Feasibility and Acceptability of a Real-Time Adherence Device among HIV-Positive IDU Patients in China

Abstract

We collected data on feasibility and acceptability of a real-time web-linked adherence monitoring container among HIV-positive injection drug users (IDU) in China. “Wisepill” uses wireless technology to track on-time medication dosing. Ten patients on antiretroviral therapy (ART) at the Guangxi CDC HIV clinic in Nanning, China, used Wisepill for one ART medication for one month. We monitored device use and adherence and explored acceptability of the device among patients. Mean adherence was 89.2% (SD 10.6%). Half of the subjects reported a positive overall experience with Wisepill. Seven said that it was inconvenient, supported by comments that it was large and conspicuous. Five worried about disclosure of HIV status due to the device; no disclosures were reported. Twelve signal lapses occurred (5.4% of prescribed doses), of which one was due to technical reasons, nine to behavioral reasons (both intentional and unintentional), and two to unclear reasons. Although the technical components must be monitored carefully, and acceptability to patients presents challenges which warrant further exploration, the Wisepill device has potential for adherence interventions that deliver rapid adherence-support behavioral feedback directly to patients, including IDU. The use of wireless technology appears uniquely promising for providing time-sensitive communication on patient behavior that can be harnessed to maximize the benefits of HIV treatment.

Acceptability and Feasibility of Real-Time Antiretroviral Therapy Adherence Interventions in Rural Uganda: Mixed-Method Pilot Randomized Controlled Trial (Preprint)

“…In these instances, the intervention could not function as planned because participants opted to take medication from different sources other than the monitor. These participants worried about stigma and discrimination associated with unintended HIV status disclosure, as has been seen previously in China [2,22]. Youth also reported concerns of HIV status disclosure resulting from other people accessing SMS reminders in another study in Kampala, Uganda [6].…”

Cell Phone-Based and Adherence Device Technologies for HIV Care and Treatment in Resource-Limited Settings: Recent Advances

“…In the studies described above, Wisepill and Wisebag were found to be generally acceptable and convenient to use, and most participants liked using the devices [53][54][55]. Likewise, in a feasibility and acceptability study of Wisepill among HIV-positive injection drug users in China, the device was found to be generally acceptable, although several participants reported concerns about potential disclosure from the device [62].…”

Feasibility and Acceptability of Digital Gaming to Improve Adherence among Adolescents and Young Adults Living with HIV (Preprint)

“…Providers described their efforts to use age-appropriate, culturally-relevant analogies to increase understanding of viral resistance and ART adherence among AYA in care. One provider shared an example in which direct references to videogames were used to help educate a patient: 13 …”

“…Autonomy also differs between AYA and adults living with HIV as younger persons must frequently rely on parents or caregivers for treatment [12,13]. Furthermore, AYA living with HIV may experience a higher frequency of cognitive deficits, depression, and substance abuse issues compared to general populations [14].…”