1533. Galapagos Islands: structuring of an HIV clinic in a captive territory

BACKGROUND: Galapgos contributes 0.11% of the HIV cases in all Ecuador. There is a social and biological distinction, especially considering that the islands receive 245,000 tourists/year from all over the world, which also includes sex tourism by the LGTBI community. In 2016, the HIV Clinic project began in the Santa Cruz hospital, as an initiative carried out by a specialist in Internal Medicine. Graphic 1. Distribution by type f case notification at the diagnosis of PLWHA at the Galapagos Islands [Image: see text] Graphic 2. Distribution by gender of PLWHA at the Galapagos Islands [Image: see text] METHODS: An initial descriptive analysis of the variables was performed, frequency tables were used for the qualitative variables. For the quantitative variables, measures of central tendency (mean, median, mode). The analyzed data correspond to the period between 2016 to 2019. Graphic 3. Impact of HIV Clinic on viral load value of the PLWHA at the Galapagos Islands [Image: see text] Graphic 4. Impact of HIV Clinic on CD4 cell count of the PLWHA at the Galapagos Islands [Image: see text] RESULTS: The 43.1% of cases correspond to HIV+ and 58.8% of AIDS. 67.3% of PLWH are men and 32.7% are women. All cases occur due to unprotected sex (100%). 64% of HIV+ and 40.6% of AIDS patients report homosexual intercourse. Of the AIDS cases, 58.8% are in the A2 to C2 CDC category, and have less than 200 CD4+. The most frequent opportunistic infection in this group is Oropharyngeal Candidiasis (16.7%) followed by tuberculosis of any location (16.7%) and Pneumocistys jirovecii pneumonia (3.3%). 93.1% of patients receive ART, the remaining 6.9% corresponds to loss of follow-up. Thus, since the creation of the unit, a positive impact on the evolution of viral load as well as the values of CD4+ count can be seen. This would be related to the fact that PLWHA controls have been more frequent and are given in the context of a special care unit for their pathology. CONCLUSION: We can conclude that the behavior of HIV infection in the Galapagos Islands has a distribution in vulnerable groups as in the continental Ecuador. It is important to mention that the diagnosis of HIV is late in the insular region. The creation of an HIV clinic strategically located on the island of Santa Cruz has significantly improved the status of infection in PLWH, however, large population and qualitative studies are needed to determine other factors related to the quality of life of these patients and the behavior of the infection in this population. DISCLOSURES: All Authors: No reported disclosures