997. The Purview Paradox: PrEP Utilization at a Major Southern California County Teaching Hospital and Affiliated Clinics

Background According to the Centers for Disease Control (CDC), PrEP coverage in the United States was approximately 18% in 2018 and 21.9% in California. We predict that PrEP prescription is lower at Harbor-UCLA Medical Center (HUMC) and affiliated clinics within Los Angeles County Department of Health Services. Methods A retrospective chart review of HIV-negative patients with ICD-10 coded diagnoses of sexually transmitted infections (STIs) or high-risk sexual behavior was performed across various medical specialties at HUMC and affiliated clinics in 2018. Documentation of sexual behavior risk reduction counseling, PrEP discussion and prescription was reviewed from electronic medical records for each encounter. Descriptive statistics and analysis were completed in STATA Version 16.1, StataCorp LLC. Results The sample included 250 individual patients, all with indications for PrEP. Of those, 47.2% identified as Latinx and 27.2% Black. Table 1 shows 74% of patients identified as heterosexual whereas 9.2% identified as gay, and 4.4% bisexual. Of the 250 individual patients, 87 (34.8%) returned for a 2nd visit, 35 (14.0%) for a third, and 9 (3.6%) for a 4th visit, for a total of 381 encounters. Of the total encounters, 49.3% had sexual behavior risk reduction counseling, 7.3% had discussions about PrEP with their provider, and only 2.1% were newly prescribed PrEP (Table 2). Of the 2.1% new PrEP prescriptions, 1.8% were prescribed by family medicine providers with no new prescriptions by OB/GYN or acute care providers. Only 25% of new PrEP prescriptions were female patients. A positive test for an STI occurred in 45.1% of total encounters while high risk sexual behavior was identified in 54.9% of encounters (Table 3). Table 1: First Encounter Demographics (N=250 Individual Patients) Table 2: Primary Outcomes by Specialty (N=381 Total Encounters) Table 3: Sexually Transmitted Infections Frequency (N=381 Total Encounters) Conclusion Our findings demonstrate that the percent of individuals newly prescribed PrEP (2.1%) at HUMC and affiliated clinics is less than that reported nationally and in California. This suggests that municipal health systems fall short in PrEP usage, notably for structurally vulnerable populations such as racial minorities as well as heterosexual females. Ending racial/ethnic disparities in HIV and in PrEP coverage not only requires educating specialty providers on PrEP, but also addressing structural racism and identifying structural barriers to care in vulnerable communities. Disclosures All Authors: No reported disclosures

Description of Sexual Behavior Risk on Early Adolescent in Hope Island Villages of Thousand Island

Adolescent is a period of psychosexual development which at this stage are very prominent change is when the sexual function of maturity shown through behavior change. Indonesia Adolescent Reproductive Health Survey proves that nationally there is an increasing incidence of sexual intercourse than 3 million teens who claimed ever done premarital sexual behavior in 2007 to 3.7 milliion youth in 2012. This study is adescriptif study with 135 respondents as study sample are early adolescent in the Hope Island Villages 0f Thosand Island. The result of this study showed that most respondents are adolescent aged 11 years (40%), 52,6% were male and 47.4% female, 54.8% had sexual behavior risk and 21.5% of respondents ever do sexual intercourse. Advice to government, social agencies, and research institutions and community servicein college in order to perform adolescent reproductive health education to adolescent in Hope Island Villages of Thousand Island.

Crack users, sexual behavior and risk of HIV infection

OBJECTIVE: To compare a sample of injecting cocaine users and crack users, assessing sexual behavior, risk for infection by HIV and its seroprevalence. METHOD: 109 injecting cocaine users and 132 crack users were assessed, using the World Health Organization questionnaire from the expanded "Cross-Site Study of Behaviors and HIV Seroprevalence among Injecting Drug Users" and HIV serology. Data were assessed by Multiple Correspondences Analysis. RESULTS: Crack users showed less time of drug consumption when compared to the injecting cocaine users. Despite this fact, they had higher rates of risky sexual activity, differences in poli-consumption of drugs, and higher rates of involvement in illegal issues. HIV seroprevalence among crack users, although lower than for injecting cocaine users (7% vs. 33%) is high when compared to the general population at the same age. CONCLUSIONS: Sexual behavior of crack users in the studied sample may be considered a risk factor for HIV infection. Crack users have access to information on HIV/ AIDS, but do not make use of it to change risk behaviors that may expose them to HIV infection and dissemination. HIV seroprevalence among crack users (7%) is concerning, which makes it necessary to create preventive strategies for HIV infection and dissemination that are specifically directed toward this population.