Risk Factors For HIV Infection Research Articles

B/F/TAF forgiveness to non-adherence

BackgroundART forgiveness is the ability of a regimen to maintain HIV-RNA suppression despite a documented imperfect adherence. We explored forgiveness of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF).MethodsIn this retrospective cohort study pharmacy drug...

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

A systematic review and meta-analysis of HIV transmission risk behaviors, genetic variations, and antiretroviral (ARV) resistance in LGBT populations.

Currently, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) has become one of the major health problems worldwide, including Indonesia. East Java is one of the provinces in Indonesia with the highest prevalence of HIV infection. One of the causes of HIV infection transmission is lesbian, gay, bisexual, and transgender (LGBT) practice. Furthermore, the treatment using antiretroviral (ARV) drugs in HIV-1 patients can fail due to the presence of HIV drug resistance. The aim of this study is to identify the behavior at risk of HIV transmission among LGBT, patterns of genetic variation and antiretroviral (ARV) resistance. A systematic review and meta-analysis based on the PRISMA guidelines was conducted. We searched three databases including PubMed, ScienceDirect, and Google scholar for studies investigating the non-heterosexual behavior as risk factor of HIV infection and antiretroviral resistance. Only studies published in English are considered. The adjusted estimates of the risk were carried out using best-adjusted OR with 95% confidence interval (CI) and significant p value < 0.05. In the quantitative analysis of HIV infection risk factors, a total of 13 studies were included, which investigated non-heterosexual behavior as a potential factor. The studies involved a total of 37,129 participants, comprising 10,449 individuals in the non-heterosexual behavior group (LGBTQ+) and 26,680 individuals in the heterosexual group. The majority of the participants in this study were from the USA, Japan, China, and Brazil, and the main HIV subgenotypes were B and CRF. Additionally, the antiretroviral resistance of HIV patients was examined, involving a total of 3062 individuals, with 1296 individuals in the non-heterosexual behavior group and 1766 individuals in the heterosexual group. Our calculation showed that non-heterosexual behavior was significant as risk factor of HIV infection (OR = 2.17, 95% CI = 1.94-2.43, p < 0.001) and antiretroviral resistance (OR = 1.31, 95% CI = 1.00-1.71, p = 0.05). This study concludes that non heterosexual behavior is significant risk factor of HIV infection. A quite prevalent of antiretroviral resistance were found among non heterosexual behavior. The main subgenotype of HIV are B and CRF.

Diagnostic challenge of Pneumocystis jirovecii pneumonia infection mimicking interstitial lung disease in initially HIV negative patient

Background: Pneumocystis jirovecii pneumonia (PJP) infections are common in immunocompromised patients and are rarely found in immunocompetent patients. Lung radiology in PJP patients could mimic the appearance of interstitial lung disease (ILD) and could be used to diagnose HIV-negative patients. Clinicians should rule out false negatives in patients with patterns suggestive of opportunistic infections and risk factors for HIV infection. Case illustration: A 34-year-old man presented with a chief complaint of shortness of breath, had history of 15 years of smoking, and daily chlorine exposure. The radiology pattern and initial HIV-negative test results suggested an ILD diagnosis. Owing to persistent symptoms despite initial management and the presence of risk factors, repeat HIV testing was initiated and was positive. The patient was treated with cotrimoxazole and showed rapid clinical improvement. Discussion: The diagnosis of PJP in our patient was based on radiology and an HIV-positive status. In patients who are not immunocompromised, the diagnosis of PJP is unlikely, and other diagnoses, such as ILD, should be considered. However, in the HIV testing window period of infection, a poor advanced state of HIV could cause a false negative result. Therefore, clinical judgement is essential in suspecting such a result. The empirical treatment course of cotrimoxazole has been shown to provide better clinical outcomes in PJP. Conclusion: The possibility of PJP must be considered in patients with initially HIV-negative results, especially in patients with risk factors and clinical symptoms suggestive of immunocompromise. While some ILD showed similar PJP, the risk factors for ILD and PCP could be distinguishing factors. Retesting for HIV infection can confirm the diagnosis and rule out false-negative results.

A comparative study of transgender women accessing HIV testing via face-to-face and telemedicine services in Chiang Mai, Thailand during the COVID-19 pandemic and their risk of being HIV-positive

BackgroundDue to the restricted availability of health services in Thailand, there are still some transgender women (TGW) who do not have access to HIV counseling and testing. Telehealth, which is accessible to individuals who are reluctant to undergo face-to-face interviewing, played an especially important role during the COVID-19 epidemic. The objectives of this study are to compare the characteristics, pattern of accessing HIV testing, and the HIV-positive rates of TGW between the face-to-face and telemedicine services.MethodsWe conducted a cross-sectional study to compare the access to HIV testing and the HIV-positive rates among TGW via face-to-face service and telemedicine services and examined the influence of potential associated factors on the risk of being HIV-positive.ResultsOf the 637 TGW participants, 26 (4.1%) were HIV-positive. Accessing the telemedicine service increased in the third and fourth COVID-19 waves (28.1% in the first and second vs. 71.9% in the third and fourth). There was no difference in the risk of being HIV-positive between the types of service. Having sex work experience (adjusted odds ratio (aOR) = 5.92; 95% confidence interval (CI): 1.57–22.30) and either never having been or tested more than 1 year ago were independently significantly associated with a higher risk of being HIV-positive (aOR = 4.05; 95% CI: 1.11–14.77).ConclusionThe telemedicine service became more popular among TGW during the COVID-19 pandemic and was not related to a higher risk of being HIV-positive. Moreover, it proved to be an effective alternative channel to access HIV testing, especially for intravenous drug users. Sex work experience and irregular HIV testing are key risk factors for HIV infection in TGW seeking either the telemedicine or face-to-face service.

Effectiveness, Acceptability, and Feasibility of a Telehealth HIV Pre-Exposure Prophylaxis Care Intervention Among Young Cisgender Men and Transgender Women Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

Despite its promise for HIV prevention, the uptake of pre-exposure prophylaxis (PrEP) has been slow, and there have been substantial inequities in PrEP access. Young men who have sex with men and transgender women of color are most in need of PrEP and least likely to have that need fulfilled. PrEP telehealth care, which provides remote PrEP care via electronic communication, seems well suited to address several of the challenges of PrEP provision, including discomfort with stigmatizing and difficult-to-access health care systems, transportation challenges, and privacy concerns, and address disparities in PrEP access. Research suggests that PrEP telehealth care has promise and is a favored option for many prospective recipients of PrEP. However, despite growing attention to telehealth approaches as an avenue for increasing access to PrEP amidst the COVID-19 pandemic, there have been no published randomized controlled trials (RCTs) on PrEP telehealth care to date, making it difficult to draw strong conclusions about the advantages or disadvantages of telehealth compared with usual PrEP care. We developed PrEPTECH, a telehealth intervention that focuses specifically on alleviating issues of stigma, access, cost, and confidentiality for young people with risk factors for HIV infection who are seeking PrEP care. Leveraging data from the 2017 observational pilot study, we redesigned and enhanced PrEPTECH. This study aims to assess the effectiveness, acceptability, and feasibility of a telehealth HIV PrEP care intervention, PrEPTECH, in increasing PrEP uptake. This is the protocol for an RCT of young cisgender men and transgender women who have sex with men in 4 regions within the United States: the San Francisco Bay Area, California; Los Angeles County, California; Miami-Dade County, Florida; and Broward County, Florida. Participants in the intervention arm received access to a web-based telehealth program, PrEPTECH, which offers a fully web-based pathway to PrEP, whereas those in the control arm received access to a dynamic web page containing publicly available informational resources about PrEP. Follow-up data collection occurred at 3 and 6 months. An analysis will be conducted on outcomes, including PrEP initiation, persistence, adherence, coverage, and medication prescription, as well as PrEPTECH acceptability and feasibility. The study was funded in 2019 and received institutional review board approval in 2020. The PrEPTECH intervention was developed over the next 1.5 years. Study recruitment was launched in February 2022 and completed in September 2022, with 229 participants recruited in total. Data collection was completed in April 2023. The results of this RCT will offer valuable evidence regarding the effectiveness, acceptability, and feasibility of telehealth HIV PrEP care interventions among young cisgender men and transgender women who have sex with men. ClinicalTrials.gov NCT04902820; https://clinicaltrials.gov/ct2/show/NCT04902820. PRR1-10.2196/47932.

Prevalence and shared risk factors of HIV in three key populations in Vietnam: A systematic review and meta-analysis.

This study aims to estimate the prevalence of HIV among each of the three key populations in Vietnam: people who inject drugs (PWID), female sex workers (FSW), and men who have sex with men (MSM) and quantify their shared risk factors for HIV infection through a systematic review and meta-analysis of recent literature (published in 2001-2017) in the relevant topics. A total of 17 studies consisting of 16,304 participants were selected in this review. The meta-analysis results revealed that the pooled prevalence estimates with 95% confidence intervals (CIs) among PWID, FSW, and MSM were: 0.293 (0.164, 0.421), 0.075 (0.060, 0.089), and 0.085 (0.044, 0.126), respectively. The findings also indicated that injecting drug use (OR: 9.88, 95%CI: 4.47-15.28), multiperson use of injecting equipment (OR: 2.91, 95%CI: 1.69, 4.17), and inconsistent condom use (OR: 2.11, 95%CI: 1.33, 2.90) were the shared risk factors for HIV infection among these population groups. The findings highlighted the importance of HIV prevention approaches to addressing the shared sexual and drug-related practices among the key populations in consideration of their overlapping social networks.

Comparative study on sero-prevalence and risk factors of HIV/AIDs between intra-city and long-distance commercial drivers in Kano State

Background: the transportation industry is primarily a male-dominated industry, of which drivers are at risk of contracting HIV. They spend a lot of time away from their wives or partners due to the nature of their occupation. Identifying risk factors of HIV among both the long distance and intra-city commercial drivers could provide strategies for effective prevention and control. Aim: this study assessed the Sero-prevalence and risk factors of HIV infection among commercial drivers in Kano Central Senatorial District. Method: Cross-sectional comparative study design was used. A multi-stage sampling technique was used to select 434 study participants from each category. Results: a total of 407 LDDs and 418 Intra-city drivers participated in the study. The mean and standard deviation of age of the respondents in the LDDs and Intra-city drivers groups were 42.3± 11.2 and 42.0 ± 11.3 years respectively. The sero-prevalence of HIV between LDDs and Intra-city drivers was found to be 12.5% and 6.7% respectively. The LDDs were two times at risk of being HIV Sero-positive (OR=2.00 95% CI of OR 1.20 – 3.33, p&lt;0.05) than the Intra-city drivers. On adjusting for the confounding effects for LDDs group using logistic regression analysis, the risk factors for HIV were marital status of single [AOR=4.25; (95% CI: 1.97- 9.31)] and separated [ AOR=6.07; (95% CI: 5.26-16.45)], monthly income [&gt;100,000.00 AOR=6.11; (95% CI: 1.53-41.97)] and history of extra-marital sex [AOR=4.01; (95% CI: 6.07-10.43)]. While on adjusting for the confounding effects for Intra-city drivers group using logistic regression analysis, educational status [post-secondary AOR=0.33; (95% CI: 0.16-0.89)], marital status [separated AOR=3.00; (95% CI: 5.26-16.33)], working experience [ 11-20 years AOR=4.10; (95% CI: 1.19-18.25)], history of extra-marital sex [AOR=4.97; (95% CI: 6.07-10.43)] and use of drugs or alcohol [AOR=3.98; (95% CI: 2.04-12.43)]. Conclusion: the establishment of STI clinics in strategic locations, as well as making condoms available, accessible, affordable, and acceptable for use by this group of people in our society, should all be part of the prevention strategy. Government and all key stakeholders must take appropriate measures to educate this occupational group in order to change and improve their sexual behaviors.

Risk factors for HIV infection at a large urban emergency department: a cross-sectional study

ObjectivesIn 2019, the US Preventative Services Task Force released updated guidelines recommending HIV screening in all individuals aged 15–64 years and all pregnant females. In the current study, we aimed...

Syndrome of substance abuse, violence and HIV-infection/AIDS (SAVA) and some related factors among sex workers in 4 cities in Russian Federation

Introduction. Social determinants of health are often a major topic for syndemic research. This is consistent with the fundamental idea of syndemic conditions that share common social factors and bio-social interactions. One of the earliest syndemies was the reported abuse of psychoactive substances in the United States, the experience of victimization from interpersonal violence and HIV infection (SAVA).The objective of this study was to assess the prevalence of SAVA syndrome and its relationship with risk factors for HIV infection in key groups — female sex workers (SW). Materials and methods. The analysis is based on data from a biobehavioral study carried out in 4 cities of the Russian Federation and involving 817 SWs (time-place sampling). The study included a questionnaire survey and determination of HIV status.Results and discussion. The prevalence of SAVA syndemics in the groups of SWs and MSM was relatively low because of relatively low (in comparison with IDUs) prevalence of HIV infection. Full syndemics occurred in 1.27%, [95% CI=0.30–2.24%] female sex workers. Incomplete syndemics (excluding HIV infection from definition) was detected in 7.31%, [95% CI=4.59–10.02%] of SW.SWs who were physically and sexually abused had HIV infection in 16.7% of cases, only physically abused — in 10% of cases, while among those who denied violence against them — only 6.5%.

Long-Term Survivors in a Cohort of People Living with HIV Diagnosed between 1985 and 1994: Predictive Factors Associated with More Than 25 Years of Survival.

Although the mortality rate among individuals diagnosed during the pre-Highly Active Antiretroviral Treatment era has been substantial, a considerable number of them survived. Our study aimed to evaluate the prevalence of HIV long-term survivors in a cohort of People Living with HIV diagnosed between 1985 and 1994 and to speculate about potential predictive factors associated to long survival. This is a retrospective single-center study. Subjects surviving more than 300 months (25 years) from HIV diagnosis were defined as Long Term Survivors. Overall, 210 subjects were enrolled. More than 75.24% of the included people living with HIV were males, with a median age of 28 years (IQR 25-34). The prevalent risk factors for HIV infection were injection drug use (47.62%), followed by unprotected sex among heterosexual individuals (23.81%). Ninety-three individuals (44.29%) could be defined as LTS with a median (IQR) survival of 333 (312-377) months. A hazard ratio of 12.45 (95% CI 7.91-19.59) was found between individuals who were exposed to Highly Active AntiRetroviral Treatment (HAART) and individuals who were not, with the latter being at greater risk of death. The availability and accessibility of effective antiretroviral therapy for people living with HIV remain the cornerstone of survival.

Maternal Socio-Demographic Factors and Mother-to-Child Transmission of HIV in the North Region of Cameroon.

Socio-demographic factors are important risk factors for HIV infection. Maternal socio-demographic factors associated with HIV transmission from mother to child are not well elucidated to our knowledge. This study aimed to assess the maternal socio-demographic factors associated with HIV vertical transmission. A matched case-control study was conducted among children under 15 years of age born to HIV-infected mothers; using a structured questionnaire. The study was conducted in four health facilities in the North Region of Cameroon from July 2015 to October 2016. HIV- infected children were the cases, and HIV-uninfected children were the controls. One case was matched to nearly 4 controls according to age and sex. A total of 113 HIV-infected mothers of children under 15 years of age were purposively enrolled in the study. A questionnaire was administered to mothers and socio-demographic characteristics were collected. Blood samples were collected from the mother and her child for the determination or confirmation of HIV status. Univariate and multiple logistic regressions were used to assess associations between socio-demographic variables and HIV transmission from mother to child. A total of 113 HIV-infected mothers and 113 children under 15 years of age were enrolled in this study. The majority of the mothers were between the age ranges of 25 years to 34 years. Of the 113 HIV-infected mothers, 69 (61%) were Muslims, 33 (32.1%) were not educated, 88 (77.8%) were unemployed, 80 (70.9%) were married, out of which 49 (61.6%) were engaged in a monogamous union. Of the 113 children (49.6%) were female, 25 (22.1%) were HIV-infected and 88 (77.9%) were HIV-exposed uninfected. At the univariate level, mothers who achieved a primary level of education were less likely to transmit HIV to infants compared to uneducated mothers [OR=0.28; CI (0.08-0.95); p=0.04]; and widows had a higher likelihood of HIV transmission to infants compared to married mothers [OR=4.65; CI (1.26-17.20); p=0.02]. Using multiple logistic regression, the maternal primary education level [aOR=0.32; CI (0.08-0.90); p=0.03] and widowerhood [aOR=7.05; CI (1.49-33.24); p=0.01] remained highly associated with the likelihood of HIV transmission to infants. Uneducated mothers and widows had a higher likelihood of mother-to-child transmission of HIV. Our findings should prompt reinforcement of prevention strategies targeting uneducated women and widows.

HIV Positivity, Linkage to Medical Care, Interview for Partner Services, and Pre-Exposure Prophylaxis Awareness and Referral Among Men Who Have Sex With Men Tested in Non-healthcare Settings in the United States, 2019.

Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. This study reports data on HIV testing program outcomes among MSM tested for HIV in non-healthcare settings in the United States. We analyzed Centers for Disease Control and Prevention's National HIV Prevention Program Monitoring and Evaluation data collected in 2019. Descriptive and multivariate robust Poisson regression analyses were conducted to summarize the patterns of HIV testing program outcomes [ie, positivity, linkage to HIV medical care within 30 days of diagnosis, interview for partner services (PS), and pre-exposure prophylaxis (PrEP) awareness and referral] by demographic characteristics, HIV prevalence, and testing site type. A total of 123,251 HIV tests were conducted among MSM; of these, 1773 (1.4%) were newly diagnosed with HIV. Among MSM newly diagnosed with HIV, 75% were linked to HIV medical care and 80% were interviewed for PS. Among MSM who tested HIV-negative, 63% were aware of PrEP and 47% of those who were eligible for PrEP were referred to PrEP providers. Referral or linkage to services varied by demographic characteristics or other factors. Linkage to HIV medical care and interview for PS among MSM newly diagnosed with HIV in non-healthcare settings were below national or funding program targets. Most MSM with risk factors for HIV infection were not referred to PrEP providers. Expanded efforts to address barriers to equitable access to services may help improve HIV-related outcomes among MSM and contribute to ending the HIV epidemic in the United States.

Analysis of the impact of HIV on perinatal outcomes

Aim: to consider the impact of HIV infection on the course of pregnancy, childbirth and perinatal outcomes in women with established HIV status. Design: Retrospective study. Materials and methods. The analysis of medical histories of 96 HIV-infected women and their newborns and outpatient cards (form 111/y) of mothers with HIV infection was carried out. Results. In the majority of women with HIV infection (87.5%), pregnancy was burdened by adverse factors, such as smoking and drug use. Out of 96 newborns, 90 children were born alive, and 6 were born dead. Of the 90 live births, there were 56 (62.22%) full-term and 34 (37.78%) premature babies. Of the 34 premature infants, 13 (38.23%) were born from HIV-infected mothers with stage III of the disease, 21 (61.76%) from mothers with stage IV. Out of 6 stillborn children, 2 (33.33%) children were born to HIV-infected women with stage III of the disease, 4 (66.67%) with stage IV. All 6 stillborn babies were premature. 85 (88.54%) women had concomitant diseases during pregnancy, and 11 (11.46%) had uncomplicated pregnancy. Congenital malformations of the fetus were observed in 9 (10.59%) newborns, of which 4 children (44.44%) from timely delivery in women with stage III HIV, and 5 (55.56%) with stage IV. Conclusion. To prevent the transmission of HIV infection from mother to child, it is necessary to carry out timely HIV diagnosis, effectively identify risk factors for HIV infection, observe the correct tactics of pregnancy and childbirth, as well as further monitoring of the child in the first 1.5 years of life. Keywords: HIV infection, children, pregnancy, perinatal outcomes.

A study on prevalence of HIV and its associated risk factors in patients visiting tertiary care center of North India

Background: India is home to the second largest population of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) with an estimated 5.134 million infections. HIV has infected &gt;75 million people worldwide, with an estimated 37 million people now living with the virus making it the major cause of morbidity and mortality worldwide. HIV is a significant public health problem with tremendous social and economic implications. Aims and Objectives: Our primary aim is to estimate the prevalence of HIV infection and the associated risk factors of HIV infection. Materials and Methods: This is a retrospective study of the patients who visited in integrated counseling and testing center (ICTC) and State Reference Laboratory at a tertiary care center of Agra, Uttar Pradesh from January 2017 to December 2021. The data are in accordance with NACO portal. Results: The highest HIV seropositivity was observed in 35–49 years age group in both males and females in three consecutive years 2017, 2018, and 2019, respectively. HIV seropositivity in males decreased from 8.3% in 2017 to 4.9% in 2021 and in females from 6.0% to 4.6%. The most seropositives belong to married population (41.2%) and the least in divorced population (4.2%). Overall, housewives (20.7%) were maximally affected by HIV seropositivity, followed by skilled workers (15.8%) and unemployed/retired persons (15.7%). Uneducated population had maximum seropositivity rate (35.3%). Majority of HIV positives were heterosexual non-commercial partner (47.4%), while the homosexuals were the least (1.8%) affected. Conclusion: This study highlights the most affected group of HIV seropositive population and their risk behavior. Thus, by making ICTC, more accessible to ramp up the focused screening and prevention efforts for the suspected HIV population and evolving the appropriate policies/strategies for public awareness program will help to reduce the spread of HIV infection among the masses.

1932. Antibody Response to SARS-CoV-2 Vaccination in US Veterans Living with HIV

Abstract Background COVID-19 (C-19) vaccines have demonstrated effectiveness in reducing SARS-CoV-2 related morbidity/mortality. The duration of protection in the general population is showing a waning immunity over time. Variable antibody responses to C-19 vaccines have been shown in persons living with HIV. We followed the anti-SARS-CoV-2 receptor biding domain (RBD) antibody titers, after 2 and 3 (booster) C-19 vaccinations, in US Veterans living with HIV (USVLH). Methods Retrospective chart review of USVLH who had received C-19 vaccinations at Northport VAMC. Testing was done with the © Beckman Coulter enzyme immunoassay measuring total IgG antibody to the RBD, a critical target of neutralizing antibodies within the spike protein encoded in the mRNA vaccines. Titers were drawn after the 2nd and 3rd doses C-19 vaccines in variable timing. Demographic data, CD4+ T cell counts nadir and current, HIV viral load, comorbid conditions were reviewed. Results We analyzed the SARS CoV-2 RBD IgG titers in 50 vaccinated USVLH. The median age is 65 years (range 36-75). 50% were Black, Caucasian 40%, Hispanic 10%. Risk factor for HIV infection, Heterosexual 52%, IVDU 18%, MSM 26%, needle stick 2%, blood transfusion 2%. The median CD4 nadir was 200/µL (5- 600), median current CD4 656 (174-1529). All USVLH were on HAART, 92% on INSTI-based therapy. 45 had undetectable HIV viral load (&amp;lt; 20), 5 had viremia from 22 to 563 copies. Medical conditions: diabetes 30%, CAD 18%, HTN 60%, COPD 8%, HLD 66%, smokers 18%. Six USV had C-19 prior to vaccination, and six had C-19 after vaccination with median 102 days (90-148) from last vaccine dose. Vaccines given: Janssen in 3 USVLH: Moderna (MOD)- 2 doses: 4; MOD-3 doses:5; Pfizer (PFZ)-2: 6; PFZ-3: 32. IgG titers decrease with time after 2nd vaccine dose and increase after booster dose. IgG titers checked after 2nd dose median days 120 (11-392) {titers: median 4.63 S/CO [0.17 – 53.66]}, 91 days (5-181) after 3rd dose {titers: median 16.22 [1.15-73.92]}. Titers were higher in MOD-2 vs. PFZ-2, median 25.7 vs. 4.63, P: 0.039, MOD-3 vs. PFZ-3 33.89 vs. 15.5, P: 0.117. No death due to C-19 was seen. SARS-CoV-2 RBD IgG titers in US Veterans living with HIV after 2nd dose of COVID vaccine. COVID-19 VACCINATED IN US VETERANS LIVING WITH HIV N=50 Conclusion In a cohort of USVLH, well controlled on HAART, C-19 vaccinations produced a serologic response that decayed over time and increased after booster dose. MOD vaccine may have achieved higher titers than PFZ. Disclosures All Authors: No reported disclosures.

2070. Risk Factors Affecting PrEP Offering and Uptake Among At-Risk Youth in an Area of High HIV Prevalence

Abstract Background New HIV cases are steadily reported in our community among at-risk youth despite the availability of highly effective pre-exposure prophylaxis (PrEP). Although providers regularly offer PrEP during sexually transmitted disease (STD) screening visits, PrEP utilization rates remain low among those patients. The primary outcomes of this study are determining the rates of PrEP offering and uptake in high-risk individuals seeking care for STD screening at local youth clinics and whether these rates differ by demographic factors. Methods A retrospective chart review was conducted on 218 charts of patients ages 18 - 24 years with risk factors for HIV infection who sought care at a youth clinic in Tampa, FL between 2018 and 2020. PrEP offering and utilization rates were compared across demographic and risk factor variables using Chi-square tests for categorical variables and Mann-Whitney U tests for continuous variables. Results Of 218 patients, 86 (39.4%) were offered or had a documented discussion of PrEP at their visit but uptake occurred only in 22 (10.1%). Factors associated with offerings are depicted in table 1. Factors associated with uptake are depicted in table 2. Age at first visit, insurance type, level of education, and employment did not significantly impact PrEP offering or uptake. Additionally, there was no significant difference in PrEP uptake associated with race or ethnicity. PrEP Offerings Demographic characteristics associated with offering and uptake of PrEP among young people screened for STD in a high prevalence of HIV area PrEP Uptake Demographic characteristics associated with uptake of PrEP among young people screened for STD in a high prevalence of HIV area Conclusion This study highlights differences in offering and uptake of PrEP among young adults with a high risk of acquiring HIV living in a high prevalence of HIV area. Males and MSM are offered more PrEP and also use it more. Black patients are less likely to be offered PrEP. These differences emphasize the need for interventions to improve the rate of PrEP discussions among female and black patients at risk for HIV and to improve adherence to PrEP among young individuals at risk of HIV infection. Interventions targeting these demographics may lessen disparities and incidence of HIV in the community. Moving forward we will continue to investigate additional data collected on PrEP compliance at 6mo and at 12mo follow-ups among our patient population. Future studies with qualitative data identifying barriers to use PrEP will provide important information on this topic. Disclosures All Authors: No reported disclosures.

HIV infection in the homeless in Saint Petersburg in 2021

Introduction. 44 cases of HIV-infection among the homeless were registered in Saint Petersburg in 2021. At the same time, it is known that the case reporting and medical treatment in Russia are limited by the lack of required document minimum among a large number of them — passport and compulsory medical insurance policy. The cohort of the homeless is heterogeneous and in many countries the predominant risk factors of HIV infection and prevalence are different. So far, the studies of HIV spread among the homeless in Russia are rare.Objective. Assess the prevalence of HIV infection among the homeless in Saint Petersburg.Materials and methods. Cross-sectional study was carried out among the homeless in «places of attraction»: heating points, overnight shelters, care services from May, 24th to October, 1st 2021 and involved 199 participants. There was questionnaire and rapid HIV antibody testing in capillary blood by the set «Wondfo HIV 1,2». The study was completed anonymously.Results. When examining HIV infection was detected in 9 out of 199 participants — 4.5% (CI 95% [1.61%, 7.39%]), thus, HIV prevalence among the homeless is on average higher than in Saint Petersburg (0.81%) and the country (0.78%). The factors, associated with HIV infection, are the use of injection drugs: odds ratio of prevalence in the adjusted model adjusted prevalence ratio (APR)=4.3 (p&lt;0.05, CI 95% [1.1, 17.5]) and incarceration: APR=9.4 (CI 95% [1.1, 82.2]).Conclusion. The results obtained and the factors, defined in the study of risk factors for infection, allow to determine the main directions of HIV prevention among the homeless and to highlight the need for attributing the cohort of the homeless to the «key» population group along with others.

Prevalence and Risk Factors of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Infections among Prisoners Admitted to DMCH

Background: There are approximately 66 thousand prisoners remained in 68 prisons in Bangladesh. (source: Kara Adhidoptar, Bangladesh). So these number of prisoners suffers from different diseases. Prisoners are associates with various high risk of infectious diseases, as a result of the possibility of transmission of infections in prisons surroundings. A high prevalence of blood borne hepatitis viruses and HIV carried out in correctional facilities around the world by investigations have shown. There are limited data on medical disorders among prison inmates in Bangladesh. The study was aimed at confirming prevalence of HIV, hepatitis B and hepatitis C as well to assess knowledge and attitudes related to HIV, HBV and HCV infections among prisoners admitted to DMCH who referred to medicine department and/ or attended out-patient department in DMCH. Objective: To determine the prevalence and risk factors of HIV, HBV and HCV infection among prisoners referred to tertiary care hospital. Methods: This cross sectional study was done with a total number of 100 inmates over a period of one year. Prisoners, imprisonment for more than six months and who gave consent voluntarily were included in the study. After taking consent from the patient’s/guardians history was taken and physical examination was done. Sample was selected from the population by purposive sampling technique. Data were analysis was done using SPSS version 22.0. Result was expressed in tables and graphs. Results: The results showed a significantly higher seroprevalence of HBV (6%) and HCV (4%) though no prisoner was found to be HIV positive compared to the seroprevalence of these virus infections reported in the general Bangladeshi population (5.8% for HBV and 0.3% for HCV). Exposure of risk factors estimated H/O foreign travels 12%, IV drug abuse 14%, extramarital sexual exposure 16%, sharing of needle 10%, H/O blood transfusion 08%, family H/O diseases 05%, immunization of hepatitis B only 8% and homo sexuality 0%. Risk factors for HBV infection was estimated-family h/o disease 20%, IV drug abuse 7.10%, sharing of needles &amp; syringes 10%, sexual exposue12.50%, blood transfusion 12.50%. Risk factors for HCV infection was estimated -IV drug abuse 7.10%, sexual exposue6.25%, sharing of needles &amp; syringes 20%. Risk factors for HIV infection 0% for all risk factors as no one was HIV infected. Among the IDUs 14% was HBV positive and 30% was HCV positive. Conclusion: The results indicate higher prevalence of HBV and HCV infections among prisoners which has proven that HBV and HCV are the emerging public health problem in a developing country like Bangladesh. Various risk factors contribute to raise prevalence of hepatitis B, hepatitis C and HIV in prisoners. So avoidance from these risk factors is essential to prevent transmission of infection in prison. So health education and dissemination of message about the moods of transmission of these diseases is very important in prison.

153 Risk Factors for Human Immunodeficiency Virus Infection at a Large Urban Emergency Department

In 2019, the United States Preventative Services Task Force (USPSTF) released updated guidelines recommending HIV screening in all individuals aged 15 to 64 years and all pregnant females. In the current study, we aimed to identify risk factors for HIV infection in an emergency department (ED) population.