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Hirshfield S, Teran RA, Downing MJ, et al. Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study. JMIR Public Health Surveill. 2018;4(4):e10847doi: 10.2196/10847.
Hirshfield, S., Teran, R. A., Downing, M. J., Chiasson, M. A., Tieu, H. V., Dize, L., & Gaydos, C. A. (2018). Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study. JMIR public health and surveillance, 4(4), e10847. https://doi.org/10.2196/10847
Hirshfield, Sabina, et al. "Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study." JMIR public health and surveillance vol. 4,4 (2018): e10847. doi: https://doi.org/10.2196/10847
Hirshfield S, Teran RA, Downing MJ, Chiasson MA, Tieu HV, Dize L, Gaydos CA. Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study. JMIR Public Health Surveill. 2018 Nov 01;4(4):e10847. doi: 10.2196/10847. PMID: 30389648; PMCID: PMC6238105.
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JMIR Public Health Surveill. 2018 Nov 01;4(4):e10847. doi: 10.2196/10847.

Quantification of HIV-1 RNA Among Men Who Have Sex With Men Using an At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study.

JMIR public health and surveillance

Sabina Hirshfield, Richard A Teran, Martin J Downing, Mary Ann Chiasson, Hong-Van Tieu, Laura Dize, Charlotte A Gaydos

Affiliations

  1. Research and Evaluation, Public Health Solutions, New York, NY, United States.
  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
  3. Psychology Department, Lehman College, Bronx, NY, United States.
  4. Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, United States.
  5. Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, United States.
  6. Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, United States.

PMID: 30389648 PMCID: PMC6238105 DOI: 10.2196/10847

Abstract

BACKGROUND: Suboptimal antiretroviral therapy (ART) adherence and disengagement in care present significant public health challenges because of the increased probability of HIV transmission. In the United States, men who have sex with men (MSM) continue to be disproportionately affected by HIV, highlighting a critical need to engage high-risk MSM living with HIV who are not engaged or retained in care.

OBJECTIVE: The aim of the study was to assess the feasibility of at-home blood self-collection and laboratory quantification of HIV-1 RNA viral load (VL) to report laboratory-based VL outcomes and compare self-reported and laboratory-reported VL.

METHODS: Between 2016 and 2017, 766 US HIV-positive MSM enrolled in a Web-based behavioral intervention were invited to participate in an at-home dried blood spot (DBS) collection study using HemaSpot-HF kits (Spot On Sciences, Inc, Austin, TX) for laboratory-quantified VL.

RESULTS: Of those invited to participate, 72.3% (554/766) enrolled in the DBS study. Most (79.2%, 439/554) men enrolled reported attempting to collect their blood, 75.5% (418/554) of participants mailed a DBS specimen to the research laboratory, and 60.8% (337/554) had an adequate blood sample for VL testing. Of the 337 specimens tested for VL by the laboratory, 52.5% (177/337) had detectable VL (median: 3508 copies/mL; range: 851-1,202,265 copies/mL). Most men (83.9%, 135/161) who returned a DBS specimen with laboratory-quantified detectable VL self-reported an undetectable VL during their last clinical visit.

CONCLUSIONS: Home collection of DBS samples from HIV-positive MSM is feasible and has the potential to support clinical VL monitoring. Discrepant laboratory HIV-1 RNA values and self-reported VL indicate a need to address perceived VL status, especially in the era of treatment as prevention. Most participants were willing to use an at-home DBS kit in the future, signaling an opportunity to engage high-risk MSM in long-term HIV care activities.

©Sabina Hirshfield, Richard A Teran, Martin J Downing Jr, Mary Ann Chiasson, Hong-Van Tieu, Laura Dize, Charlotte A Gaydos. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 01.11.2018.

Keywords: HIV-1; dried blood spot testing; men who have sex with men; viral load

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