bluuebunny/crossref_metadata_2025_split huggingface dataset:
2075. Assessing HIV prevention knowledge and HIV stigma in an urban midwestern community
Authors: Uhlar Adrianna , Lewis Steven A , Bogorodskaya Milana , Avery Ann A 
Published: December 2022

Abstract

Background
Stigma and discrimination within communities remain major barriers to HIV prevention, diagnosis, and treatment. Prior studies have focused on HIV stigma as perceived by individuals with HIV and among HIV care providers. Our study aims to assess knowledge of HIV prevention, the prevalence of certain misconceptions about HIV, and internal and external HIV-associated stigma within our community.

Methods
We surveyed patients at three sexually transmitted infection clinics and employees at a community organization and the safety-net hospital in Cleveland, OH. The participants’ involvement was voluntary and anonymous. Participants were asked questions regarding demographics, sexual behavior, HIV prevention, and HIV stigma.

Results
Among 262 patients surveyed, 19.0% were ≤ 24 years old, 51.5% were male, 85.2% identified as Black, and 45.6% completed high school. Among 137 employees surveyed, 4.0% were ≤ 24 years old, 21.2% were male, 15.6% identified as Black, and 43.1% graduated college/university. Only 98 (38.7%) of patients knew of the concept “Undetectable equals Untransmissible” compared with 79 (59.0%) of employees (p&lt; 0.001). Few patients and employees thought HIV was a punishment sent from God for sinful acts (3.2% vs. 2.0%, p=0.32) but many patients thought HIV was a man-made virus (26.0% vs. 5.3%, p&lt; 0.001) and that there was a known cure for HIV (42.5% vs. 18.7%, p&lt; 0.001). Almost half of participants in both groups endorsed that others talk badly about people with HIV (40.2% vs. 42.5%, p=0.66), and while only 8.4% and 3.7% of patients and employees, respectively, reported they would be ashamed if one of their family members had HIV, 42.4% and 60.9% (p=0.009) of patients and employees, respectively, reported that they would not want their neighbors/coworkers to know that they had HIV.

Conclusion
While internal stigma related to HIV appears to be low, expected external stigma remains high. Suspicions that HIV is a man-made virus and that a cure exists but withheld from certain communities were prevalent among the community. Further studies can help elucidate the underlying reasons that lead to persistent expected external stigma and suspicions associated with HIV.

Disclosures
All Authors: No reported disclosures.
2077. Assessing the Association Between Parent-Child Relationships and HIV Testing in the Asian American Population: A Longitudinal Study
Authors: Kaul Christina 
Published: December 2022

Abstract

Background
Asian Americans (AAs) make up approximately 2% of new HIV diagnoses, 1.5% of all diagnoses, and are the only ethnic group noted to have a continuous increase in infection rate from 2011 to 2016. AAs also report the lowest rates of HIV testing (33.5%). Barriers to HIV testing in Asian Americans continue to exist; however, the predictors of HIV testing among Asians in the United States are not well studied.
Prior studies have shown that the parent-child relationship may play a role in increasing the likelihood of HIV testing. One study found that father-child communication in the Black population was positively associated with HIV testing. No such study has been performed in the AA population.
This study examined the association between parent-child relationships and HIV testing in AAs to understand what factors can contribute to increased HIV testing uptake.

Methods
We used data from Waves I and III of the National Longitudinal Study of Adolescent Health, a nationally representative, longitudinal study. Parent-child relationships were categorized as authoritarian (low warmth, high control), permissive (high warmth, low control), neglectful (low warmth, low control) and compared to an authoritative reference group (high warmth, high control. Based on prior studies as well as theory, age, gender, and parental education were included as covariates. Analyses were performed using Stata 17.0. We used multivariate logistic regression, controlling for covariates. Analyses were weighted to account for the complex survey design.

Results
302 respondents self-reported as Asian. 147 (48.68%) identified as female. 42 respondents (13.91%) reported having been tested for HIV, while 259 (85.76%) did not. Compared to the authoritative reference group, both authoritarian and neglectful parenting were significantly associated with having a lower likelihood of obtaining an HIV test (authoritarian OR 0.27, p=0.026; neglectful OR 0.08, p=0.026), after adjusting for covariates.

Conclusion
Authoritative parenting style is most supportive of HIV testing in Asian American adolescents and young adults, while authoritarian and neglectful parenting predicted decreased HIV testing. Parenting style likely plays a role in HIV testing uptake in the Asian American population.

Disclosures
All Authors: No reported disclosures.
2078. Barriers and Facilitators to the HIV (PrEP) Care Continuum: Perspectives of Key Stakeholders and Formerly Incarcerated Individuals.
Authors: Arant Elizabeth C , Walker Abbey , Knittel Andrea K , Ashkin Evan A , Lauren Brinkley-Rubenstein , White Becky L 
Published: December 2022

Abstract

Background
Recently incarcerated individuals are at increased risk for HIV acquisition during community re-entry but have poor access to HIV pre-exposure prophylaxis (PrEP). There is an opportunity to integrate PrEP into an existing Formerly Incarcerated Transition (FIT) program in North Carolina (NC). We aimed to explore potential barriers and facilitators to post release PrEP implementation within the existing FIT program from the perspectives of formerly incarcerated individuals (FIT clients) and community stakeholders (community health clinicians, community health workers).

Methods
We conducted 28 semi-structured in-depth interviews (14 FIT clients and 14 community stakeholders). We used a rapid assessment method to summarize interview transcripts based on the domains of the semi-structured interview guide and to characterize the contents of the summaries as potential barriers or facilitators to steps of the PrEP cascade.

Results
HIV stigma was mentioned as a potential barrier at each step of the PrEP cascade among both FIT clients and stakeholders. Both groups emphasized the importance of PrEP education for FIT clients, stakeholders, and the community to facilitate awareness and HIV risk perception. Stakeholders and FIT clients believed that competing priorities would be a significant barrier to PrEP uptake post-release. Linking incarcerated individuals to PrEP services during incarceration was mentioned as a facilitator to increase PrEP uptake. A lack of ongoing social support was seen as a critical barrier by FIT clients to achieve the necessary adherence to PrEP and retention to PrEP appointments. Both groups cited financial and logistical challenges such as the cost of PrEP services and transportation as potential barriers to PrEP adherence and retention.

Conclusion
Community stakeholders and FIT clients recommended several strategies that can be implemented to increase PrEP knowledge, uptake, and retention upon release. However, they also identified critical structural barriers that must be overcome before PrEP can be adopted among formerly incarcerated individuals in a non-Medicaid expansion state.

Disclosures
All Authors: No reported disclosures.
2081. Failing to PrEPare is PrEParing to Fail: Advocating for PWID PrEP Inclusion
Authors: Barner Amanda , Shipton Linda , Jackson Ebony 
Published: December 2022

Abstract

Background
The CDC recommends that PrEP be offered to anyone with a history of injection drug use, with a particular focus on those that have injected in the past 6 months, shared injection equipment, or have sexual risk factors. Yet, PrEP remains underutilized. The SARS-CoV2 pandemic introduced additional barriers to HIV testing and substance use treatment. We sought to develop a specialty pharmacy-driven program to minimize barriers and increase education surrounding PrEP in PWID in patients admitted to the hospital with IV drug use related complications. Patients identified by the ID consultant or stewardship team were offered enrollment in the program as part of a comprehensive harm reduction strategy. Upon referral, specialty pharmacists provided phone counseling, prescribed TDF/FTC, and conducted laboratory monitoring.

Methods
From November 2020 through March 2022, we collected data on our accepted referrals including number of refills, laboratory appointments, reason for discharge, duration of retention in the program, and injection-related emergency department visits and hospital admissions for 90 days after program discharge.

Results
During the eighteen month period, 23 patients accepted referral into the program. The median age was 42 years and 47.8% were male. Despite accepting the initial referral while inpatient, 87% (n=20) of patients did not remain in the program to receive the first month's supply of TDF/FTC once discharged. Sixteen (69.6%) were not able to be contacted on the phone number provided despite multiple attempts. Four (17.4%) declined ongoing IV drug use. Eight patients (35%) had an injection related ED visit or hospitalization within 90 days of program discharge.

Conclusion
In conclusion, high risk PWID admitted to the hospital who agreed to PrEP with daily TDF/FTC had a low retention rate after discharge. PWID need to be included in future research studies, especially studies involving novel PrEP treatments.

Disclosures
All Authors: No reported disclosures.
2082. HIV Pre-Exposure Prophylaxis Practices and Beliefs in Four African Countries
Authors: Shah Neha , Dear Nicole , Cavanaugh Joseph S , Iroezindu Michael , Bahemana Emmanuel , Kibuuka Hannah , Owuoth John , Maswaii Jonah , Sing'oei Valentine , Crowell Trevor A , Parikh Ajay , Esber Allahna , Polyak Christina , Ake Julie A 
Published: December 2022

Abstract

Background
Pre-exposure prophylaxis (PrEP) is an essential component to stopping the HIV epidemic. Recent breakthroughs in PrEP including the vaginal ring and long-acting preparations provide more options for individuals. However, PrEP uptake continues to be a challenge. We evaluated PrEP awareness and barriers to PrEP uptake among individuals in four sub-Saharan African countries.

Methods
Individuals aged 16 years or older without HIV were referred to the African Cohort Study (AFRICOS) at 12 PEPFAR-supported clinics in Uganda, Kenya, Tanzania and Nigeria through their sexual partners, social media outlets or outreach to communities and schools. Starting in 2020, participants were administered a survey regarding PrEP knowledge, practices, and beliefs every six months. We conducted descriptive analyses from a participant’s first study visit after PrEP-related questions had been introduced.

Results
From February 2020 to November 2021, the PrEP survey was completed by 372 participants, of whom 204 (55%) were female; their median age was 37.5 (interquartile range (IQR): 26.6-46.5) years old; 228 (61%) were married; 64 (17%) consumed alcohol and 6 (2%) used recreational drugs. Of the 314 (92%) who reported ever having sex, the median age at sexual debut was 18 (IQR: 16-19); 241 (77%) reported 1 regular partner; 295 (94%) had no casual partners in the past six months, 97 (31%) had an HIV+ partner and 26 (10%) had a partner with an unknown HIV status. Results from the PrEP survey are in the Figure. When asked about PrEP, 44 (29%) had discussed PrEP with their provider and 73 (20%) stated they would feel ashamed or embarrassed taking PrEP. Those who had heard of PrEP were more likely to be unmarried (p=0.046) and more likely not to have used a condom during the last sexual encounter with their regular partner (p&lt; 0.05).
PrEP knowledge and practices

Conclusion
In our cohort, few participants had heard of or were taking PrEP. While our cohort may not represent a high-risk population, PrEP awareness was limited among those who were either unaware of their partner’s status or who had a partner infected with HIV. The lack of PrEP awareness highlights the need for increased provider education and outreach especially as new, and potentially less stigmatizing, PrEP options come to market.

Disclosures
All Authors: No reported disclosures.
2085. PrEP Interest and Preferences Among US Black and Hispanic Men – A National Survey
Authors: Poteat Tonia , Sarkar Supriya , Ragone Leigh , Rawlings Keith , Rinehart Alex R , Hill Jennifer N , Gallington Kyli , Coyne Karin S , Vannappagari Vani 
Published: December 2022

Abstract

Background
Use of daily oral HIV pre-exposure prophylaxis (DO PrEP) has increased steadily in the past several years, but patterns of racial disparities have emerged in PrEP uptake. Although Black and Hispanic people are disproportionately affected by HIV in the US, they constitute a minority among those accessing DO PrEP. Newly available prevention options, such as long-acting injectable (LA) PrEP may help close the gap in unmet need for PrEP; however, interest in LA PrEP has not been evaluated specifically among racial/ethnic minority groups. Awareness, willingness, and usage of PrEP as well as HIV prevention preferences were assessed among sexually active adult men in the US.

Methods
Participants were recruited through a geographically targeted social media campaign and completed a self-administered, cross-sectional, online survey on demographics, sexual health and behavior, healthcare access, PrEP awareness and usage, and PrEP intention and preferences. Eligible participants met the following criteria: cisgender men, self-identified Black race and/or Hispanic ethnicity, 18 years or older, reporting unknown or HIV-negative status, currently residing in the US, and reporting anal or vaginal sex in the past six months. Descriptive statistics were calculated using SAS v9.4.

Results
From November to December 2021, 1365 men completed the survey (median age: 29.0 years; Black non-Hispanic: 43.1%, Black Hispanic: 40.3%, White Hispanic: 10.2%, Other Hispanic: 6.4%). A majority had heard of DO PrEP (66.6%) and LA PrEP (47.5%) as a way to prevent HIV; however, a smaller proportion had spoken to a healthcare provider (HCP) about PrEP (42.1%), had ever used PrEP (24.7%), or were currently taking PrEP (16.3%) (Figure 1). A large majority (74.0%) reported interest in using LA PrEP. When asked about their preferred PrEP option, 60.2% chose LA PrEP and 7.4% chose DO PrEP, while 27.5% stated that they preferred neither PrEP option. Figure 1.PrEP Awareness, Discussion with HCP, and Usage Among US Black and Hispanic Men, Overall and by Race/Ethnicity

Conclusion
Most participants demonstrated high awareness of PrEP and a strong interest in LA PrEP. The availability of and interest in LA PrEP may serve as an opportunity to help increase overall PrEP uptake among Black and Hispanic men in the US.

Disclosures
TONIA POTEAT, PhD, MPH, PA-C, ViiV Healthcare: Advisor/Consultant Supriya Sarkar, PhD, MPH, ViiV Healthcare: Salary|ViiV Healthcare: Stocks/Bonds Leigh Ragone, MS, GlaxoSmithKline: Stocks/Bonds|ViiV Healthcare: Employment Keith Rawlings, MD, ViiV Healthcare: Employee Alex R. Rinehart, PhD, ViiV Healthcare: Stocks/Bonds Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare: I am full time employee of ViiV Healthcare and receive GlaxoSmithKline stock as part of my compensation package|ViiV Healthcare: Stocks/Bonds.
2096. Associations with Pneumocystis Pneumonia in Solid Organ Transplant Recipients: Impact of Posttransplant Lymphoproliferative Disorder
Authors: Yetmar Zachary A , Duffy Dustin , Smith Byron , Vikram Holenarasipur R , Brumble Lisa M , Limper Andrew H , Beam Elena 
Published: December 2022

Abstract

Background
Pneumocystis jirovecii pneumonia (PCP) is a potentially deadly infection afflicting the immunocompromised population, including solid organ transplant recipients. Several risk factors have been described, including acute rejection, lymphopenia, and cytomegalovirus (CMV) infection. However, little is known regarding the risk imparted by posttransplant lymphoproliferative disorder (PTLD).

Methods
We performed a nested case-control study of solid organ transplant recipients diagnosed with PCP from 2000-2020. PCP was defined as positive smear or polymerase chain reaction testing with compatible clinical symptoms and radiographic findings. Two control were matched to each case by year of first transplant, first transplanted organ, and sex. Each control had at least as much follow-up from their transplant date to their matched case’s PCP diagnosis date. Multivariable conditional logistic regression was performed to analyze theorized risk factors.

Results
Sixty-seven cases met inclusion criteria and were matched to 134 controls (Table 1). Median age was 60.9 years, and the most common transplant type was kidney (52.2%). Fourteen patients had a history of PTLD, 12 of which developed PCP. All cases of PTLD were monomorphic, 6 were EBV-positive, 9 were receiving chemotherapy at the index date, and only 1 control patient was receiving PCP prophylaxis. The cases with PTLD developed PCP a median of 85 days after PTLD diagnosis, while the two controls were diagnosed more than 1 year earlier. After adjusting for age, acute rejection requiring treatment within the last 6 months, CMV infection within 6 months, current PCP prophylaxis, and lymphopenia (lymphocyte count &lt; 0.5 x109/L) within 6 months, PTLD had a significant association with PCP (OR 14.0, 95% CI 1.7-114.5; p = .014). Lymphopenia was also associated with PCP (OR 8.2, 95% CI 3.2-20.7; p &lt; .001), while the other factors were not. Table 1:Characteristics of 67 Solid Organ Transplant Recipients with Pneumocystis Pneumonia and 134 Matched Controls

Conclusion
Diagnosis of PTLD is independently associated with subsequent PCP after adjustment for recognized risk factors. This association is likely influenced by PTLD-directed chemotherapy, particularly regimens containing rituximab. PCP prophylaxis should be initiated in solid organ transplant recipients with PTLD, particularly those undergoing active therapy, and those with severe lymphopenia.

Disclosures
All Authors: No reported disclosures.
2366. Impact of the Febrile Podcast and Learning Resource as an Infectious Diseases Education Platform
Authors: Dong Sara W , Stead Wendy 
Published: December 2022

Abstract

Background
Febrile is a digital infectious diseases (ID) learning platform with the aim of providing high quality and accessible ID content. We describe utilization of Febrile as a resource for learning and teaching ID, learner satisfaction, and the perceived impact on clinical practice.

Methods
Febrile was launched in December 2020 as a trainee-focused resource as shown in Figure 1. Content is also promoted on social media. Podcast analytics are available from the media host, Captivate, which is Interactive Advertising Bureau certified. Website and Twitter engagement was obtained from Google and Twitter Analytics, respectively. An online anonymous survey was conducted to assess educational impact using Likert scales and open answer questions.

Results
As of April 26 2022, Febrile has produced 39 episodes and has been downloaded &gt; 107,000 times in all 50 United States (US) and 140 countries. Majority of the audience (62%) listens from within the US, see Fig. 2 for geographic distribution. The website has received &gt; 60,000 views, and the Twitter account has garnered &gt; 8,100 followers.
A total of 224 participants from 30 countries and 37 US states completed the survey, of whom 78 (35%) were ID fellows in training and 71 (32%) were ID faculty physicians. Breakdown of other respondents is in Fig. 3.
Most had listened to either ≥ 21 episodes (57, 25%) or 11–20 episodes (86, 38%). In addition, 72% reported visiting the website and 82% had seen a Febrile infographic. There was a high level of satisfaction with the resources, and 83% of respondents have already recommended Febrile to a colleague (Fig. 3).
Enhancing core ID knowledge was the primary driver for listening among other reasons noted in Fig. 4. Two-thirds of respondents indicated that information they learned from Febrile has changed their practice, and 50% have used Febrile as a way to teach others (Fig. 4). Of note, for those considering ID as a career, Febrile had a favorable impact on perception of the specialty (30/34, 88%). Many respondents also indicated Febrile as a source of community (50%, Fig. 4 and 5).

Conclusion
Febrile is a novel and impactful tool for ID medical education. In addition to providing educational resources, this innovative digital platform holds the potential for meaningful community building and attracting trainees to the field of ID.

Disclosures
All Authors: No reported disclosures.
2110. Immunocompromised Adults Hospitalized with Community-Acquired Pneumonia in the United States: Incidence and Clinical Outcomes
Authors: Ramirez Julio A , Chandler Thomas R , Furmanek Stephen , Carrico Ruth , Wilde Ashley M , Sheikh Daniya , Ambadapoodi Raghava Sekhar , Salunkhe Vidyulata , Tahboub Mohommad T , Arnold Forest W , Bordon Jose , Cavallazzi Rodrigo 
Published: December 2022

Abstract

Background
Community-acquired pneumonia (CAP) is an important complication in immunocompromised adults (ICAs). In hospitalized patients, the burden of CAP in ICAs is not well defined. The primary objective of this study was to define incidence, epidemiology, and outcomes of ICAs hospitalized with CAP in the city of Louisville. The secondary objective of this study was to estimate the burden of CAP in ICAs in the US.

Methods
This was a prospective population-based cohort study of consecutive hospitalized adult Louisville residents with CAP at all adult hospitals in Louisville from 1 June 2014 to 31 May 2016. An ICA was defined as a patient with any of the following medical conditions or treatments: (1) primary immunodeficiency disease; (2) advanced-stage cancer (stage III or IV cancer or hematologic cancer); (3) advanced HIV infection (CD4 T-lymphocyte count &lt; 200 cells/mL or &lt; 14%); (4) solid organ transplantation; (5) hematopoietic stem cell transplantation; (6) receiving cancer chemotherapy; (7) receiving biological immune modulators; (8) receiving corticosteroid therapy with a dose ≥ 20 mg prednisone or equivalent daily for at least 14 days prior to hospitalization; or (9) receiving disease-modifying antirheumatic drugs (DMARDs). The annual population-based CAP incidence among ICAs was calculated. Mortality was evaluated during hospitalization and at 30 days, 6 months, and 1 year after hospitalization.

Results
A total of 7449 unique patients were included, with 854 (11%) ICAs identified. Figure 1 depicts the immunocompromising conditions. Per 100,000 adults in Louisville, each year 75 ICAs are hospitalized with CAP (95% CI: 68-78), corresponding to an estimated 190,106 ICAs hospitalized with CAP in the US. Mortality during hospitalization was 8% in ICAs vs 6% in non-ICAs; at 30 days 23% in ICAs vs 11% in non-ICAs, at 6 months 42% in ICAs vs 20% in non-ICAs, and at 1 year 52% in ICAs vs 27% in non-ICAs. Figure 1:Frequency of Immunocompromising Conditions and TreatmentsImmunocompromising conditions and treatments among 7449 patients hospitalized for community-acquired pneumonia sorted by frequency. Abbreviations: DMARDs: Disease-modifying antirheumatic drugs; HIV: Human immunodeficiency virus.

Conclusion
This study indicates that nearly one out of nine hospitalized CAP patients are immunocompromised, and 190,000 ICAs may be hospitalized due to CAP each year in the US. We found a twofold increase in mortality at every time point after discharge for ICAs compared to non-ICAs hospitalized due to CAP. Further strategies to prevent CAP and improve outcomes in ICAs hospitalized with CAP are necessary.

Disclosures
Forest W. Arnold, DO, MSc, Gilead Sciences, Inc.: Grant/Research Support.