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. 2025 Apr;29(4):1247-1255.
doi: 10.1007/s10461-024-04599-2. Epub 2025 Jan 27.

Acceptability and Feasibility of Self-Collected Dried Blood Spot Specimens for Viral Load Monitoring among Rural Older People Living with HIV

Jennifer L Walsh  1 , Sabina Hirshfield  2 , Steven A John  3 , Katherine G Quinn  3 , Olivia H Algiers  3 , Timothy L McAuliffe  3 , Andrew E Petroll  3   4
Affiliations

Acceptability and Feasibility of Self-Collected Dried Blood Spot Specimens for Viral Load Monitoring among Rural Older People Living with HIV

Jennifer L Walsh et al. AIDS Behav. 2025 Apr.

Abstract
in English, Spanish

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 (Mage = 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.

Las pruebas con gotas de sangre seca (DBS) auto-recolectadas pueden ser útiles para monitorear la carga viral (CV) en estudios de investigación o clínicamente, dado que eliminan la necesidad de que los participantes viajen a los sitios de estudio o laboratorios. A pesar de esto, existe poca información sobre el monitoreo de la CV usando DBS auto-recolectadas en el hogar, y no existe información sobre DBS para este uso entre personas rurales mayores que viven con VIH (PVVIH), una población que podría beneficiarse de la auto-recolección dada la dificultad de acceder a la atención médica. Informamos sobre la viabilidad y aceptabilidad de las muestras de DBS auto-recolectadas, los resultados de la CV de DBS, la concordancia entre la CV auto-reportada y la DBS, y los factores asociados con la CV detectable por DBS en una muestra rural del sur de EE. UU. de PVVIH de 50 años o más. Entre 2021 y 2022, 61 PVVIH rurales mayores de 9 estados del sur de EE. UU. (Medad = 58, 25% mujeres) completaron medidas de encuesta y muestras de DBS auto-recolectadas en el hogar; 51 de estos participantes completaron los mismos procedimientos en el seguimiento de 3 meses. Casi todos los participantes (96–98%) recogieron muestras de DBS que podían analizarse con éxito para CV, y los participantes encontraron que la auto-recolección era altamente aceptable. Aproximadamente una cuarta parte de los participantes tenían CV detectable cuantificable (≥ 839 copias/mL) en cada punto temporal. La concordancia entre la CV auto-reportada y la CV DBS fue del 69% al inicio y del 82% en el seguimiento; la mayoría de aquellos con CV detectable DBS auto-reportaron CV indetectable (86% al inicio y 60% en el seguimiento). La auto-recolección de muestras de DBS para el monitoreo de CV puede agregar valor a la investigación realizada de forma remota, incluida la investigación asociada con el cuidado de PVVIH rurales y/o mayores.

Keywords: Dried Blood Spots; Feasibility Study; HIV; Older Adults; Rural; Viral load.

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Conflict of interest statement

Declarations. Ethics Approval: This study was performed in line with the principles of the Declaration of Helsinki. This research was approved by the Medical College of Wisconsin Institutional Review Board (protocol #PRO00037672). Consent to Participate: Informed consent was obtained from all individual participants included in the study. Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article.

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