Background:
Public health isolation policies assist in reducing infection spread, but may result in unintended psychological effects, particularly when implemented without structural supports. We examined acute psychological distress among people diagnosed with mpox, and assessed differences by access to paid sick leave and experiences of financial hardship and stigma.

Methods:
We analyzed data from the Mpox Prospective Observational Cohort Study (MPOCS). Participants in Toronto and Vancouver diagnosed with mpox between 05/2022-07/2025 self-completed questionnaires during the acute phase of illness. This included the Kessler Psychological Distress Scale (Cronbach’s alpha=.95) and items on access to paid sick leave, isolation duration, financial hardship, employment income loss, challenges paying rent/mortgage during isolation, and perceived mpox-related stigma. Psychological distress scores were compared using Mann-Whitney U tests.

Results:
Among 62 participants, 24 (39%) were living with HIV, 61 (98.4%) were cisgender men, and 60 (97%) gay/queer/bisexual. Median (IQR) isolation duration was 16.5 (7.25-22) days. Over half (57%) of participants reported no access to paid sick leave, 21 (34%) employment income loss during isolation, 15 (24%) financial hardship, and 16 (26%) challenges paying rent/mortgage. Median (IQR) psychological distress score was 22 (15.25-29) out of 45, and did not differ by HIV status (p=0.40). Psychological distress scores were higher among individuals without access to paid sick leave (27 vs 19, p=.01) and those reporting employment income loss (29 vs 19, p<.001), financial hardship (22 vs 20.5, p=.02), and rent/mortgage payment challenges (29 vs 20, p=.002). The 18 (29%) who reported experiencing mpox-related stigma, had higher distress scores than those who did not (28 vs 20, p=.01).

Conclusions:
Psychological distress was significantly higher in people with mpox lacking structural supports, experiencing financial hardship during isolation, and experiencing stigma. Future outbreak isolation policies should be implemented alongside social protections, including paid sick leave, to mitigate harms to equity-deserving communities.

Introduction: In BC, HIV Treatment (HIV-Tx) and PrEP are centrally distributed, monitored and evaluated, with client, prescriber, and lab monitoring records securely stored in the BC-CfE Drug Treatment Program registry. BC-CfE therapeutic guidelines recommend screening for syndemic conditions including HCV. We piloted a quality improvement (QI) initiative for program clients with HCV viremia with the aim of facilitating follow-up testing and HCV treatment where indicated.

Methods: In February 2025, active HIV-Tx and PrEP clients where latest HCV RNA was detectable, were identified. Where no follow-up HCV RNA testing had been performed after a minimum of 6 months, a confidential client-specific communication was sent to the corresponding HIV-Tx or PrEP provider. The communication included (1) the client’s latest HCV RNA record, (2) recommendation to repeat HCV RNA, and (3) links to resources (HCV treatment guidelines, BC HCV treatment access and coverage information, and a list of BC Hepatitis referral clinics if needed for evaluation and treatment).

Results: Of more than 8,000 HIV-Tx and >10,000 PrEP clients, 54 HIV-Tx clients and 1 PrEP client were identified for the prescriber communication, which was mailed in February 2025.

Of the 55 clients identified, 28 (51%) had repeat HCV RNA testing (39% undetectable, 61% detectable) within 6 months after the communication. Some prescribers reported barriers to client care (e.g., lost to follow-up, declined treatment, no show for consultation), or plans for client follow-up.

Conclusions: The centralized nature of the BC HIV-Tx and PrEP programs allows for systematic implementation of QI measures, for both HIV and syndemic conditions. This HCV communication is an example of a client- and provider-specific tool that can facilitate focused follow-up and appropriate care, which can be applied to other conditions. Reassuringly, a low number of BC HIV-Tx and PrEP program clients had recent or current HCV viremia.

Objectives: Frailty, a multi-system geriatric syndrome, is prevalent and poses threats to the health of older adults living with HIV. However, the way frailty evolves over time in this population remains underexplored. We aimed to investigate frailty trajectories and associated factors among a prospective cohort of older adults ≥65 years old living with HIV in Canada.
Methods: We analyzed three waves of longitudinal data collected approximately 18 months apart from the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study. Frailty was assessed using Fried’s criteria and categorized as frail (scores ≥3) or non-frail (scores 0-2). We determined frailty trajectories among participants with complete frailty assessments across all three waves. We conducted logistic regression models to identify factors associated with favorable frailty trajectories (remaining non-frail or improving from frail to non-frail). We applied inverse probability weighting to account for potential selection bias due to missing frailty assessments over time.
Results: At baseline (n=192), the median age was 69 years (25th–75th percentiles: 67–72). Most participants were male (92%) and White (74%). Fifteen percent were classified as frail at baseline, 22% at wave 2 and 27% at wave 3. Five trajectories were observed, including remained non-frail (65%), improving (3%), worsening (15%), remained frail (9%), and fluctuating (8%). Older age was associated with lower odds of a favorable frailty trajectory (adjusted odds ratio (aOR)=0.14; 95%CI: 0.05-0.38). Conversely, HIV diagnosis at age ≥50 years (aOR=4.18; 95%CI: 1.28-13.65), reporting being physically active (RAPA; aOR=2.90; 95%CI: 1.22-6.93), and better physical function (SPPB; aOR=1.45; 95%CI: 1.09-1.93) were associated with higher odds of a favorable trajectory.
Conclusion: The diversity of frailty trajectories underscores the need for continued monitoring and personalized care strategies for older adults living with HIV. Interventions promoting physical activity and preserving function may help prevent or mitigate frailty in this growing population.

Introduction: Women living with HIV are at higher risk of cardiovascular disease (CVD) than men, likely due to a combination of risk factors. Soluble urokinase plasminogen activator receptor (suPAR), a marker of immune activation, has been associated with adverse cardiac outcomes, whereas soluble (s)CD163, a marker of macrophage activation, has been associated with atherosclerosis. Cardiovascular risk estimators such as the recently developed PREVENT are useful tools in primary prevention of CVD, stratifying individual risk by combining risk factors into a single estimate.

Methods: We included all women enrolled in BCC3 (Dec 2020-July 2024), a community-engaged healthy aging study, eligible for the 10-year PREVENT Risk Calculation (aged 30-79), and with inflammatory marker data. We calculated PREVENT risk age, which estimates “heart age vs. chronological age,”. suPAR and CD163 concentrations were assessed using MesoScale Discovery R-plex kits. Quantile regression was used to assess PREVENT risk age association with inflammatory markers, controlling for covariates/confounders.

Results: Among 354 BCC3 participants [58.1% living with HIV], higher PREVENT risk age was significantly associated with higher levels of suPAR (R2=0.421) and sCD163 (R2=0.380), both before and after adjusting for potential confounders, including chronological age itself.

Conclusions: Known heart health-associated inflammatory markers suPAR and CD163 are both associated with a higher PREVENT risk age, independent of HIV status, chronological age, smoking, and ethnicity. Further analysis will determine whether inflammatory markers not linked to heart health are also associated with PREVENT risk age and if they differ by HIV status.

Introduction: Missed doses, vaccine hesitancy, and waning immunity are driving a global rise in measles cases, including in Canada. People with HIV (PWH) are at higher risk of measles-related complications. Ensuring adequate herd immunity is essential to prevent severe measles-related morbidity and mortality.

Objectives: To estimate the seroprevalence of measles IgG among adult and pediatric PWH and identify risk factors associated with negative/equivocal results.

Methods: We conducted a retrospective chart review of PWH attending the McGill University Health Centre (MUHC) Chronic Viral Illnesses Service (CVIS) Clinic, The Ottawa Hospital (TOH) Immunodeficiency clinic, and the Centre hospitalier Sainte-Justine HIV clinic undergoing routine measles IgG screening using the Diasorin LIAISON measles IgG assay. Values > 16.5 IU/mL were considered positive and ≤ 16.5 IU/mL were deemed negative/equivocal. Mumps and rubella serostatus were also assessed. Univariate and multivariate logistic regressions analyses were used to identify risk factors for negative/equivocal measles serologies.

Results: A total of 270 patients were included (233 adults and 37 children/teenagers: 53.5% female, 46.5% male). Overall, 79 patients (29.3%) had negative or equivocal measles IgG results, of whom 10 (12.7%) were <18 years old and 58 (65.8%) were born outside of Canada. The median viral load was lower in the measles seropositive group than in the non-seropositive group (0 and 160 copies/mL respectively, p<0.0001). Younger age, negative or equivocal rubella and mumps results, unsuppressed viral load, and lower CD4 count were associated with higher odds of testing negative or equivocal measles IgG on univariate and multivariate logistic regression analysis.

Conclusion: Approximately 29.3% of PWH in our cohort lacked confirmed measles immunity. Younger age, unsuppressed viral load, lower CD4 count, and negative/equivocal rubella and mumps serostatus were associated with lower measles IgG seropositivity, suggesting a role for verification of measles serostatus in this population and additional vaccine doses when appropriate.

Introduction: Semaglutide is now widely prescribed for the treatment of diabetes and obesity. Concerns have emerged regarding its psychiatric safety, particularly its potential effects on depression and suicidality. People with HIV (PWH) have high rates of depression, yet evidence on the mental health safety of semaglutide among PWH remains limited.

Methods: We conducted a within person pre–post study of PWH initiating semaglutide at nine sites of the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS), a multicentre U.S. cohort (2018–2024). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), collected approximately every six months at routine visits. Mean changes in depressive symptoms, as measured by PHQ-9 scores, before and after semaglutide initiation were estimated with linear mixed models adjusted for age, sex, race/ethnicity, and time. We examined changes in PHQ-9 scores overall and stratified by baseline depression severity (0–4: no/minimal, 5–9: mild, 10–14: moderate, ≥15: moderately-severe to severe), as well as by body mass index (BMI), diabetes status, and antidepressant use.

Results: Among 354 PWH (mean age 54; 77% male; 38% non-Hispanic White; 78% obesity; 60% diabetes), baseline PHQ-9 scores were 0–4 in 53%, 5–9 in 28%, 10–14 in 10%, and ≥15 in 9%. Semaglutide was not associated with overall changes in depressive symptoms (ΔPHQ-9 −0.1 [95% CI −0.7, 0.5]). Scores increased slightly in those with no/minimal baseline depression (+1.2 [95% CI 0.5, 1.8]), were stable in mild/moderate depression, and decreased in moderately-severe to severe depression (−4.7 [95% CI −7.3, −2.2]). No worsening was observed across BMI, diabetes, or antidepressant subgroups.

Conclusion: Semaglutide initiation was not associated with worsening depressive symptoms among PWH. While individual responses may vary, these findings add to evidence on semaglutide safety regarding mood in this population.