Table 1.

Antiretroviral Therapy Adherence Monitoring Tools: Accuracy, Advantages and Disadvantages

ART Adherence Monitoring Tool	Validity/Reliability	Detection of Ad- herence Patterns	Real-Time Monitoring	Setting of Use	Cost
Self-Report	Specific, Very Insensitive. Poor Reliability	Yes	No	Clinical Practice & Research	Low
Pharmacy Refill or Claim	Specific, Fairly Sensitive & Reliable	No	Could be	Clinical Practice & Research	Low
Announced or Unannounced Pill Count	Fairly Specific, Fairly Sensi- tive, Fair Reliability	No	No	Clinical Practice & Research	Low
Electronic Pill-Container Caps (MEMS caps)	Specific, Too Sensitive & High Reliability	Yes	No	Research	High
Electronic Web-Enabled Pill Box (Med-eMonitor; Wise Pill; etc.)	Specific, Too Sensitive	Yes	Yes	Research	High
Directly Observed or Admin- istered Therapy (DOT/DAART)	Specific, Sensitive and Reli- able	N/A	Yes	Vulnerable Popula- tions & Research	Labor- Intensive
Monitoring of Antiretroviral Drug Concentration (Blood, Urine, Hair, etc.)	Specific, Sensitive, Reliable	Yes	Yes	Research	High