The EXACT Science of HIV Treatments

As antiretroviral therapies became more effective and available, Gregory Kirk and his colleagues found that some participants in the ALIVE (AIDS Linked to the Intravenous Experience) study could stick with their therapy and fend off AIDS, while others couldn't.

Developing a good method to predict which drug users are likely to adhere to treatment and which ones will fail is the goal of the EXACT (EXposure Assessment in Current Time) study, a subset of the decades-old ALIVE study.

EXACT collects real-time information from drug users to develop predictive algorithms on what might cause them to use drugs, and ultimately, why they might not fully adhere to HIV treatments. Pilot studies using PalmPilots and wearable GPS devices yielded data multiple times a day from current or former intravenous drug users with HIV in the Baltimore-metro area.

After getting a prompt from their PalmPilots, 89 volunteers answered a series of questions on what they were up to and their stress levels, moods and drug use. The GPS recorded their location.

Ultimately, Kirk says, he and his team hope the study will help the health care team focus more time and resources on patients more likely to be nonadherent. Eventually, he adds, smartphones might help patients improve their health directly, alerting counselors such as peer navigators that patients need interventions.