Due to marked reductions in morbidity and mortality, antiretroviral (ARV) adherence monitoring is of high interest. Researchers and clinicians often resort to the most feasible and cost-effective adherence methods possible, which may result in biased or inaccurate estimates and require the physical presence of a participant at a research or clinic site. The objective of our study was to evaluate the feasibility and acceptability of three objective, innovative, and remote methods to estimate ARV adherence which may be conducted with less time and financial resources in a wide range of clinic and research settings. These three methods included: (a) text-messaged photographs of pharmacy refill dates to measure refill-based adherence, (b) text-messaged photographs of ARV medications to estimate pill-count-based adherence, and (c) home-collected hair samples for the measurement of ARV concentration to determine pharmacologic-based adherence. We conducted a pilot study from March through October 2017 to examine the feasibility and acceptability of these three adherence measures and the remotely conducted study procedures in 93 adults living with HIV nationwide. From our diverse national sample of participants, 95.7% were retained until the end of the study, 89.9% sent all text messages, and 84.3% sent all hair samples. Approximately 74.2% of participants reported excellent overall experience with the study, 60.2% were very or extremely satisfied with participating in a hair collection study, and 76.3% noted extremely high likelihood of participating in a similar study including text messaging pictures of medications or refill dates. We noted high levels of feasibility and acceptability with the remote study methodology, collection of photographed and text messaged pharmacy refill dates and pill counts, and home-collected hair samples. Here we describe the feasibility and acceptability metrics, results from the exit qualitative interviews with the participants, and lessons learned. These adherence measures represent innovative approaches to expand monitoring tools for HIV treatment and prevention adherence in future research.

由于发病率和死亡率显着降低，抗逆转录病毒（ARV）依从性监测受到高度关注。研究人员和临床医生经常采用尽可能最可行和最具成本效益的遵守方法，这可能会导致估计有偏差或不准确，并且需要参与者亲自出现在研究或诊所现场。我们研究的目的是评估三种客观、创新和远程方法来估计抗逆转录病毒药物依从性的可行性和可接受性，这些方法可以在广泛的临床和研究环境中以更少的时间和财政资源进行。这三种方法包括：(a) 药房补充日期的短信照片，以衡量补充的依从性；(b) 抗逆转录病毒药物的短信照片，以估计基于药丸计数的依从性；(c) 家庭收集的头发用于测量 ARV 浓度的样本，以确定基于药理学的依从性。我们从 2017 年 3 月到 10 月进行了一项试点研究，以检验这三项依从性措施以及在全国 93 名成人艾滋病毒感染者中远程进行的研究程序的可行性和可接受性。在我们不同国家的参与者样本中，95.7% 的人被保留到研究结束，89.9% 的人发送了所有短信，84.3% 的人发送了所有头发样本。大约 74.2% 的参与者报告了该研究的总体体验非常好，60.2% 对参与毛发收集研究非常或非常满意，76.3% 的参与者指出参与类似研究（包括短信图片或补充日期）的可能性极高。我们注意到远程研究方法、收集照片和短信药房补充日期和药丸数量以及家庭收集的头发样本的高度可行性和可接受性。在这里，我们描述了可行性和可接受性指标、参与者退出定性访谈的结果以及吸取的教训。这些依从性措施代表了在未来研究中扩大艾滋病毒治疗和预防依从性监测工具的创新方法。