871. Sexual Health Service Experience and Preferences for Non-Traditional Service Delivery Among a Predominately Immigrant Latino MSM Population in Miami

Background Miami-Dade County (MDC) has the highest rate of new HIV diagnoses in the United States (US), with highest incidence among Black and Latino men who have sex with men (MSM). Immigrants may be especially vulnerable to HIV acquisition and may lack or avoid accessible sexual health services. The University of Miami Mobile PrEP (MP) Clinic provides sexual health services including STI and HIV testing as well as PrEP initiation and follow-up in four highly impacted areas of MDC. The majority of MP clients are immigrant Latino MSM. We evaluated sexual healthcare access, preferences, and facilitators or barriers to receiving sexual health services through non-traditional platforms. Methods A brief survey was offered to clients at four MP locations from September 2020 to June 2021. Multiple-choice questions addressed healthcare access, usage, and experience as well as preferences for service receipt including home-based, mobile clinic, and telehealth options. Brief qualitative short answer responses were also elicited. Results were tabulated and presented descriptively. Results A total of 115 clients were surveyed. Mean age was 36; 82.6% identified as male. Most respondents were either White/Caucasian (56.5%) or Black/African-American (19.1%) and 78 (67.8%) identified as Hispanic/Latinx. Of the 66% that reported being born outside the US, 34.2% had immigrated in the past 5 years. Only 41.7% of respondents had a primary care provider. Before coming to the MP clinic, 27% had not been seen for sexual health services in over 2 years. Most clients indicated satisfaction with MP services. The most important characteristics for a care site identified included comfort with staff, location, and affordability. 43.5% preferred a clinic time outside of 9am-5pm. Only 13% of clients preferred home-based labs using a self-collection kit with a majority preference for in-person follow-up at the MP clinic. Conclusion Key populations at risk for HIV infection including immigrants and Black and Latino MSM may experience barriers to traditional clinic care. Clients expressed satisfaction with MP services, and a preference for clinic-collected rather than self-collected specimens. Further research to tailor service delivery to client preferences is needed. Disclosures All Authors: No reported disclosures

Pilot randomised controlled trial of a patient navigation intervention to enhance engagement in the PrEP continuum among young Latino MSM: a protocol paper

IntroductionMen who have sex with men (MSM) are one of the most at-risk group for contracting HIV in the USA. However, the HIV epidemic impacts some groups of MSM disproportionately. Latino MSM comprise 25.1% of new HIV infections among MSM between the ages of 13 and 29 years. The daily medication tenofovir/emtricitabine was approved by the Food and Drug Administration for pre-exposure prophylaxis (PrEP) in 2012 and has demonstrated strong efficacy in reducing HIV acquisition.Methods and analysisThrough extensive formative research, this study uses a pilot randomised controlled trial design and will examine the feasibility and acceptability of a patient navigation intervention designed to address multiple barriers to improve engagement in the PrEP continuum among 60 Latino MSM between the ages of 18 and 29 years. The patient navigation intervention will be compared with usual care plus written information to evaluate the feasibility and acceptability of the intervention and study methods and the intervention’s potential in improving PrEP continuum behaviours. The results will be reviewed for preparation for a future full-scale efficacy trial.Ethics and disseminationThis study was approved by the institutional review board at San Diego State University and is registered at ClinicalTrials.gov. The intervention development process, plan and the results of this study will be shared through peer-reviewed journal publications, conference presentations and healthcare system and community presentations.Registration detailsRegistered under the National Institutes of Health’s ClinicalTrials.gov (NCT04048382) on 7 August 2019 and approved by the San Diego State University (HS-2017–0187) institutional review board. This study began on 5 August 2019 and is estimated to continue through 31 March 2021. The clinical trial is in the pre-results stage.

978. Barriers to Recruitment of Latino Men who Have Sex with Men and Transgender Women to Behavioral HIV Seroprevalence Studies

Background Chicago’s HIV epidemic disproportionally affects people of color. Almost a quarter (23%) of these infections occur in Hispanics. It is important to understand sexual behaviors and HIV risk in Latino MSM and transgender women (TGW) to create targeted culturally sensitive harm reduction interventions. However, participation of minority MSM and TGW in survey-based studies is low. The main objective of the study was to understand the sexual health and of Latino MSM and TGW residing in Chicago, Illinois, United States. We herein report subject’s attitudes towards participating in the study and qualitative observations about perceived barriers to enrollment of this population. Methods This study was a cross sectional analysis of a behavioral/HIV seroprevalence survey administered during 2017-2020 to presumed HIV negative, Latino identifying, MSM and TGW individuals. The survey included questions on sexual risk, HIV knowledge and depression scores. We categorized recurrent themes of the most common reasons participants provided for declining to participate in the study. We generated descriptive statistics. Results A total of 48 community organizations assisted with recruitment. Of 149 participants screened, only 18 (12%) agreed to complete the survey. Among those who declined to complete the survey (n=131), the most common reasons given were: participants were uncomfortable answering some questions (n=59, 45.0%), participant’s did not have the time to initiate or complete the survey (n=41, 31.3%) and survey was deemed long (n=16, 12.2%). We categorized barriers to successful recruitment into the following general themes: 1) Participants were unwilling to discuss their sexual history; 2) Participant’s felt uncomfortable taking a rapid oral HIV test; 3) Participant’s lacked transportation; and 3) Participants didn’t have time to complete the survey or thought it was too long. Conclusion Despite extensive community networking, we found barriers to recruitment of high-risk Latino MSM and TGW into an HIV seroprevalence study. Further research is needed to better understand and address these barriers, and thus, increase representation of this key population in prevention studies. Disclosures All Authors: No reported disclosures

958. Feasibility and Acceptability of HIV Self-Test Kit Distribution Through PrEP Clients’ Friendship and Sexual Networks

Background Personal networks can influence behaviors, beliefs, attitudes, and values through contact and communication. The University of Miami Mobile PrEP Program offers low-barrier pre-exposure prophylaxis (PrEP)/HIV prevention services through a mobile clinic in five highly impacted neighborhoods in Miami-Dade, the county with the highest HIV incidence in the US. The highest rates are among black and Latino men who have sex with men (MSM). The goal of this study is to understand the acceptability and feasibility of expanding the reach of testing through our clients’ friendship and sexual networks. Methods This study was implemented in five locations across Miami from December 2019 to February 2020. During scheduled PrEP quarterly follow-up clinic visits, participants were offered Ora-Quick oral fluid self test (ST) kits, free of cost for distribution to up to four sexual partners and/or friends. In addition to the information available in the testing kit, brief training regarding the test and resources for post-test engagement were provided. A survey evaluated participants’ distribution plan, comfort level and concerns in offering the test kits to friends/sexual partners. Descriptive statistics included frequencies for categorical variables, and means and ranges for continuous variables. Results A total of 84 participants were offered the ST kits, of which 49 (58%) accepted. Of those accepting kits, 40 (81.63%) of 49 were Latino MSM. Participants requested an average of 3 (mean=2.9, range 1-4) kits, for a total of 144 kits. Overall, 41(84%) felt very comfortable and 47(96%) indicated they felt very comfortable offering this test to their friends/sexual partners. Also, 29(59.2%) planned to distribute kits only to friends, 2(4%) only to sexual partners, 11(22.4%) to both sexual partners and friends and 7(14.2%) to either family or self-test to provide ‘moral support’ to those taking the test. None of the participants expressed any concerns about offering kits to friends or sexual partners. Conclusion Distribution of home based self-test HIV kits through current Mobile PrEP clients’ friendship and sexual networks is acceptable and feasible. Similar social network strategies may be considered to expand reach of HIV testing and PrEP engagement to those with barriers to care. Disclosures All Authors: No reported disclosures

Lubricants and rectal douching: associations with rectal gonorrhea, chlamydia, and/or syphilis infection among men who have sex with men

Despite widespread prevalence of lubricant use and rectal douching for receptive anal intercourse (RAI) among men who have sex with men (MSM), research evaluating the association of these behaviors with sexually transmitted infections (STIs) is limited. This is an observational analysis of a longitudinal cohort of predominantly Black/Latino MSM in Los Angeles. Every six months from August 2014 to January 2018, participants received STI screening and surveys evaluating lubricant use, douching, substance use, and sexual risk behaviors. General estimating equations evaluated the association between consistent lubricant use and douching for RAI with positive rectal Neisseria gonorrhoeae, Chlamydia trachomatis, and/or syphilis (positive STI). Among 313 participants across 552 study visits, 16.5% (91/552) had positive STI. Consistent lubricant use was reported in 52.7% (243/552) and rectal douching in 57.6% (318/552) of study visits. Consistent lubricant use was associated with STI diagnosis (adjusted OR [AOR] 1.81; 95% CI 1.11–2.96; p = 0.018). Each episode of rectal douching before RAI was associated with 2% increased odds of positive STI (AOR 1.02; 95% CI 1.00–1.04; p = 0.041). Among this cohort of HIV-positive and high-risk HIV-negative MSM, lubricant use and douching was common and independently associated with an STI, suggesting the utility of prevention messaging around barrier methods/condoms for sexual encounters involving douching/lubricant use.