Background: Older people living with HIV (PLWH) often experience elevated levels of depression, anxiety, and loneliness.Methods: This waitlist-controlled trial examined the effectiveness of online audio mindfulness lessons in impacting these feelings among older PLWH.Results: Among 214 participants, the mean (SD) age was 60.4 (5.9) years, 89% were male, and 69% were white. After 25 days, the intervention group showed significant improvements versus the waitlist control group in symptoms of depression (20.3% improvement, p < .01) and symptoms of anxiety (22.4% improvement, p = .03), but not in loneliness as measured by a Daily Diary (12.9% improvement, p = .07) or the 3-Item Loneliness Scale (4.8% improvement, p = .27). Secondary analyses among participants with elevated baseline symptoms of depression showed a 26.3% improvement (p < .01), with a moderate effect size (Hedge's g = 0.69). Similarly, those with elevated baseline symptoms of anxiety showed a 25.6% improvement (p < .01), a moderate effect size (g = 0.54), while those with moderate or severely elevated loneliness showed an 18.9% improvement in daily loneliness (p < .01), a moderate effect size (g = 0.55).Conclusion: This waitlist-controlled trial is the first to show that a series of brief, online audio mindfulness lessons improves mental health outcomes among older PLWH. For many patients, this intervention may offer relief that is both accessible and affordable.

A long-acting injectable (LAI) antiretroviral therapy (ART) regimen is now available as a treatment option for virologically suppressed adults with HIV-1. This study assessed preference for a LAI regimen using an online survey of virally suppressed people living with HIV (PLWH) and physicians treating HIV in the US and Canada. Preference was elicited in a discrete choice experiment (DCE) with three choice options (switch to a LAI regimen, switch to another daily oral ART regimen, or stay on their current daily oral ART regimen) and four treatment attributes. A total of 553 PLWH and 450 physicians completed the survey. From the DCE results, 59% of PLWH were predicted to prefer a LAI over an alternative oral ART or staying on their current oral treatment, and 55–66% of physicians were predicted to recommend LAI for PLWH, depending on the treatment challenge scenario presented. PLWH indicated LAI would remove daily reminders of HIV (75%) and reduce feelings of being stigmatized (68%). A majority of PLWH and physicians preferred a LAI over oral ART to overcome treatment challenges such as daily pill burden and adherence. These benefits of LAI ART along with preferences of PLWH and physicians can help to inform ART choice.

Abstract Background Despite decades of work evaluating multiple interventions to improve ART adherence, viral load suppression in the U.S. remains far below Ending the HIV Epidemic goals. Previous research demonstrates that income and other factors, including social well-being (SWB), resilience, and exercise, are correlated with ART adherence. However, it is unclear how these factors interact with income to impact adherence in older adults living with HIV (OALWH). Methods Self-reported outcome measures from the Aging with Dignity, Health, Optimism, and Community (ADHOC) cohort were collected from November 2017 to June 2019. Adherence was measured using the Brief Adherence Self-Report Questionnaire, depression using the Patient Health Questionnaire-2, SWB using the Functional Assessment of HIV Infection, and resilience using the Connor-Davidson Resilience Scale. Face-valid questions provided data on household income, race, sexual orientation, # of ART pills daily, and exercise. Linear regressions assessed the associations between these variables and adherence. Mediation analysis using bootstrapping assessed the significance of the mediation effects of income on these variables. Results For 1,039 ADHOC participants, average age was 59 years, 86% were male, 69% were White, and mean adherence was 96.2% (SD=11.2). In bivariate analyses, depression, SWB, exercise, resilience, White race, # ART pills daily, and sexual orientation were each significantly correlated with both ART adherence and income. Interestingly, depression, SWB, resilience, and exercise became non-significant predictors of adherence after adjusting for the effects of income. Mediation analysis with bootstrapping demonstrated significant causal mediation effects of income on depression and adherence (B=-0.14, 95% CI (-0.25 – -0.04)), SWB and adherence (B=0.03, 95% CI (0.01 – 0.05)), resilience and adherence (B=0.15, 95% CI (0.04 – 0.27)), and exercise and adherence (B=0.002, 95% CI (0.0007-0.003)). Conclusion In OALWH, household income mediates the relationship between ART adherence and depression, SWB, resilience, and exercise. Therefore, interventions to improve adherence must address the causal role of income and focus on providing low-income patients with economic support to help lift them out of poverty. Disclosures Peter J. Mazonson, MD, MBA, ViiV Healthcare: Grant/Research Support Maile Y. Karris, MD, Gilead Sciences: Grant/Research Support|Gilead Sciences: I have received honorarium to speak at conferences|ViiV Healthcare: Grant/Research Support Emily Huang, MPH, ViiV Healthcare: Grant/Research Support Jeff Berko, MPH, ViiV Healthcare: Grant/Research Support Frank Spinelli, MD, Gilead Sciences: Employee|ViiV Healthcare: former employee Andrew Zolopa, MD, ViiV Healthcare: full time employee|ViiV Healthcare: Stocks/Bonds.

Resilience, a measure of stress coping ability, may be important in helping older people (age 50+) living with HIV (PLWH) age successfully, but limited data exist regarding factors that contribute to resilience for this group. This study uses the Connor–Davidson Resilience Scale 2 (CD-RISC2) to assess resilience, based on a cross-sectional analysis of 1047 older PLWH. Bivariate linear regression models were used to identify predictor variables that had a relationship with resilience. Those variables were then included in a multivariable linear regression model, which was pared using backward selection. In the multivariable model, higher income and greater interpersonal support were associated with greater resilience, whereas depression and anxiety were associated with lower resilience. Relevant interventions that address these issues, such as increasing opportunities for social support and increasing screening for and treatment of depression and anxiety, are identified as potential pathways to increase resilience among older PLWH.

Abstract Background Many older (age 50+) adults living with HIV (OALWH) are sexually active. However, little is known about the relationship between number of sexual partners and mental health outcomes among OALWH. Methods Data were utilized from the Aging with Dignity, Health, Optimism and Community (ADHOC) cohort, an observational study of OALWH from ten US clinics. To measure sexual activity, participants were asked “How many sexual partners have you had in the last year?” with response options ranging from zero to “greater than five.” Loneliness was measured using the Three-item Loneliness Scale, and depression was measured using the Patient Health Questionnaire-2. Significance was determined by Kruskal-Wallis tests followed by unadjusted pairwise comparisons. Results Of 1,027 participants, the mean (SD) age was 58.9 (6.1) and 876 (85%) were male. 312 (30%) had zero sexual partners in the past year, 308 (30%) had one partner, 197 (19%) had 2-5 partners, and 210 (20%) had >5 partners. Of the participants with one partner, 230 (75%) were married, coupled or partnered, and 78 (25%) were single, widowed, separated, or divorced (Single). Figure 1 shows that people with one partner were significantly less lonely than any other group (p< 0.01 for pairwise comparisons), and all other groups were statistically similar to each other. This pattern was also seen with depression (p< 0.01 for pairwise comparisons, Figure 2). Among subgroup of people with one sexual partner, those who were married, coupled or partnered were less lonely (4.41 vs. 5.67, p< 0.01) and less depressed (0.95 vs 1.38, p=0.02) than those who were single, widowed, separated, or divorced. Conclusion Among OALWH, people with one sexual partner were less lonely and depressed than people with zero or with ≥2 partners. Furthermore, people with one sexual partner who were married or in a committed relationship were less lonely and depressed than people with one sexual partner who were not. Disclosures Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Scientific Research Study Investigator) Theoren Loo, MPH, ViiV Healthcare (Grant/Research Support) Giselle D. Coelho, MD. MPHTM, Lilly (Research Grant or Support)Medscape, Clinical Care Options (Independent Contractor)Viiv, Gilead, Janssen (Advisor or Review Panel member, Research Grant or Support) Erik Lowman, MD, Gilead (Grant/Research Support)Janssen (Grant/Research Support)ViiV (Grant/Research Support) Peter Shalit, MD, PhD, Abbvie (Grant/Research Support)Gilead Sciences (Consultant, Grant/Research Support, Speaker’s Bureau)Glaxo Smithkline (Consultant, Grant/Research Support)Janssen (Consultant, Grant/Research Support, Speaker’s Bureau)Merck (Grant/Research Support, Speaker’s Bureau)Thera (Speaker’s Bureau)ViiV Healthcare (Speaker’s Bureau) Frank Spinelli, MD, ViiV Healthcare (Employee)

Abstract Background The educational campaign “Undetectable = Untransmittable” (U=U) began in 2016 to improve the well-being of people living with HIV (PLHIV) and recalibrate HIV-related social norms. As medical practice can vary by region, we examined reports from PLHIV in North American countries to identify if the campaign affected healthcare provider (HCP) communication of U=U and if positive health outcomes differed by U=U-informed status or country. Methods Data were collected from the 2019 Positive Perspectives survey of PLHIV in Canada (n=120), Mexico (n=63), and the United States (US; n=400) and stratified by country. Outcomes were self-rated mental and sexual health (“Good”/”Very good”), viral suppression, and sharing of HIV status. Treatment perceptions were also assessed. Results Whether diagnosis occurred before or after the U=U campaign launch did not significantly affect the proportion of PLHIV who reported receipt of U=U from an HCP in any North American country. Whether an individual was informed of U=U varied significantly by sexual orientation (heterosexual, 62.8%; homosexual, 74.9%; other, 87.8%), sex (men, 64.7%; women, 89.8%; other, 100%), and metropolitan vs non-metropolitan residence (metropolitan, 78.2%; non-metropolitan, 65.2%) in the US (P< 0.01 for all) but not in Canada or Mexico. Prevalence of sharing of HIV status with ≥ 1 person besides an HCP varied among PLHIV (Canada, 87%; Mexico, 95%; US, 84%). Prevalence of other positive outcomes varied by country and whether PLHIV had been informed of U=U (Figure). Whether PLHIV were informed of U=U was also correlated with treatment satisfaction and the perception that treatment needs were being met among PLHIV in the US and Canada (P< 0.01 for all), and with the belief that treatment prevents transmission among PLHIV in the US (P=0.01). Figure. Prevalence of positive outcomes among PLHIV in Canada (n=120), Mexico (n=63), and the US (n=400). PLHIV, people living with HIV; US, United States; U=U, Undetectable = Untransmittable. *P<0.01 for U=U informed vs uninformed. Conclusion Being informed of U=U was associated with higher treatment satisfaction, and higher mental and sexual health outcomes among PLHIV in North America. Receipt of U=U was associated with significantly higher treatment satisfaction among PLHIV in the US and Canada, and significantly more PLHIV with optimal mental and sexual health in the US. Disclosures Frank Spinelli, MD, ViiV Healthcare (Employee) Bruce Richman, JD, ViiV Healthcare (Consultant) Patricia De Los Rios, MSc, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Benjamin Young, MD, PhD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Nicolas Van de Velde, PhD, ViiV Healthcare (Employee) Chinyere Okoli, PharmD, MSc, DIP, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee)

Background: Older adults living with HIV (OALWH) are a growing population facing unique challenges to successful antiretroviral therapy. Objective: To assess efficacy and safety profiles of antiretroviral regimens, including those containing dolutegravir, in OALWH. Methods: Combined data from 6 phase III/IIIb trials in treatment-naive (ARIA, FLAMINGO, SINGLE, SPRING-2; N = 2634) and treatment-experienced (DAWNING, SAILING; N = 1339) participants receiving dolutegravir- or non–dolutegravir-based regimens were analyzed by age (<50, ≥50 to <65, and ≥65 years). Baseline data included comorbidities and numbers of concomitant medications. Week 48 efficacy outcomes included virologic response (HIV-1 RNA <50 copies/mL) and CD4+ cell count change from baseline. Safety outcomes included incidence of adverse events (AEs), serious AEs, and AE-related withdrawals. Results: Use of ≥5 concomitant medications was more frequently reported among treatment-naive and treatment-experienced participants aged ≥50 to <65 (30% [90/296] and 25% [57/227], respectively) and ≥65 years (43% [10/23] and 29% [4/14]) than among those aged <50 years (13% [310/2315] and 11% [118/1098]). Comorbidities were more prevalent in the older age groups. For dolutegravir-based regimens, Week 48 rates of virologic response and change in CD4+ cell count were similar across age groups (treatment naive, 80–87% and 234–251 cells/mm3; treatment experienced, 70–100% and 105–156 cells/mm3, respectively). There were no major differences in safety outcomes in each age group. Conclusions: In these analyses of combined phase III/IIIb trial data, efficacy and safety of dolutegravir-based regimens were generally similar across age groups in treatment-naive or treatment-experienced participants. Polypharmacy and comorbidities were more common among OALWH than those aged <50 years.

Background: Older adults (≥50 y) living with HIV (OALWH) may experience elevated levels of depression, anxiety, and loneliness. Online mindfulness lessons have the potential to ameliorate these problems and enhance access, especially during the COVID-19 pandemic. The objective of this randomized controlled trial was to determine the effectiveness of online mindfulness lessons in reducing feelings of depression, anxiety, and loneliness among OALWH. Methods: The study was conducted between May and August 2020. Individuals with any degree of self-reported loneliness at baseline were eligible to participate. Outcomes of interest included depression, measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10), anxiety measured using the Generalized Anxiety Disorder (GAD-7), and loneliness measured using both the Three-item Loneliness Scale (3IL) and a Daily Diary that asked “How lonely do you feel today?” Two sample t-tests were used to compare group scores at follow-up. Results: Of 214 participants who were randomized, the mean (SD) age was 60.4 (5.9) years, 89% were male, 69% were white, and 74% were gay or lesbian. At the end of the 25-day intervention, the intervention group demonstrated reduced levels of depression (2.6 point improvement;p<0.01), and reduced levels of anxiety (1.5 point improvement;p=0.03) compared to the control group (Table 1). Among the subset of participants with elevated baseline depression scores (defined as CES-D-10 ≥ 8), the between-group improvement in depression scores was greater (4.2 point improvement;p<0.01). Similarly, among the subset of participants with elevated baseline anxiety scores (defined as GAD-7 ≥ 5), the between-group improvement in anxiety scores was greater (2.4 point improvement;p<0.01). Loneliness improved significantly, as indicated by the Daily Diary, for those with at least moderate loneliness at baseline (0.7 point improvement;p<0.01). Conclusion: This randomized controlled trial is the first to show that a series of brief, online mindfulness audio lessons improves mental health outcomes among OALWH who report some degree of loneliness. For many patients, this intervention may offer emotional relief, particularly with regard to depression and anxiety, even in the face of the COVID-19 pandemic.

Background Loneliness is a concern among older people living with HIV (PLWH), especially given the ongoing COVID-19 pandemic. Currently, there is little research characterizing loneliness and race. To investigate how HIV impacts older (age 50+) PLWH in the US, a study called Aging with Dignity, Health, Optimism and Community (ADHOC) was launched at ten sites to collect self-reported data. This study uses ADHOC data to compare loneliness between older Black and White PLWH. Methods A cross-sectional analysis was performed to compare loneliness between older Black and White PLWH. Loneliness was assessed using the Three-item Loneliness Scale, a validated patient-reported outcome measure (range 3–9), with higher scores indicating greater loneliness. Student’s t-test was used to compare loneliness between White and Black people. Control variables for loneliness were identified a priori and included in a multivariable linear regression model. Results Of 868 participants, the average age was 60 (SD 6.2) years, 77% (N=671) were White and 23% (N=197) were Black, 85% were male, and 82% were gay or lesbian. In bivariate analyses, Black participants were less lonely than White participants (5.2 vs 5.6, P=.02). In the multivariable linear regression analysis, Black participants were again less lonely than Whites (coef. -0.45, P=0.01) while controlling for age, education, depression, anxiety, number of co-morbid conditions, being single, income, gender, sexual orientation, and spirituality (Adjusted R2=0.38; P<.01). Conclusion Among PLWH over age 50 in ADHOC, Black participants experienced less loneliness than White participants, even after controlling for a variety of factors. Additional research is needed to better understand the causes of these racial differences, so that programs designed to decrease loneliness among PLWH can consider the unique characteristics of each group.

Abstract Background Improving quality of life (QoL) is an important goal of care for people living with HIV (PLWH). This analysis uses data from the Aging with Dignity, Health, Optimism and Community (ADHOC) online registry to identify the different challenges faced by older white/Caucasian (“white”) and black/African American (“black”) gay or bisexual men living with HIV, and to assess differences in total QoL between the two groups. Methods QoL was measured using the PozQoL, a validated instrument for PLWH. The PozQoL assesses QoL across four domains: health concerns, psychological, social, and functional wellbeing. Total QoL was determined by combining domain scores for a total score. Student’s t-tests and chi-squared tests were used to identify disparities between black and white men. Factors with p< 0.05 were used as control variables in a multivariable linear regression model where PozQoL total score was the dependent variable. Results In the ADHOC database, 91% (n=612) of respondents were white men (WM) and 9% (n=59) were black men (BM). Both BM and WM had a median age of 59 years, and had a similar number of comorbidities (7.9 vs 9.2 respectively, p=0.12). Compared to WM, BM were more likely to be single (74% vs 51%, p< 0.001), less likely to have an income greater than $50,000 (25% vs 56%, p< 0.001), less likely to have a college degree or more (42% vs 69%, p=0.034), and less likely to be virally suppressed (87% vs 96%, p=0.001). Even after controlling for these differences in the multivariable model, BM had significantly higher total QoL than WM (Table 1). Conclusion In this analysis, there were substantial differences between older BM and WM living with HIV. After controlling for sociodemographic and clinical challenges, BM still reported higher QoL than WM. Programs designed to improve QoL for older gay and bisexual BM and WM living with HIV should take into consideration the unique strengths and challenges faced by each group. Disclosures Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Theoren Loo, MS, BS, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Grant/Research Support) Oluwatoyin Adeyemi, MD, ViiV Healthcare (Grant/Research Support) Alan Oglesby, MPH, ViiV Healthcare (Employee) Frank Spinelli, MD, ViiV Healthcare (Employee) Andrew Zolopa, MD, ViiV Healthcare (Employee)

ABSTRACT Loneliness is common among older (age 50+) people living with HIV (PLWH). However, little is known about the prevalence of loneliness across subgroups of older PLWH, and the factors that impact loneliness. An online questionnaire was used to collect data from 998 older PLWH. Of those, 61% were 50–59 years old and 39% were 60 or older. The majority were male (89%), gay (77%), and white (69%). Fifty-one percent of participants were classified as lonely. The prevalence of loneliness was lower in the older age group, 46.2% vs. 53.8% (Χ 2 = 5.53, p = 0.02). Covariates associated with loneliness included being younger, being single, having at least a four-year college degree, living alone, screening positive for depression, using recreational drugs, smoking tobacco, having a lower quality of life, and not feeling close to friends. Logistic regression analysis showed that the “younger old” were at 26% greater risk of loneliness, after controlling for the effects of these covariates (RR 1.26, 95% CI: 1.06–1.45). Reasons why the “older old” were less lonely may include lower rates of depression and lower likelihood of feeling distant from friends. Understanding factors that protect the “older old” against loneliness may provide guidance for future interventions.

People living with HIV (PLWH) experience chronic pain that may impact function. Gaps in knowledge exist for factors that impact pain and pain medication use in older (age 50+) PLWH. Data for this study were obtained from the Aging with Dignity, Health, Optimism and Community (ADHOC) cohort, an observational study of older PLWH from 10 clinics across the United States. Participants self-reported socioeconomic, psychosocial, and health factors via an online questionnaire. Of 1,051 participants, 66% reported pain. In a multivariable regression model, multimorbidity and tobacco use were associated with a greater likelihood of experiencing pain, whereas being male, black, and having higher cognitive function were associated with a lower likelihood of experiencing pain. Of the 696 participants who reported pain, 46% reported using pain medication. In a multivariable regression model, pain medication use was associated with multimorbidity and with lower income. Recognition of the factors associated with pain and pain medication use in this vulnerable population may lead to strategies that mitigate negative health outcomes.

Pain impacts up to 55% of people living with HIV (PLWH) and negatively impacts function. To date, limited data exist regarding factors that contribute to pain in older PLWH. Data were utilized from the Aging with Dignity, Health, Optimism and Community (ADHOC) cohort, an observational study of older PLWH from ten clinics across the U.S. that collects patient-reported outcomes (PROs) on socioeconomic, psychosocial, and health factors. To measure pain, ADHOC participants were asked whether they had been diagnosed with back pain, hip pain, joint pain, or muscle pain, and were also instructed to report chronic pain conditions that were not listed. Bivariate analyses were performed to determine the associations between pain and PROs. Of 1,051 participants, 66% reported at least one type of pain. Factors associated with pain included multimorbidity, low income, anxiety, loneliness, depression, tobacco use, and older age (Table 1). Factors negatively associated with pain included employment, higher cognitive function, higher quality of life, greater resilience, higher social well-being, and alcohol use. Table 1. Characteristics associated with pain among older people living with HIV. Pairwise correlations are reported above using correlation coefficient r. Improving pain management is currently a priority in the US healthcare system. Some factors identified in this study, including systemic issues such as socioeconomic status and employment, are not easily modifiable. Other factors, such as anxiety, depression, and smoking, are modifiable and therefore represent targets for interventions focused on improving pain and its sequelae in older PLWH. Maile Karris, MD, Gilead Sciences (Grant/Research Support)Viiv Healthcare (Grant/Research Support) Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Theoren Loo, MS, BS, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Grant/Research Support) Frank Spinelli, MD, ViiV Healthcare (Employee) Andrew Zolopa, MD, ViiV Healthcare (Employee)

Abstract Background Antiretroviral treatment (ART) for patients living with HIV (PLHIV) has improved greatly, however, challenges with daily oral dosing remain. New ART options with reduced dosing frequency and innovative delivery methods may help address these challenges. This study assesses patient and physician satisfaction with current treatments and preferences for switching to a monthly or every other month long-acting injectable (LAI) ART. Methods This is a cross-sectional online survey of PLHIV and physicians treating PLHIV in United States and Canada. A literature review, clinical expert input, and qualitative and quantitative pilots informed survey design. Eligible PLHIV were on ART for ≥ 6 months and virally suppressed (self-reported). Survey questions for patients evaluate satisfaction and adherence to current ART. Treatment preferences are assessed using a discrete choice experiment (DCE), where respondents choose between staying on current ART, switching to another oral ART or switching to a LAI ART. DCE treatment attributes include dosing frequency, side effects, forgivability, food/mealtime restrictions, and mode of administration. Pilot data for US patients is included here; the main survey will include approximately 550 patients and 450 physicians. Results Of 51 PLHIV completing the pilot survey, 80% were male, mean age was 54 years, and 63% were on ART for ≥10 years. Switching ART was common, with 55% reporting changing their ART ≥ 3 times. Just under half of patients (47%) were not totally satisfied with their current ART. Most common reasons for dissatisfaction included daily reminder of having HIV (31%) and having to take medicine every day (28%). Just over a quarter of patients (28%) reported forgetting to take their ART in the prior month. Across all DCE choices, patients preferred to remain on their current treatment 47% of the time, while 45% of the time patients preferred switching to the LAI, and for the remaining 8%, patients chose switching to another oral ART regimen. Conclusion Despite advances in ART, treatment challenges remain. Among the treatment-experienced PLHIV in this pilot survey, over half of their choices resulted in switching to an alternative regimen, and when opting to switch, most patients preferred the long-acting injectable treatment regimen. Disclosures All authors: No reported disclosures.

Abstract Background The population of people living with HIV (PLHIV) is aging. A new registry and online community, called Aging with Dignity, Health, Optimism and Community (ADHOC), has been launched to investigate how HIV impacts the lives of older PLHIV. Methods A cross-sectional analysis of ADHOC was performed on 208 PLHIV 50+ years of age. One hypothesis was that increasing age would be associated with greater loneliness. Loneliness was assessed using the UCLA Loneliness Scale (ULS-3). A score ≥6 was classified as lonely. The impact of aging on loneliness was analyzed by ANOVA and multiple linear regression. Results ULS-3 scores ranged from 3 to 9 and 48.6% of subjects were classified as lonely. Significant differences were found between the 50–59, 60–65 and 65+ age groups, with older age associated with decreased loneliness (P = 0.018) (Table 1). In the multiple linear regression model, these observations persisted even after controlling for gender, sexual orientation, race/ethnicity, relationship status, education, income, and number of comorbidities (Table 2). Decreases in loneliness were associated with female gender, being in a relationship, higher income, and fewer comorbidities (P < 0.05). Conclusion Among PLHIV over 50, loneliness is less severe in older age groups. Additional investigation is needed to better understand potential causes and to find ways to remediate loneliness among older PLHIV. Table 1: Comparison of ULS-3 Scores by Age 50–59 (n = 133) 60–65 (n = 40) 65+ (n = 35) P-value1 ULS-3 Mean ± SD 5.8 ± 2.1 5.1 ± 2.0 4.8 ± 1.8 0.018 1 P-value from ANOVA. Table 2: Multiple Linear Regression of ULS-3 Scores n % Coef. P-value Age 50–59 113 54.3 Ref. 60–65 40 19.2 −0.80 0.026 65+ 35 16.8 −1.41 <0.001 Gender Male 196 94.2 Ref. Female 12 5.8 −2.06 0.024 Sexual orientation Gay/lesbian/other 185 93.4 Ref. Heterosexual 19 9.3 1.32 0.108 Race/ethnicity White 167 81.1 Ref. Black 13 6.3 −0.34 0.600 Hispanic/Latino 16 7.8 −0.96 0.070 Other 10 4.9 −0.99 0.138 Relationship status Single 95 54.3 Ref. In a relationship 113 45.7 −1.43 <0.001 Education Less than college graduate 86 41.4 Ref. College graduate (4 years) 82 39.4 0.23 0.474 Graduate school graduate 40 19.2 −0.02 0.963 Income <$50,000 84 44.9 Ref. ≥$50,000 103 55.1 −0.60 0.049 Comorbidities 0–5 77 37.0 Ref. 5+ 131 63.0 0.65 0.026 Disclosures M. Kane, ViiV Healthcare: Research Contractor, Research grant and Research support. Mazonson & Santas, Inc.: Employee, Salary. P. Mazonson, Mazonson & Santas, Inc.: Co-Founder and Shareholder, Salary. ViiV Healthcare: Investigator and Research Contractor, Research grant and Research support. A. Zolopa, ViiV Healthcare: Employee, Salary. F. Spinelli, ViiV Healthcare: Employee, Salary. P. Eitz Ferrer, ViiV Healthcare: Employee, Salary. P. Shalit, Gilead: Consultant, Investigator and Speaker’s Bureau, Consulting fee, Research support and Speaker honorarium. Viiv: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium. Janssen: Consultant, Investigator and Speaker’s Bureau, Research support and Speaker honorarium. Merck: Speaker’s Bureau, Speaker honorarium.