Interventions addressing syndemics and ART adherence are needed for individuals with uncontrolled HIV and psychosocial problems. Twenty-seven participants with detectable HIV plasma viral load (PVL) or recent STI participated in an open trial of transdiagnostic adherence counseling and cognitive behavioral therapy. Outcomes were collected at baseline, 4-, and 8-months. Log PVL improved from baseline to 4-month (γ = - 1.13, 95% CI - 1.72, - 0.55, p < 0.001) and 8-month (γ = - 0.93, 95% CI - 1.57, - 0.30, p = 0.006), with more participants suppressed at 4- (χ2(1) = 9.09, p = 0.001) and 8-month (χ2(1) = 5.14, p = 0.016). Self-reported adherence improved across major assessments (γ = 0.87, 95% CI 0.28, 1.46, p = .005); Wisepill adherence did not. Negative affect declined during treatment (γ = - 0.28, 95% CI - 0.40, - 0.16, p < 0.001), with improvement at 4- (γ = - 4.34, 95% CI - 6.99, - 1.69, p = 0.002) but not 8-month. Positive affect trended positively during treatment and from baseline to 4-month, with significant 8-month improvement (γ = 3.84, 95% CI 0.33, 7.44, p = 0.04). Depressive symptoms did not change. In a complicated sample of participants selected for uncontrolled HIV, the intervention yielded improved PVL and self-reported adherence. Efforts to end HIV should improve upon strategies such as these, addressing syndemics. Registration: clinicaltrial.gov: NCT02696681.

中文翻译：

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解决艾滋病毒不受控制的个体的综合症和自我护理：跨诊断治疗的公开试验。


对于艾滋病毒和心理社会问题不受控制的个人，需要采取干预措施来解决并发流行病和坚持抗逆转录病毒治疗。 27 名可检测到 HIV 血浆病毒载量 (PVL) 或近期患有 STI 的参与者参加了跨诊断依从咨询和认知行为治疗的公开试验。收集基线、4 个月和 8 个月的结果。 Log PVL 从基线改善至 4 个月（γ = - 1.13，95% CI - 1.72，- 0.55，p < 0.001）和 8 个月（γ = - 0.93，95% CI - 1.57，- 0.30，p = 0.006） ），更多参与者被抑制在 4 个月（χ2(1) = 9.09，p = 0.001）和 8 个月（χ2(1) = 5.14，p = 0.016）。自我报告的依从性在主要评估中得到改善（γ = 0.87，95% CI 0.28, 1.46，p = .005）； Wisepill 坚持没有。治疗期间负面情绪下降 (γ = - 0.28, 95% CI - 0.40, - 0.16, p < 0.001)，改善为 4- (γ = - 4.34, 95% CI - 6.99, - 1.69, p = 0.002)，但不是8个月。治疗期间以及从基线到 4 个月，积极情绪呈积极趋势，8 个月后有显着改善（γ = 3.84，95% CI 0.33、7.44，p = 0.04）。抑郁症状没有改变。在选择艾滋病毒不受控制的参与者的复杂样本中，干预措施改善了 PVL 和自我报告的依从性。消灭艾滋病毒的努力应该改进诸如此类的策略，以解决并发流行病。注册：clinicaltrial.gov：NCT02696681。