Abstract
Background
Virologic suppression is necessary to reduce the risk of complications from HIV infection and to prevent transmission to other individuals. Understanding factors associated with elevated HIV RNA levels in HIV-infected individuals could lead to interventions to improve engagement in care.
Methods
This retrospective, observational study assessed HIV-infected individuals engaged in care in an urban HIV clinic between April 1, 2015 and March 31, 2016. The electronic medical record was reviewed for demographic and HIV-related factors for all individuals with elevated HIV RNA PCR ≥200 copies/mL (EVL) during the study period. Demographic data were compared with individuals with decreased HIV RNA PCR (DVL) <200 copies/mL. Patients with recent HIV diagnosis within 6 months of EVL were excluded due to the possibility of insufficient time to achieve viral suppression after engagement in care. Statistical analysis including Student T-test and Chi Square test was conducted in SPSS, version 24.
Results
There were 519 individuals with EVL with 72 (13.9%) excluded due to recent HIV infection. Of 1,789 patients included in this analysis, 447 (25.0%) had an EVL. The median HIV RNA PCR was 7,240 copies/mL (range 200 to 6,720,990) and median CD4 count was 411 cells/mm3(range 1 to 1,510) in the EVL group. Individuals with EVL were more likely to be younger (mean EVL group age 43.4 years ± S.D. 11.7, range 22–77 vs. 47.5 years ± S.D. 12.4, range 19–84 in DVL group) (P < 0.0001). Individuals with EVL were more likely to be Black (82.1%) (with White 9.2% and Hispanic 8.7%) compared with those with DVL (74.8% Black, 12.4% White, 11.6% Hispanic, 1.6% other) (P = 0.004). The EVL group was 59.3% male, 39.8% female and 0.9% transgender vs. 64.8% male, 34.3% female, and 1.0% transgender in the DVL group. The main risk factors for HIV acquisition were heterosexual sex (46.3% of EVL vs. 43.4% DVL), men who have sex with men (31.8% vs. 36.4%) and injection drug use (14.3% vs. 14.6%). There were no significant differences in gender or risk factors for HIV acquisition between the two groups.
Conclusion
Decreased levels of HIV viremia is a major focus of quality HIV care. Younger age and Black race were associated with elevated HIV RNA levels in individuals engaged in care in a large urban HIV clinic.
Disclosures
All authors: No reported disclosures.
P1-S5.14 Risk factors associated with HIV acquisition: a comparative analysis of older and younger women who participated in the MDP301 trial in Johannesburg
