%0 Journal Article
%T Feasibility and Acceptability of a Real-Time Adherence Device among HIV-Positive IDU Patients in China
%A Mary Bachman DeSilva
%A Allen L. Gifford
%A Xu Keyi
%A Zhong Li
%A Cheng Feng
%A Mohamad Brooks
%A Mark Harrold
%A Hu Yueying
%A Christopher J. Gill
%A Xie Wubin
%A Taryn Vian
%A Jessica Haberer
%A David Bangsberg
%A Lora Sabin
%J AIDS Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/957862
%X 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. 1. Introduction Interventions to improve adherence to antiretroviral therapy (ART) are urgently needed among HIV-positive patients, particularly in developing countries, where most of the world¡¯s HIV-infected population lives. China has experienced a major HIV/AIDS epidemic since the 1990s, with an estimated 780,000 persons living with HIV in 2011 [1]. Free ART is available nationwide and over 126,000 Chinese patients are now on treatment. However, few ART adherence studies have been conducted in China. As it is elsewhere in the world, ART adherence is suboptimal in China in large part because HIV/AIDS is highly stigmatized [2, 3]. Recently, wireless technology has emerged as a potential tool for monitoring medication adherence in real time [4¨C8]. This is noteworthy given the recognized association between late dose-timing and loss of viral suppression [9]. One promising tool, the Wisepill personal medication container (Wisepill Technologies, Cape Town, South Africa), detects the exact date and time whenever the patient opens it to access medication. It then transmits a real-time signal by general packet radio service
%U http://www.hindawi.com/journals/art/2013/957862/