Formative perceptions surrounding the use of a taggant-based adherence tool to measure antiretroviral therapy adherence in people with HIV

Adherence to antiretroviral therapy (ART) is important in people with HIV (PWH). This study explores perceptions of a novel adherence measurement system (TruTag) using silica-based microparticles in ART pills that when scanned with a smartphone camera, indirectly measure adherence. Twenty PWH on ART were recruited from a community health center and operated the TruTag system during a semi-structured interview. Qualitative data were analyzed using a framework matrix to understand perceptions and recommendations for the use of the TruTag system. Participants ranged in age from 26 to 68 (median 46 years), were White (60%), and homosexual or gay (70%). Most participants (70%) self-reported 100% ART adherence over the past 6 months. After instruction, all participants successfully operated the TruTag system, with many participants willing to consider it as a platform for their own adherence measurement. Key facilitators included the ability to verify medication, track adherence over time, and share data with healthcare providers. Some participants expressed concerns about scanning difficulties and perceived the system as an unnecessary step in their adherence routine. Participants suggested refinements to enhance scanning and emphasized the importance of reminders to support adherence. These findings suggest that this system may be a strategy for measuring ART adherence in PWH.