Feasibility, Acceptability, and Validity of Remote Sweat-derived Biomarker Collection - Systemic inflammation plays a central role in HIV pathogenesis- one that persists even when viral replication is controlled by anti-retroviral therapy. This persistent inflammatory state means it is important to better measure and understand inflammation in people living with HIV (PLWH), especially those who engage in pro- inflammatory behaviors such as stimulant use (SU). Unfortunately, current methods of collecting biospecimens to measure inflammation rely on invasive techniques (e.g., blood draws), highly variable sampling techniques with low concentrations of analytes (e.g., dry blood spots), and easily contaminated samples (e.g., saliva). Human sweat, however, provides a novel way to circumvent many of the current issues in inflammatory biomarker collection. Containing inflammatory biomarkers in similar proportions as human blood, sweat has been shown to be highly correlated with serum blood levels of immunological biomarkers in populations across the lifecourse. Sweat-derived inflammatory biomarkers collected via sweat patches, which are worn on the arm or abdomen for 24 hours, are non-invasive, fairly temperature-stable, and more convenient than many existing methods. However, no studies have so far trialled the use of sweat-derived biomarkers collected remotely, in PLWH, or in people who use stimulants. In this study, we aim to demonstrate the feasibility, acceptability, and validity of remote self-collection of sweat-derived biomarkers for the first time. To do this, we will recruit a sub- sample of N=100 participants enrolled in the American Remote Collection HIV Epidemiology Study (ARCHES; 5UG3DA058304), an ongoing, longitudinal cohort of N=1000 men living with HIV (n=700 of whom use stimulants). Building on our previous pilot of in-person, sweat-derived biomarker collection, we will examine the feasibility and acceptability of remotely collected, sweat-derived biomarkers compared to two common collection methods: dry blood spot (DBS) and blood (Aim 1). We will then test the validity of these specimens by comparing within-persons correlations of inflammatory cytokines collected via sweat, DBS, and blood (Aim 2). This cost-effective study is well-aligned with the NIDA Strategic Plan framework and stands to have a sustained and powerful impact on HIV science by trialing an inexpensive and accessible method of inflammatory biomarker data collection, developing methods to do so remotely, and assessing its validity compared to currently accepted methods. If funded, this ASTART application will provide the formative data for PI Metheny to apply for additional R-level funding designed to achieve his long-term goal of understanding how stress, violence, substance use, and ART adherence influence systemic inflammation. It will also provide other scientists with the initial data to begin extending sweat-derived biomarker collection to other research areas.
