Integrated PTSD and adherence treatment for people living with HIV: a feasibility pilot trial for cognitive processing therapy- lifesteps (CPT-L) at a Ryan white clinic

作者：Cristina M. López, Nathaniel L. Baker, Stephanie Amaya, Erin Bisca, Tayler Wilson, Allison Ross Eckard, Angela D. Moreland, Patricia A. Resick, Steven A. Safren, Carla Kmett Danielson · 发表于：AIDS Research and Therapy · 年份：2025 · DOI：10.1186/s12981-025-00808-7 · 被引用次数：1 · 研究领域：HIV/AIDS Research and Interventions、Posttraumatic Stress Disorder Research、HIV Research and Treatment

BACKGROUND: People living with Human immunodeficiency virus (HIV; PLHIV) have high rates of post-traumatic stress disorder (PTSD), which contributes to poor health outcomes. Avoidant behavior, a hallmark feature and overlapping symptom of PTSD and HIV stigma, may undermine antiretroviral therapy (ART) adherence. Few studies have evaluated PTSD treatment effects on HIV outcomes. Cognitive Processing Therapy (CPT), an evidence-based PTSD treatment, can be adapted to address internalized stigma and adherence by reducing avoidance. In alignment with the U = U (Undetectable = Untransmissible) campaign, this pilot randomized controlled trial (RCT) tested feasibility of integrating CPT with an adherence intervention (Life-steps; CPT-L) in a Ryan White clinic. METHODS: Forty-one adults with HIV, PTSD, and suboptimal HIV care (e.g., missed appointments, detectable viral load) were recruited from a South Carolina Ryan White clinic. Participants were randomized 1:1 to CPT-L (n = 20) or Life-steps only (n = 21). Outcomes included PTSD symptoms, HIV stigma, quality of life, viral load, and appointment engagement, assessed at baseline, post-intervention, and 3-month follow-up. Analyses used linear regression/ANOVA, with viral load detection examined via Fisher's exact test. RESULTS: CPT-L participants showed significantly greater reductions in PTSD symptoms (Δ = 11.55, SE = 4.32, p = .01) and HIV stigma (Δ = 22.63, SE = 7.33, p = .006) compared with Life-steps only. Preliminary trends also...