Real-time adherence monitoring for HIV antiretroviral therapy

Jessica E. Haberer, Josh Kahane, Isaac Kigozi, Nneka Emenyonu, Peter Hunt, Jeffrey Martin, David R. Bangsberg

Research output: Contribution to journalArticlepeer-review

159 Scopus citations


Current adherence assessments typically detect missed doses long after they occur. Real-time, wireless monitoring strategies for antiretroviral therapy may provide novel opportunities to proactively prevent virologic rebound and treatment failure. Wisepill, a wireless pill container that transmits a cellular signal when opened, was pilot tested in ten Ugandan individuals for 6 months. Adherence levels measured by Wisepill, unannounced pill counts, and selfreport were compared with each other, prior standard electronic monitoring, and HIV RNA. Wisepill data was initially limited by battery life and signal transmission interruptions. Following device improvements, continuous data was achieved with median (interquartile range) adherence levels of 93% (87-97%) by Wisepill, 100% (99-100%) by unannounced pill count, 100% (100-100%) by self-report, and 92% (79-98%) by prior standard electronic monitoring. Four individuals developed transient, low-level viremia. After overcoming technical challenges, real-time adherence monitoring is feasible for resource-limited settings and may detect suboptimal adherence prior to viral rebound.

Original languageEnglish (US)
Pages (from-to)1340-1346
Number of pages7
JournalAIDS and Behavior
Issue number6
StatePublished - Dec 2010
Externally publishedYes


  • Antiretroviral therapy
  • Real-time adherence monitoring
  • Wireless technology

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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