Methods: 29 individuals between January 2012 and October 2022 met inclusion criteria of a history of primary care at MedStar Health who acquired an incident HIV diagnosis in this examination. Administrative, laboratory, medication, and diagnostic data were collected from the Cerner Powerchart electronic medical record system. Data was collected between February 2024 and July 2024. Statistical analyses included the chi-square test (or Fisher’s exact test), the two-sample t‐test, and odds ratios from logistic regression models.

Results: We found that in this population, the majority of males identified as LGBTQIA, while the majority of females identified as non-LGBTQIA (LGBTQIA/male: 58.8%, LGBTQIA/female: 8.30%, p< 0.01). We found that significantly more males utilized primary care within two years of diagnosis (male: 52.9%, female: 0%, p<0.01), were tested more recently to seroconversion (male: 417 d, female: 903 d, p<0.05), and obtained a PrEP prescription (male: 47.1%, female: 0%, p<0.01) than females prior to HIV seroconversion. In addition, HIV testing was significantly more likely to occur among Black persons (OR=35.0, 95% CI [3.66,905], p<0.01) and LGBTQIA-identifying persons (OR=11.4, 95% CI [1.61, 234], p<0.05).

Conclusions: Overall, our findings suggest that biomedical and behavioral prevention utilization must be improved across primary and other ambulatory care settings within the studied regional health care system, despite progress noted in some prevention discussions with some groups at elevated risk. The identified risk factors for seroconversion may inform the production of evidence-based HIV prevention strategies.

Conflicts of Interest: I have no conflicts of interest to disclose.