{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:03:25Z","timestamp":1777878205157,"version":"3.51.4"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100030692","name":"Intramural Research Program, National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["5R01DA049843-02"],"award-info":[{"award-number":["5R01DA049843-02"]}],"id":[{"id":"10.13039\/100030692","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Sexual minority men (SMM) with HIV who use stimulants may experience greater difficulties with antiretroviral therapy adherence which amplifies risk for unsuppressed HIV viral load (VL). Remote monitoring of VL could support efforts to rapidly respond to sub-optimal adherence.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This qualitative study enrolled 24 SMM with HIV who use stimulants to examine experiences with two different dried blood spots (DBS) self-sampling devices (i.e., Tasso-M20 vs. HemaSpot HD) to measure VL. Participants were asked to complete self-sampling of DBS using both devices, and then participated in a 45-minute semi-structured interview. Interviews focused on ease of use, device preference, experiences with receiving and mailing kits, and barriers to participating in research. A thematic analysis was conducted to analyze interview transcripts.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty-two participants (92%) returned the Tasso-M20 and 21 (88%) returned the Hemaspot HD devices. Among the 22 participants that completed qualitative interviews, twenty-three codes were identified and collapsed within seven themes. Preferences for devices were based on convenience, pain and prior experiences with finger-pricking technology. Participants emphasized that clearer instructions with contingency plans for self-sampling of DBS would improve the user experience with self-sampling of DBS. Intersectional stigma (e.g., HIV, sexual minority status, and substance use) was noted as an important consideration in implementing self-sampling of DBS. Promoting decision making, or the option to choose sampling method based on personal preferences, may improve engagement and likelihood of DBS completion.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Findings will guide the broader implementation of self-sampling of DBS to optimize VL monitoring in SMM with HIV who use stimulants.<\/jats:p>\n<jats:p>Routine HIV viral load (VL) testing is recommended to assess the success of anti-retroviral therapy (ART) and identify individuals who may be experiencing difficulties with adherence to optimize rates of viral suppression [1]. The U.S. Department of Health and Human Services (HHS) Panel on Antiretroviral Guidelines for Adults and Adolescents recommends routine VL monitoring every three to six months after initiating ART. For those with optimal ART adherence and consistently suppressed VL for more than one year, VL monitoring is recommended every six months [2].<\/jats:p>\n<jats:p>A convenience sample of SMM with HIV who use stimulants were recruited via email using an existing consent-to-contact database of individuals interested in potential research participation. Recruitment included up to three emails, sent between March and June 2022, which detailed the study purpose and provided a link to the online study screener. Interested individuals who clicked on the provided link were directed to a brief screener consent page before reaching the screener survey. Eligible individuals were a) cisgender man, b) aged 18 or older, c) comfortable reading and speaking English, d) US residency, e) reported ever having anal sex with a man, f) self-reported HIV diagnosis at least 90 days prior to screening, g) an active ART prescription AND\u2009&lt;\u200990% past-month adherence on the 3-item Wilson measure in the past 30 days [21], h) screened positive for a moderate or severe stimulant use disorder (i.e., cocaine or methamphetamine) in the past 3 months with an abbreviated version of the National Institute on Drug Abuse (NIDA)-modified Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) [22], and i) ownership of an iPhone or Android smartphone. Individuals who met the eligibility criteria were contacted by study staff to schedule a Zoom assessment, where they received information about the study, completed informed consent, and provided contact information so that self-sampling DBS collection devices could be mailed to their homes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0322740","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T17:52:57Z","timestamp":1747072377000},"page":"e0322740","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["\u2018I was like, this is gonna hurt\u2019: Implementing self-sampling of dried blood spots to measure HIV viral load"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4576-9898","authenticated-orcid":true,"given":"Jennifer V.","family":"Chavez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Davis Ewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozair","family":"Ilyas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delaram","family":"Ghanooni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 E.","family":"Diaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Atkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Hernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith J.","family":"Horovath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Hirshfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam W.","family":"Carrico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"pone.0322740.ref001","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm7021a2","article-title":"HIV viral load monitoring among patients receiving antiretroviral therapy \u2014 Eight Sub-Saharan Africa Countries, 2013\u20132018","volume":"70","author":"SL Lecher","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0322740.ref002","article-title":"Panel on antiretroviral guidelines for adults and adolescents.","author":"Department of Health and Human Services","year":"2023"},{"issue":"2","key":"pone.0322740.ref003","doi-asserted-by":"crossref","DOI":"10.2196\/mhealth.5287","article-title":"Creating effective mobile phone apps to optimize antiretroviral therapy adherence: Perspectives from stimulant-using HIV-positive men who have sex with men","volume":"4","author":"KJ Horvath","year":"2016","journal-title":"JMIR Mhealth Uhealth"},{"issue":"3","key":"pone.0322740.ref004","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s10461-016-1638-9","article-title":"Predictors of HIV care engagement, antiretroviral medication adherence, and viral suppression among people living with HIV Infection in St. Petersburg, Russia","volume":"22","author":"YA Amirkhanian","year":"2018","journal-title":"AIDS Behav"},{"issue":"11","key":"pone.0322740.ref005","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1080\/09540121.2016.1189496","article-title":"Disparities in achieving and sustaining viral suppression among a large cohort of HIV-infected persons in care - Washington, DC","volume":"28","author":"AD Castel","year":"2016","journal-title":"AIDS Care"},{"issue":"10","key":"pone.0322740.ref006","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1080\/00981389.2010.514563","article-title":"Barriers to HIV care: an exploration of the complexities that influence engagement in and utilization of treatment","volume":"49","author":"MA Cavaleri","year":"2010","journal-title":"Soc Work Health Care"},{"key":"pone.0322740.ref007","doi-asserted-by":"crossref","first-page":"108928","DOI":"10.1016\/j.drugalcdep.2021.108928","article-title":"Characterizing substance use typologies and their association with HIV viral load outcomes: A latent class analysis among sexual minority men living with HIV","volume":"227","author":"SA Meyers-Pantele","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"pone.0322740.ref008","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12916-018-1246-9","article-title":"Challenges and opportunities in examining and addressing intersectional stigma and health","volume":"17","author":"JM Turan","year":"2019","journal-title":"BMC Med"},{"issue":"6","key":"pone.0322740.ref009","doi-asserted-by":"crossref","first-page":"863","DOI":"10.2105\/AJPH.2017.303744","article-title":"Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes","volume":"107","author":"B Turan","year":"2017","journal-title":"Am J Public Health"},{"issue":"4","key":"pone.0322740.ref010","doi-asserted-by":"crossref","DOI":"10.2196\/10847","article-title":"Quantification of HIV-1 RNA among men who have sex with men using an at-home self-collected dried blood spot specimen: Feasibility study","volume":"4","author":"S Hirshfield","year":"2018","journal-title":"JMIR Public Health Surveill"},{"issue":"3","key":"pone.0322740.ref011","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s10461-020-03030-w","article-title":"Longitudinal viral load monitoring using home-collected dried blood spot specimens of MSM Living with HIV: Results from a feasibility pilot study","volume":"25","author":"RA Teran","year":"2021","journal-title":"AIDS Behav"},{"issue":"12","key":"pone.0322740.ref012","doi-asserted-by":"crossref","DOI":"10.2196\/24043","article-title":"Increasing HIV testing and viral suppression via stigma reduction in a social networking mobile health intervention among black and latinx young men and transgender women who have sex with men (HealthMpowerment): Protocol for a randomized controlled trial","volume":"9","author":"KE Muessig","year":"2020","journal-title":"JMIR Res Protoc"},{"issue":"1","key":"pone.0322740.ref013","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1186\/s12879-021-06110-x","article-title":"The feasibility of modified HIV and antiretroviral drug testing using self-collected dried blood spots from men who have sex with men","volume":"21","author":"W Luo","year":"2021","journal-title":"BMC Infect Dis"},{"key":"pone.0322740.ref014","doi-asserted-by":"crossref","first-page":"373","DOI":"10.3389\/fmicb.2020.00373","article-title":"Dried blood spot tests for the diagnosis and therapeutic monitoring of HIV and viral hepatitis B and C","volume":"11","author":"E Tuaillon","year":"2020","journal-title":"Front Microbiol"},{"issue":"9","key":"pone.0322740.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0203296","article-title":"Utilization of dried blood spot specimens can expedite nationwide surveillance of HIV drug resistance in resource-limited settings","volume":"13","author":"G Zhang","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pone.0322740.ref016","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s10508-019-01515-x","article-title":"Stimulant use and study protocol completion: Assessing the ability of men who have sex with men to collect dried blood spots for laboratory measurement of HIV viral load","volume":"49","author":"RA Teran","year":"2020","journal-title":"Arch Sex Behav"},{"key":"pone.0322740.ref017","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40814-015-0026-y","article-title":"Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers","volume":"1","author":"A O\u2019Cathain","year":"2015","journal-title":"Pilot Feasibility Stud"},{"issue":"2","key":"pone.0322740.ref018","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1007\/s10461-022-03796-1","article-title":"Acceptability assessment in HIV prevention and treatment intervention and service delivery research: A systematic review and qualitative analysis","volume":"27","author":"KF Ortblad","year":"2023","journal-title":"AIDS Behav"},{"key":"pone.0322740.ref019","author":"Spot on Sciences","year":"2022"},{"key":"pone.0322740.ref020","author":"Tasso, Inc","year":"2022"},{"issue":"11","key":"pone.0322740.ref021","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1007\/s10461-016-1406-x","article-title":"Validation of a new three-item self-report measure for medication adherence","volume":"20","author":"IB Wilson","year":"2016","journal-title":"AIDS Behav"},{"key":"pone.0322740.ref022","author":"National Institute on Drug Abuse","year":"2021"},{"issue":"1","key":"pone.0322740.ref023","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/qup0000196","article-title":"Conceptual and design thinking for thematic analysis","volume":"9","author":"V Braun","year":"2022","journal-title":"Qual Psychol"},{"issue":"2","key":"pone.0322740.ref024","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol"},{"issue":"1","key":"pone.0322740.ref025","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/capr.12360","article-title":"Can I use TA? Should I use TA? Should Inotuse TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches","volume":"21","author":"V Braun","year":"2020","journal-title":"Couns Psychother Res"},{"issue":"3","key":"pone.0322740.ref026","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/17439760.2016.1262613","article-title":"Thematic analysis","volume":"12","author":"V Clarke","year":"2016","journal-title":"J Posit Psychol"},{"issue":"8","key":"pone.0322740.ref027","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1080\/0142159X.2020.1755030","article-title":"Thematic analysis of qualitative data: AMEE Guide No. 131","volume":"42","author":"ME Kiger","year":"2020","journal-title":"Med Teach"},{"key":"pone.0322740.ref028","first-page":"488","volume-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"JW Creswell","year":"2017"},{"issue":"6","key":"pone.0322740.ref029","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"issue":"4","key":"pone.0322740.ref030","article-title":"A Framework for successful new product development","volume":"4","author":"N Bhuiyan","year":"2011","journal-title":"JIEM"},{"issue":"1","key":"pone.0322740.ref031","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10461-019-02607-4","article-title":"\u201cThat guy is gay and black. That\u2019s a red flag.\u201d How HIV stigma and racism affect perception of risk among young black men who have sex with men","volume":"24","author":"J Arscott","year":"2020","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0322740.ref032","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/19317611.2019.1645075","article-title":"Gay and bisexual men\u2019s experiences using self-testing kits for HIV and rectal and urethral bacterial sexually transmitted infections: Lessons learned from a study with home-based testing","volume":"31","author":"SA John","year":"2019","journal-title":"Int J Sex Health"},{"issue":"2","key":"pone.0322740.ref033","doi-asserted-by":"crossref","DOI":"10.2105\/AJPH.2014.302322","article-title":"The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men","volume":"105","author":"LA Eaton","year":"2015","journal-title":"Am J Public Health"},{"key":"pone.0322740.ref034","doi-asserted-by":"crossref","first-page":"18640","DOI":"10.7448\/IAS.16.3.18640","article-title":"Impact of HIV-related stigma on treatment adherence: Systematic review and meta-synthesis","volume":"16","author":"IT Katz","year":"2013","journal-title":"J Int AIDS Soc"},{"issue":"13","key":"pone.0322740.ref035","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1097\/QAD.0000000000003342","article-title":"Intersectional stigmas are associated with lower viral suppression rates and antiretroviral therapy adherence among women living with HIV","volume":"36","author":"A Norcini","year":"2022","journal-title":"AIDS"},{"issue":"11","key":"pone.0322740.ref036","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1080\/09540121.2017.1300633","article-title":"Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts","volume":"29","author":"S Cahill","year":"2017","journal-title":"AIDS Care"},{"issue":"9","key":"pone.0322740.ref037","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1097\/QAD.0000000000002212","article-title":"HIV stigma and viral load among African-American women receiving treatment for HIV","volume":"33","author":"CG Kemp","year":"2019","journal-title":"AIDS"},{"issue":"7","key":"pone.0322740.ref038","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1007\/s10461-020-03137-0","article-title":"Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV","volume":"25","author":"C Mugo","year":"2021","journal-title":"AIDS Behav"},{"key":"pone.0322740.ref039","doi-asserted-by":"crossref","first-page":"106358","DOI":"10.1016\/j.ypmed.2020.106358","article-title":"Given a choice between self-sampling at home for HPV testing and standard of care screening at the clinic, what do African American women choose? Findings from a group randomized controlled trial","volume":"142","author":"IC Scarinci","year":"2021","journal-title":"Prev Med"},{"key":"pone.0322740.ref040","first-page":"400","volume-title":"Successful Qualitative Research: A Practical Guide for Beginners","author":"V Clark","year":"2013"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T17:53:03Z","timestamp":1747072383000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0322740"}},"subtitle":[],"editor":[{"given":"Zypher Jude G.","family":"Regencia,","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0322740","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,12]]}}}