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n=4), Thailand (n=3), Australia (n=1), Russia (n=1), Sweden (n=1) and Malaysia (n=1). Therein, 84% sequences mixed among CN.01AE.HST/IDU-2, most of which were sampled before 2010 and born in Southeast Asia. 14% sequences clustered with CN.01AE.MSM-4 and -5. A distinct sub-cluster with small divergence that consisted of 15 Japanese variants was formed inside CN.01AE.MSM-4 and the tMRCA of CN.01AE.MSM-4 and the latter sub-cluster were around 1996 and 2006. For other four major lineages, we have not found any significant transmission cluster structure for specific geographical regions. Conclusion This results demonstrated the Chinese CRF01_AE variants have disseminated to other countries but have not scaled, and the immigrant modes of CRF01_AE variants from Asia to global has changed. Our study provided the evidences of regional and global dissemination of Chinese CRF01-AE lineages and highlighted the importance of shaping the newest global landscape of HIV and the necessity to implement the effective measures to reduce global spread of HIV. Disclosure No significant relationships.

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Purpose: HIV pre-exposure prophylaxis (PrEP) is a once-daily pill that can reduce infection risk by up to 99% and empower users to promote their sexual health and psychological well-being. Among adolescents and young adults (AYAs) who are racial/ethnic and sexual minorities, uptake of PrEP has been poor and understudied in real-world settings such as pediatric/adolescent primary care clinics. The objective of this study is to elucidate barriers and facilitators to PrEP initiation among at-risk AYA attending an urban U.S. primary care clinic. Methods: Sexually-active AYAs who were ever eligible for HIV testing were invited to complete an anonymous 19-question survey about PrEP awareness, interest in taking PrEP after learning about the "daily pill that can protect against HIV," and intention to discuss PrEP with a peer navigator that day. Bivariate and multivariable Poisson regressions were conducted to gauge response differences by age (14-19 or 20-24), gender (male or female), sexuality (heterosexual or gay/bisexual/lesbian), clinic visit type (primary care, acute, or STI testing/treatment), and PrEP awareness (aware or not). Data were analyzed using STATA 15 Ò . Results: 73 AYAs were surveyed. Most respondents were 14-19 (63%), African-American (97%), female (70%), heterosexual (84%), and visiting for primary care (57%). One-fourth were aware of PrEP and 58% (n¼42) reported they were interested in taking PrEP. The most common reasons for interest in PrEP included lowering HIV risk (95%) and reducing anxiety about sex (26%). The most common reasons for not being interested included perceiving low HIV risk (52%), believing they could not take PrEP every day (35%), knowing too little about PrEP (35%), and being concerned about side effects (29%). Among those who were interested in PrEP, 43% (n¼16) indicated that they were willing to discuss PrEP with a navigator, however few (n¼3) ultimately did. Multivariable Poisson regression analysis indicated that 14e19-year-olds had nearly 3-times greater likelihood of PrEP awareness compared to 20e24-year-olds (IRR¼2.9, 95% CI¼1.1e7.6, p¼0.03), and that gay/bisexual/lesbian respondents had nearly 4-times greater likelihood of awareness compared to heterosexual respondents (IRR¼3.6, 95% CI¼1.7e7.5, p<0.01). AYAs aged 14-19 had 2-times greater likelihood of being interested in taking PrEP than their 20-24-year-old peers (IRR¼2.3, 95% CI¼1.1e 4.8, p¼0.02). No characteristics were associated with meeting a PrEP provider.

This longitudinal, nonexperimental, quantitative study examined the acceptability, feasibility, and efficacy of a texting intervention that was added to medical case management for youth and young adults at high risk for poor HIV outcomes. The intervention, E-VOLUTION, sent automated text messages to youth participants living with HIV that reminded them to take prescribed medication and attend medical visits. Automated texts also asked clients about mood, housing, and ability to pay bills. Client responses to automated texts that indicated challenges triggered alerts for their medical case manager, who then followed up to address the issue. Participants (N = 100) were an average age between 22 and 23 years and most were Black (95%) and men who have sex with men (82%). Over a period of 26 months 89,681 automated texts were sent, resulting in 450 alerts. Additionally, clients and medical case managers exchanged more than 17,000 texts. Results of Spearman correlations indicated significant associations between greater frequency of alerts triggered and greater likelihood of kept medical appointments (p < .05). Findings also showed significant associations between greater frequency of texting with a medical case manager and greater likelihood of viral load suppression and kept medical visits at 12-month follow-up (p < .01). More frequent substance use was associated with more alerts triggered (p < .01). Use of text messaging was acceptable to the participants and is a culturally responsive way to engage youth participants living with HIV in care. Future research may examine the use of structured behavioral health assessments in the automated texting framework, as well as compare outcomes between automated and two-way texting groups.