Background Despite significant gains in the treatment of Human Immunodeficiency Virus (HIV), there are still over 38,000 newly diagnosed with the illness annually in the United States. One strategy to reduce HIV infections is Pre-Exposure Prophylaxis (PrEP) for HIV infection. PrEP involves daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF or Truvada®) to reduce infections in those with exposure(s) to HIV or high-risk groups. Studies have shown reduction in HIV transmission with PrEP treatment. The objective of the study is to investigate how behavioral, demographic, and socioeconomic status (SES) influences the awareness of PrEP treatment in NYC. Methods Data on economic, behavioral, PrEP awareness at the UHF neighborhood level was collected by the Community Health Survey (CHS) from the New York City Department of Health and Mental Hygiene and the American Community Survey from the U.S. Census. The population is a cross-sectional telephone survey of NYC residents with landlines and mobile phones for 2016 and 2017. Household income and neighborhood poverty level were used as proxies for SES. Sex-stratified, multivariate logistic regression model was constructed to estimate adjusted associations and determine differences in awareness of PrEP. The model controlled for age group, race, education level, men sex with men status (MSM), and having had an HIV test in the preceding 12 months. Results The final study sample was 5,515 and 5,761 in 2016 and 2017, respectively. In 2016 crude PrEP awareness rate was 24.3% and in 2017 it was 35.4%. In the multivariate analysis for both 2016 and 2017, PrEP awareness was independently associated with age group, education level, male MSM, and having had an HIV test in the preceding 12 months (p < 0.01). The strongest predictors of PrEP awareness were participants with a preceding HIV test in the past 12 months and males who are MSM. PrEP awareness was associated with race for males in 2016 and 2017. PrEP awareness was associated with race for women in 2016, but not 2017. Figure 1: (left) Median household income in NYC (right) HIV diagnoses and PrEP awareness for 2016 and 2017 Conclusion Understanding the relationship of neighborhood socioeconomic status and PrEP awareness is essential for HIV epidemiology. By monitoring PrEP awareness, HIV diagnoses, and risk factors associated with the two, public health officials better target interventions and health policy. Disclosures All Authors: No reported disclosures

In the United States, the prevalence of Chronic Obstructive Pulmonary Disease (COPD) is estimated to be more than 5% and carries significant morbidity and mortality.COPD mortality rates can vary considerably across geographies. Risk factors affecting COPD include socio-economic status, smoking rate, density of health-care facilities, elevation and severity of air pollution.The present investigation is an ecological study using New York City (NYC) COPD mortality data and geographical data to determine if age-adjusted mortality from COPD is associated with area-based poverty at the ZIP code level throughout the five boroughs of NYC. Understanding the socioeconomic and geographic properties COPD mortality rate in a large metropolitan area such as New York City would provide useful insight into the disease. METHODS:In 2009-2011 dataset, 4,713 COPD-related deaths were recorded across NYC ZIP codes. A slight but statistically significant correlation was found showing higher SES associated with lower age-adjusted COPD mortality rates at the ZIP code level for males and females. For males (F(1, 146) ¼ 10.08, p < 0.005) there was an adjusted R-squared of 0.05819. Male's predicted COPD mortality rate on the ZIP code level is 20.14 -0.00009413(median income) when median income is measured in dollars. For females (F(1, 155) ¼ 4.177, p < 0.05) there was an adjusted adjusted R-squared: 0.01996. Female's predicted COPD mortality rate on the ZIP code level is 20.39 -0.00006882(median income) when median income is measured in dollars. Mapping of COPD mortality for men and women revealed varied rates of COPD mortality across NYC ZIP codes. RESULTS:In 2009-2011, 4,713 COPD-related deaths were recorded across NYC ZIP codes. A slight but statistically significant correlation was found showing higher SES associated with lower age-adjusted COPD mortality rates at the ZIP code level for males and females. For males there was an adjusted R-squared of 0.05819, p-value: 0.001827; for females there was an adjusted adjusted R-squared: 0.01996, p-value: 0.04267. Mapping of COPD mortality for men and women revealed varied rates of COPD mortality across NYC ZIP codes. CONCLUSIONS: COPD mortality has been decreasing in the United States for decades. Despite this, the gains are unevenly distributed across socioeconomic statuses and geography.CLINICAL IMPLICATIONS: Understanding the spatial prevalence of the disease in a large metropolitan area such as New York City provides useful insight into the disease, health care systems, and public policy.

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