People with HIV experience elevated levels of co-occurring psychosocial concerns, which can interfere with HIV-related self-care behaviors, such as medication adherence. We recently developed transdiagnostic, integrated cognitive-behavioral therapy and motivational interviewing psychotherapy to address interrelated psychosocial problems (syndemics) that can interfere with medication adherence and self-care among people with uncontrolled HIV (i.e., a detectable viral load). Through completion of a field trial that included development, clinical supervision, treatment, and administrative coordination of this project, we identified recommendations for engaging, retaining, and delivering transdiagnostic cognitive-behavioral therapy/motivational interviewing to individuals with HIV and experiencing psychosocial and structural barriers to mental and physical health. We describe these recommendations, which include (a) building the relationship; (b) addressing HIV in the context of syndemics; (c) attending to the impact of stigma on health; (d) being flexible in delivering the treatment; (e) managing emergent crises with relevant skill material; (f) tailoring the treatment to education, language, and sociocultural context; (g) implementing problem-solving skills for structural barriers; (h) scheduling flexibly and following up; (i) colocating mental health services and coordinating among providers; and (j) providing a comfortable and affirming physical space. In addition to describing these recommendations, we provide clinical examples and highlight empirical research to illustrate and support using these recommendations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译：

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为服务欠缺的艾滋病病毒感染者提供参与，保留和诊断的综合认知行为治疗和动机访谈。

艾滋病毒感染者会同时发生社会心理问题，这可能会干扰与艾滋病毒有关的自我护理行为，例如药物依从性。我们最近开发了经诊断，综合的认知行为疗法和动机访谈心理疗法，以解决相互关联的社会心理问题（综合症），这些问题可能会干扰不受控制的HIV患者（即可检测到的病毒载量）患者的药物依从性和自我护理。通过完成包括该项目的开发，临床监督，治疗和行政协调在内的现场试验，我们确定了参与，保留，并为艾滋病毒感染者提供经诊断的认知行为疗法/动机访谈，并经历心理和身体健康方面的社会心理和结构障碍。我们描述了这些建议，其中包括：（a）建立关系；（b）在同伴关系中应对艾滋病毒；（c）重视污名化对健康的影响；（d）灵活地提供治疗；（e）利用相关技能材料应对突发危机；（f）根据教育，语言和社会文化背景调整待遇；（g）实施解决结构性障碍的技巧；（h）灵活安排和跟进；（i）安排精神卫生服务并在提供者之间进行协调；（j）提供舒适和肯定的物理空间。除了描述这些建议之外，我们提供了临床实例，并重点介绍了经验研究，以说明和支持这些建议。（PsycINFO数据库记录（c）2019 APA，保留所有权利）。