Walsh Jennifer L, Hirshfield Sabina, John Steven A, Quinn Katherine G, Algiers Olivia H, McAuliffe Timothy L, Petroll Andrew E
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2153 N. Dr. Martin Luther King Jr. Dr., Milwaukee, WI, 53212, USA.
STAR Program, Department of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA.
AIDS Behav. 2025 Apr;29(4):1247-1255. doi: 10.1007/s10461-024-04599-2. Epub 2025 Jan 27.
Self-collected dried blood spot (DBS) samples may be useful in monitoring viral load (VL) in research studies or clinically given that they eliminate the need for participants to travel to study sites or laboratories. Despite this, little information exists about monitoring VL using DBS self-collected at home, and no information exists on DBS for this use among older rural people living with HIV (PLH), a population that could benefit from self-collection given difficulty accessing care. We report on the feasibility and acceptability of self-collected DBS samples, DBS VL results, concordance between self-reported and DBS VL, and factors associated with DBS detectable VL in a rural Southern U.S. sample of PLH aged 50 years and older. Between 2021 and 2022, 61 older rural PLH from 9 Southern U.S. states (M = 58, 25% female) completed survey measures and self-collected DBS specimens at home; 51 of these participants completed the same procedures at 3-month follow-up. Nearly all participants (96-98%) collected DBS specimens that could be successfully analyzed for VL, and participants found self-collection highly acceptable. Approximately one quarter of participants had quantifiable detectable VL (≥ 839 copies/mL) at each time point. Concordance between self-reported and DBS VL was 69% at baseline and 82% at follow-up; the majority of those with DBS detectable VL self-reported undetectable VL (86% at baseline and 60% at follow-up). Self-collection of DBS specimens for VL monitoring can add value to research conducted remotely, including research associated with the care of rural and/or older PLH.
自行采集的干血斑（DBS）样本在研究或临床中监测病毒载量（VL）可能很有用，因为它们无需参与者前往研究地点或实验室。尽管如此，关于在家自行采集DBS监测VL的信息很少，而且对于感染艾滋病毒（PLH）的农村老年人使用DBS进行此项监测尚无相关信息，鉴于获得护理困难，这一人群可从自行采集样本中受益。我们报告了美国南部农村地区50岁及以上PLH样本中自行采集DBS样本的可行性和可接受性、DBS VL结果、自我报告的VL与DBS VL之间的一致性，以及与DBS可检测VL相关的因素。2021年至2022年期间，来自美国南部9个州的61名农村老年PLH（平均年龄58岁，25%为女性）完成了调查测量并在家自行采集了DBS标本；其中51名参与者在3个月随访时完成了相同程序。几乎所有参与者（96 - 98%）采集的DBS标本都可成功进行VL分析，参与者认为自行采集非常可接受。大约四分之一的参与者在每个时间点都有可量化的可检测VL（≥839拷贝/毫升）。自我报告的VL与DBS VL之间的一致性在基线时为69%，随访时为82%；大多数DBS可检测VL的参与者自我报告VL不可检测（基线时为86%，随访时为60%）。自行采集DBS标本用于VL监测可为远程开展的研究增加价值，包括与农村和/或老年PLH护理相关的研究。
