| Autor: |
Goodman GR; Department of Emergency Medicine, Brigham and Women's Hospital., Carnes TC; etectRx, Inc., Albrechta H; The Fenway Institute, Fenway Health., Alpert P; etectRx, Inc., Hokayem J; The Fenway Institute Fenway Health., Goldfine C; Department of Emergency Medicine, Brigham and Women's Hospital., Lee JS; Department of Psychiatry, Massachusetts General Hospital., Boyer EW; Department of Emergency Medicine, Ohio State University, Wexner Medical Center., Rosen R; Warren Alpert Medical School, Brown University., Mayer KH; The Fenway Institute, Fenway Health., O'Cleirigh C; Department of Psychiatry, Massachusetts General Hospital., Chai PR; Department of Emergency Medicine, Brigham and Women's Hospital. |
| Abstrakt: |
Once-daily oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but its efficacy is dependent on adherence, which can be challenging for men who have sex with men (MSM) with substance use. Digital pill systems (DPS) represent a novel tool for directly measuring adherence through ingestible radiofrequency sensors that confirm ingestions in real-time. We examined operational challenges across two studies involving DPS to measure PrEP adherence. While most participants successfully operated the system, a number of technological and sociobehavioral challenges requiring intervention were identified across both studies. Technological issues were both system- and participant-related, and were primarily addressed with technical updates and participant re-education, while sociobehavioral issues, including health and housing changes and issues with technology access, warranted innovative solutions. Future research leveraging DPS technology should develop robust supportive infrastructure and mitigation procedures to promptly identify and resolve operational issues to optimize the potential benefits of DPS use. |
