tia Morton, RN, MS Boston, MA, USA University Institute/Harvard Fenway Kenneth Mayer, MD Pavia, University ofPavia Franco Maggiolo, MD Jackson, MS, USA University ofMississippiMedicalCenter Deborah Konkle-Parker, PhD, FNP Atlanta, GA, USA DiseaseControlandPrevention Centers for Linda Koenig, PhD, MS Bethesda, MD, USA InstituteonDrug National Abuse Shoshana Kahana, PhD West Yorkshire,UK University ofHuddersfield Ian Hodgson, MA, PhD Philadelphia, PA, USA University ofPennsylvania Robert Gross, MD, MSCE Washington, DC, USA International ofProviders Association Reuben Granich, MD, MPH Washington, DC, USA InstituteofMentalHealth National Christopher M. Gordon, PhD Infectious Diseases Care of AIDS ITALY 10th International Conference on 10th International

HIV Treatment andPreventionAdherence Jane M. Simoni, PhD Fort Lauderdale, FL, USA Nova SoutheasternUniversity Elizabeth Sherman, PharmD Pomona, CA, USA Western University James D. Scott, MEd, PharmD Boston, MA, USA MedicalSchool Harvard Steven A. Safren, PhD 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, and thePostgraduate InstituteforMedicine(PIM). was jointlysponsoredbytheInternational ofProviders Association AIDS Care(IAPAC) June 28-30, 2015, theEdenRocMiamiBeachinMiami, at FL, USA. This 2.5-dayconference ConferenceonHIV 10th International Treatment andPrevention Adherence, held attended the ______that This letterisaconfirmation To Whom ItMayConcern: ADHERENCE 2015 JUNE 28-30,2015•MIAMI A WorldofOpp A DecadeofSuccess, o r tunities AND PREVENTION 10th International HIV TREATMENT Conference on ADHERENCE

Having the Courage of Our Convictions • October 1-2, 2015 • Paris, France

The International Association of Providers of AIDS Care, in collaboration with the City of Paris, Joint United Nations Programme on HIV/AIDS, AIDS Healthcare Foundation, and other partners (to be announced), will host a summit aimed at leveraging antiretrovirals to end AIDS-related mortality and prevent new HIV infections.

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.

Summit Themes Leadership to End AIDS and Control HIV State of the Science and Lessons Learned Taking Stock of Global Efforts to End AIDS and Control HIV Sobering Assessments and a Clarifying Debate on HIV Control Focusing on Solutions: Overcoming Barriers to HIV Control The 10th 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

AbbVie Gilead Sciences Merck & Co.

Corporate Sponsor