P-263. Informing Multi-level HIV Prevention Strategies Through Molecular Network Analysis in Georgia

Abstract Background Georgia remains heavily impacted by HIV, particularly among Black and Latino communities. HIV molecular epidemiology (HME) uses HIV pol gene sequence similarity to detect rapidly transmitting networks in near real time, supporting timely public health response and resource allocation. However, integration of behavioral, sociodemographic, and network-level dynamics into HME-informed interventions remains limited. To address this, we developed epidemiologic profiles of five HIV molecular networks in Georgia and applied a multi-level framework to guide equitable, data-driven public health action.Table 1.Demographic, Behavioral, Structural, and Prior STI Characteristics of Individuals in Five HIV Molecular Networks in Georgia.MSM = Men who have sex with men. IDU = Injection drug use. SVI = Social Vulnerability Index (range: 0–1), matched to eHARS data by census tract at time of HIV diagnosis, with higher values indicating greater community-level vulnerability. “Anonymous Sex”: refers to sexual activity with a partner whose identity is unknown. “Drug-associated sex” refers to sex with a partner who injects drugs, sex exchanged for drugs, or sex under the influence of injection drug use. “STI Before HIV” indicates individuals with a documented STI diagnosis prior to their HIV diagnosis. Median and range reflect the number of years between earliest recorded STI and HIV diagnosis.Table 2.Care Continuum Outcomes Among Individuals in Five HIV Molecular Networks in Georgia. Care engagement and retention were assessed using HIV viral load data from surveillance systems. Individuals were considered engaged if they had ≥1 lab in the past 12 months and retained if they had ≥2 labs ≥3 months apart. Viral suppression was defined as the most recent viral load