# A Rapid Point-of-Care Test to Improve ART and PrEP Adherence

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $765,546

## Abstract

PROJECT SUMMARY/ABSTRACT
Oral antiretroviral therapy (ART) is highly effective for HIV-infected people to prevent transmission and HIV-
uninfected people to prevent acquisition, known as pre-exposure prophylaxis (PrEP), but monitoring and
improving drug adherence have been challenging. The World Health Organization recommends all HIV-infected
people receive ART and all people at substantial risk of HIV infection receive PrEP with priority for high incidence
groups (≥3 infections/100 person-years) in both the US and developing countries. However, ART and PrEP are
only effective when people maintain drug levels equivalent to ≥4 doses per week. As many patients taking ART
or PrEP have difficulty with adherence, clinicians currently have no available tools to monitor drug levels or
adherence to provide targeted counseling and support. We propose that a simple, rapid, point-of-care assay to
monitor ART or PrEP drug adherence could be a useful tool for clinicians and patients to monitor drug levels and
guide adherence counseling, which may lead to less HIV transmission and better coordination of HIV prevention
efforts. Since 2013, we have been developing a simple, point-of-care assay to accurately and inexpensively
measure tenofovir, the primary drug of both ART and PrEP. In 2016, we initiated an NIH-funded pharmacokinetic
study to establish the necessary limit of detection and drug levels for our point-of-care PrEP adherence test.
Therefore, we will complete the development of the rapid tenofovir test, transfer the technology to a lateral flow
point-of-care assay format with the appropriate detection threshold, and conduct a clinical feasibility, acceptability
and validation study in a local PrEP clinic. Our objective in this application is to complete the development of a
rapid lateral flow point-of-care test to monitor and improve adherence to ART and PrEP, and to assess feasibility,
acceptability, and validation in a PrEP clinic. We plan to test our central hypotheses by pursuing the following
three specific aims: (1) To optimize the detection and measurement of tenofovir in buffer, blood, and urine
specimens using antibodies, aptamers, or nanobodies; (2) To transfer the immunoassay components into a
lateral flow assay format and establish the quantitative range and limit of detection of tenofovir in blood and urine
specimens; (3) To assess clinical feasibility and validation of the point-of-care tenofovir test among PrEP
providers and patients in a clinical setting. This work is innovative because it develops an entirely new category
of rapid diagnostic test for monitoring adherence, which will help patients and clinicians improve ART and PrEP
adherence and prevent HIV transmission. At the end of this project, we expect to have a rapid lateral flow assay
that will be suitable for a future large-scale clinical implementation trial. If our rapid tenofovir adherence test
proves to be valuable and cost-effective, then it could be easily implemented in...

## Key facts

- **NIH application ID:** 9831037
- **Project number:** 5R01AI136648-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Paul K Drain
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $765,546
- **Award type:** 5
- **Project period:** 2017-12-18 → 2021-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9831037

## Citation

> US National Institutes of Health, RePORTER application 9831037, A Rapid Point-of-Care Test to Improve ART and PrEP Adherence (5R01AI136648-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9831037. Licensed CC0.

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