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Moving Antiretroviral Adherence Assessments to the Modern Era: Correlations Among Three Novel Measures of Adherence

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Abstract

There is no gold standard for estimating antiretroviral therapy (ART) adherence. Feasible, acceptable, and objective measures that are cost- and time-effective are needed. US adults (N = 93) on ART for ≥ 3 months, having access to a mobile phone and internet, and willing to mail in self-collected hair samples, were recruited into a pilot study of remote adherence data collection methods. We examined the correlation of self-reported adherence and three objective remotely collected adherence measures: text-messaged photographs of pharmacy refill dates for pharmacy-refill-based adherence, text-messaged photographs of pills for pill-count-based adherence, and assays of home-collected hair samples for pharmacologic-based adherence. All measures were positively correlated. The strongest correlation was between pill-count- and pharmacy-refill-based adherence (r = 0.68; p < 0.001), and the weakest correlation was between self-reported adherence and hair drug concentrations (r = 0.14, p = 0.34). The three measures provide objective adherence data, are easy to collect, and are viable candidates for future HIV treatment and prevention research.

Resumen

No existe un estándar para estimar la adherencia a la terapia antirretroviral (TAR). Se necesitan medidas viables, aceptables y objetivas que sean económico y efectivo en el tiempo. Los adultos de EEUU (N = 93) en tratamiento antirretroviral durante ≥ 3 meses, con acceso a un teléfono móvil e Internet, y dispuestos a enviar muestras de cabello recolectadas por sí mismos, fueron reclutados para un estudio piloto de métodos de recolección de datos de adherencia remota. Examinamos la correlación de la adherencia autoinformada y tres medidas objetivas de adherencia recolectadas de forma remota: fotografías enviadas por mensaje de texto de fechas de recarga de farmacia para adherencia basada en recarga de farmacia, fotografías enviadas por mensaje de texto de píldoras para adherencia basada en conteo de píldoras, y ensayos de muestras de cabello recolectadas en el hogar para adherencia farmacológica. Todas las medidas se correlacionaron positivamente. La correlación más fuerte fue entre la adherencia basada en el recuento de píldoras y la recarga basada en medicamentos (r = 0·68; p < 0·001), y la correlación más débil fue entre la adherencia autoinformada y las concentraciones de drogas de cabello (r = 0·14, p = 0·34). Las tres medidas proporcionan datos de cumplimiento objetivos, son fáciles de recopilar y son candidatos viables para futuras investigaciones sobre prevención y tratamiento del VIH.

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Acknowledgements

The authors do not have a commercial or other association that might pose a conflict of interest. Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number Award Numbers R21MH108414 (P.I. Saberi), K23MH097649 (P.I. Saberi), and K24DA037034 (P.I. Johnson), and the National Institute of Allergy and Infectious Diseases 2R01AI098472 (P.I. Gandhi). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. These data have not been presented at any meetings. The authors would like to thank the participants for taking part in this study; Dr. Hideaki Okochi, the HAL Director, and Karen Kuncze in the HAL, for their work on the assays; Dr. Peter Bacchetti for his guidance with data analysis; and Dr. Nicolas Sheon for his help in creating the video describing the study objectives and demonstrating home-collection of hair.

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Authors and Affiliations

  1. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Parya Saberi, Deepalika Chakravarty, Kristin Ming, Dominique Legnitto, Monica Gandhi, Mallory O. Johnson & Torsten B. Neilands

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  1. Parya Saberi
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  2. Deepalika Chakravarty
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  3. Kristin Ming
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  4. Dominique Legnitto
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  5. Monica Gandhi
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  7. Torsten B. Neilands
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Correspondence to Parya Saberi.

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Saberi, P., Chakravarty, D., Ming, K. et al. Moving Antiretroviral Adherence Assessments to the Modern Era: Correlations Among Three Novel Measures of Adherence. AIDS Behav 24, 284–290 (2020). https://doi.org/10.1007/s10461-019-02744-w

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