Point-of-care and Near Real-time Testing for Antiretroviral Adherence Monitoring to HIV Treatment and Prevention
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THE SCIENCE OF PREVENTION (JD STEKLER AND JM BAETEN, SECTION EDITORS)
Point-of-care and Near Real-time Testing for Antiretroviral Adherence Monitoring to HIV Treatment and Prevention Paul K. Drain 1,2,3 & Ashley R. Bardon 1,3 & Jane M. Simoni 1,4,5 & Tim R. Cressey 6,7,8 & Pete Anderson 9 & Derin Sevenler 10 & Ayokunle O. Olanrewaju 11 & Monica Gandhi 12 & Connie Celum 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review In this report, we review the need for point-of-care (POC) or near real-time testing for antiretrovirals, progress in the field, evidence for guiding implementation of these tests globally, and future directions in objective antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP) adherence monitoring. Recent Findings Two cornerstones to end the HIV/AIDS pandemic are ART, which provides individual clinical benefits and eliminates forward transmission, and PrEP, which prevents HIV acquisition with high effectiveness. Maximizing the individual and public health benefits of these powerful biomedical tools requires high and sustained antiretroviral adherence. Routine monitoring of medication adherence in individuals receiving ART and PrEP may be an important component in interpreting outcomes and supporting optimal adherence. Existing practices and subjective metrics for adherence monitoring are often inaccurate or unreliable and, therefore, are generally ineffective for improving adherence. Laboratory measures of antiretroviral concentrations using liquid chromatography tandem mass spectrometry have been utilized in research settings to assess medication adherence, although these are too costly and resource-intensive for routine use. Summary Newer, less costly technologies such as antibody-based methods can provide objective drug-level measurement and may allow for POC or near-patient adherence monitoring in clinical settings. When coupled with timely and targeted counseling, POC drug-level measures can support adherence clinic-based interventions to ART or PrEP in near real time. Keywords HIV . Adherence . Antiretroviral therapy (ART) . Pre-exposure prophylaxis (PrEP) . Point-of-care test . Tenofovir
This article is part of the Topical Collection on The Science of Prevention * Paul K. Drain [email protected] 1
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Department of Global Health, Schools of Medicine and Public Health, University of Washington, 325 Ninth Ave, UW Box 359927, Seattle, WA 98104-2420, USA Department of Medicine, School of Medicine, University of Washington, 325 Ninth Ave, UW Box 359927, Seattle, WA 98104-2420, USA Department of Epidemiology, School of Public Health, University of Washington, 325 Ninth Ave, UW Box 359927, Seattle, WA 98104-2420, USA
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Department of Psychology, University of Washington, Seattle, USA
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Department of Gender, Women, and Sexuality Studies, University of Washington, Seattle, USA
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PHPT/IRD 174, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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Harvard T.H. Chan Scho
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