# An integrated intervention using a pill ingestible sensor system to trigger actions on multifaceted social and behavioral determinants of health among PLWH

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2023 · $1,025,878

## Abstract

ABSTRACT
Undetectable equals Untransmittable (U=U) reduces HIV stigma, empowers people living with HIV (PLWH), and
has become a pillar in the goal of ending the HIV epidemic. Viral suppression eliminating risk of sexual HIV
transmission emphasizes the importance of adherence to antiretroviral therapy (ART). Strategies to enhance
adherence have typically not intervened in real-time and have focused on pill-taking reminders without
interventions that address adverse social and behavioral determinants of health (SBDOH) associated with poor
adherence and engagement in care. The complex multifactorial pathways of SBDOH, such as food insecurity,
unstable housing, and substance use disorders, have led to inequities in achieving optimal adherence and
sustained viral suppression. Los Angeles (LA) County, a hot spot for HIV infection and transmission, has been
reported to have viral suppression rates of ~60%, well below the 95% target of Ending HIV Epidemic by 2030.
Our team has an extensive track record of research on measurement of and interventions to enhance adherence
to ART. We have used novel technology-based adherence measures of ART developed in the past two decades,
including the cutting-edge ingestible sensor (IS) technology to obtain non-inferred, real-time adherence
monitoring by Proteus® Digital Health Feedback (PDHF) system. Despite its validation reported in our recent
publications, the PDHF system has been limited by the lack of incorporation of SBDOH. For many years, a major
focus in HIV clinics has been to have multidisciplinary teams of nurses, social workers, and case managers to
address SBDOH; however, timing of interventions are often weeks to months after such problems have been
identified. This study will develop and test an integrated intervention that combines IS technology and adverse
SBDOH alerts to maximize adherence and viral suppression. Using real-time IS monitoring, our integrated
intervention will be able to immediately trigger the existing multidisciplinary team at clinic to address SBDOH
issues as soon as predefined patterns of poor adherence are observed. A cohort of 110 adult patients who have
or are at high risk for sub-optimal adherence will be recruited from a LA County safety net HIV clinic, located in
a geographic HIV hotspot, dealing many adverse SBDOH issues. Participants will be randomized into the
intervention or usual care. The integrated intervention will run for 20 weeks, followed by a 10-week period to
assess sustainability. The primary end points include acceptability of the integrated intervention, frequency and
timeliness of SBDOH interventions, level of challenges of SBDOH in HIV treatment, and adherence to ART. The
secondary end points include viral load, high-risk sexual activity defined by self-report, and detection of sexually
transmitted infections. The overarching goals are to evaluate (i) acceptability of the integrated intervention,
frequency and timeliness of SBDOH intervention, and level of c...

## Key facts

- **NIH application ID:** 10820048
- **Project number:** 1R01MD019188-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** ERIC S DAAR
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,025,878
- **Award type:** 1
- **Project period:** 2023-09-24 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10820048

## Citation

> US National Institutes of Health, RePORTER application 10820048, An integrated intervention using a pill ingestible sensor system to trigger actions on multifaceted social and behavioral determinants of health among PLWH (1R01MD019188-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10820048. Licensed CC0.

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