There is a strong need for clinical interventions that improve engagement in HIV care among men who have sex with men (MSM) with HIV who have histories of trauma. Cognitive behavioral therapy (CBT) has substantial support for treating posttraumatic stress among people with HIV and among HIV-negative MSM. In this population, posttraumatic responses can include both general avoidance of distress related to the trauma but also specific avoidance of HIV-related stimuli that can reduce engagement in HIV care. The present paper introduces an application of Cognitive Behavioral Therapy for Trauma and Self-Care (CBT-TSC), which integrates CBT strategies to address posttraumatic stress symptoms with the Life-Steps framework, an evidence-based, single-session problem-solving intervention that increases adherence to antiretroviral therapies. Other CBT components include psychoeducation and the reduction of specific trauma symptoms, including avoidance and negative self-beliefs that can act as barriers to care engagement. The intervention is presented via four individual case studies. These cases demonstrate the ways in which CBT-TSC can be used to support mental health and self-care among MSM with HIV who have histories of trauma and are facing barriers to full participation in HIV care.

中文翻译：

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创伤认知行为疗法和自我护理治疗创伤后应激症状并支持男男性行为艾滋病毒感染者的艾滋病毒护理参与：案例系列

迫切需要临床干预措施来提高有创伤史的艾滋病毒感染者（MSM）对艾滋病毒护理的参与度。认知行为疗法 (CBT) 对治疗 HIV 感染者和 HIV 阴性 MSM 的创伤后应激障碍有很大支持。在这一人群中，创伤后反应既包括一般性地避免与创伤相关的痛苦，也包括具体避免与艾滋病毒相关的刺激，从而减少对艾滋病毒护理的参与。本文介绍了创伤和自我护理认知行为疗法 (CBT-TSC) 的应用，它将解决创伤后应激症状的 CBT 策略与 Life-Steps 框架相结合，这是一种基于证据的单次问题解决干预措施这增加了抗逆转录病毒治疗的依从性。CBT 的其他组成部分包括心理教育和减少特定的创伤症状，包括回避和消极的自我信念，这些症状可能成为护理参与的障碍。该干预措施通过四个单独的案例研究来呈现。这些案例展示了 CBT-TSC 如何用于支持感染艾滋病毒的男男性行为者的心理健康和自我护理，这些男男性行为者有创伤史，并且在全面参与艾滋病毒护理方面面临障碍。