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Background HIV therapy has been moving toward smaller size, once a day regimens in hopes of improved adherence. Surprisingly, few publications characterize HIV patient’s pill preferences. To evaluate HIV-negative or treatment-naïve pill preference, we conducted a prospective randomized study at the Infectious Diseases Clinic at Henry Ford Hospital in Detroit, MI. Methods Fifty patients were recruited, receiving questionnaires regarding factors influencing the ease of swallowability, medication habits, pill preferences and adherence while being randomized to receive placebo pills representing currently FDA approved combination antiretrovirals DTG/ABC/3TC and BIC/FTC/TAF. Statistical analyses presented are descriptive. Results Patients preferred pills or tablets (84%) as their preferred form of medication. Patient’s ideal pill length size was reported between 4–9 millimeters (96%), with no responses &gt; 13 mm. The most important factors for ease of swallowability were stated as size (40%) and smoothness (38%). Interestingly, 80% of participants then reported that size and shape of the pills was only “some or less” important to them for their pills; however, 32% of participants stated that size, and shape (16%), could make them not want to take a pill daily. When offered the choice of regimens, patients preferred taking more, smaller pills (42%) vs. fewer larger pills (36%) or liquids (14%). Three most common factors indicated as making medication adherence difficult included taking multiple doses daily (38%), large pills (16%), and multiple pills per dose (14%). When given free response, pills having a smooth coating was reinforced by 10 of the 25 (40%) participants who commented. Conclusion Patient preferences for medications are varied and nuanced, but carry implications on patients self-reported likelihood to remain adherent to a regimen. Care should be taken in a clinical setting, such as HIV, to take pill characteristics into account when selecting antiretroviral regimens for patients. Disclosures All authors: No reported disclosures.

2511. Characterization of Patient Pill Preferences from a Prospective Placebo vs. Placebo Ease of Swallowability Study