Current HIV/AIDS Reports

, Volume 15, Issue 1, pp 49–59 | Cite as

Adherence Measurements in HIV: New Advancements in Pharmacologic Methods and Real-Time Monitoring

  • Jose R. Castillo-Mancilla
  • Jessica E. Haberer
HIV Pathogenesis and Treatment (AL Landay and N Utay, Section Editors)
Part of the following topical collections:
  1. Topical Collection on HIV Pathogenesis and Treatment


Purpose of Review

In this review, we present new developments in antiretroviral adherence, focusing on pharmacological measures and real-time adherence monitoring. In addition, new strategies on how to incorporate these new measures into research and clinical care are proposed.

Recent Findings

Antiretroviral drug concentrations in hair and dried blood spots are two novel pharmacological measures of cumulative drug adherence and exposure that have been recently evaluated in HIV treatment and pre-exposure prophylaxis. Real-time adherence monitoring using electronic devices has also proven highly informative, feasible, and well accepted, offering the possibility for an immediate intervention when non-adherence is detected. Both approaches offer considerable advantages over traditional adherence measures in predicting efficacy.


New methods to objectively monitor adherence in real-time and over long time periods have been developed. Further research is required to better understand how these measures can optimize adherence and, ultimately, improve clinical outcomes in HIV treatment and prevention.


ART Adherence Hair drug levels Dried blood spots Real-time adherence monitoring 


Compliance with ethical standards

Conflict of Interest

Jose R. Castillo-Mancilla reports grants K23AI104315 and R21AI124859 from NIH. Jessica E. Haberer reports grants from NIH, Gates Foundation, USAID; has served as a consultant for NIH, Merck, and WHO; and has received stock from Natera.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jose R. Castillo-Mancilla
    • 1
  • Jessica E. Haberer
    • 2
  1. 1.Division of Infectious Diseases, Department of MedicineUniversity of Colorado Anschutz Medical Campus, Medicine/Infectious DiseasesAuroraUSA
  2. 2.Massachusetts General Hospital and Harvard Medical SchoolBostonUSA

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