An Examination of Perceptions and Usage of Dried Blood Spot Biosampling Technology for HIV Viral Load Collection...

Dried blood spot (DBS) biosampling holds promise for expanding routine viral load (VL) monitoring for youth with HIV (YWH), particularly those at highest risk for HIV medication non-adherence. This mixed methods study piloted home-based DBS collection with YWH, aged 15-24 years. We enrolled 34 YWH with suppressed VL from April 22, 2020, to December 15, 2021, a subset of a fully virtual, nationwide decentralized clinical trial (ATN 144 SMART). Participants were mailed a HemaSpot^™-HF kit and asked to complete a computer-assisted self-interview (CASI) with an instructional DBS video. Surveys and semi-structured interviews provided quantitative and qualitative data to assess feasibility, appropriateness, and acceptability of home-based DBS for VL monitoring. Of 239 total screener attempts, 134 individuals were eligible and 115 provided contact information/completed the screener; 34 enrolled and returned DBS kits. Descriptive analyses showed a positive relationship between perceived suitability, feasibility, and acceptability. Perceived suitability was negatively associated with age, and feasibility differed significantly by health insurance coverage. Qualitative findings identified facilitators such as clinic/provider support, awareness of DBS innovation, insurance coverage, and streamlined mailing processes. Barriers included living environment challenges, cost concerns, and mail delivery issues. This pilot supports a self-management model and provides preliminary evidence that home-based DBS collection is feasible and acceptable among YWH. Scaling up this method through clinic and provider promotion could transform YWH HIV care by enabling remote VL monitoring. Findings also underscore the value of DBS as a practical biospecimen collection strategy for decentralized research models.