Adapting cognitive remediation group therapy: A community-based, focus group study

Cognitive impairment is a significant health issue for people aging with HIV/AIDS. With pharmacological treatment lacking, psychosocial group therapies may best help people aging with HIV who experience cognitive challenges cope with their symptoms. The COVID-19 pandemic revealed how in-person group therapies need adaptation for hybrid or online delivery. Peer-led focus groups discussed adapting cognitive remediation group therapy (CRGT) as a hybrid or online intervention. CRGT combines mindfulness-based stress reduction and brain training activities. Purposive sampling was used to recruit people aging with HIV (40+) who self-identified cognitive concerns and resided in one of two Canadian provinces. Thematic content analysis was employed on transcripts by seven independent coders. Ten, two-hour focus groups were conducted between August and November 2022. Participant (n=45) demographics included age (M=53.22, SD=7.62), gender (45% women, 42% men, 13% trans/non-binary), sexual orientation (42% gay, 40% heterosexual, 18% other), ethnicity (45% White, 33% Black, 13% Indigenous, 9% mixed-race), and employment (33% employed, 67% retired/disability), and all on treatment and retained in care. Overall, participants responded favourably to CRGT’s modalities. Alongside support for its continued implementation in-person, participants requested online synchronous and online asynchronous formats. Preferred intervention facilitators were peers and mental health professionals. We also discuss how to adapt psychosocial HIV therapies for technology-mediated delivery, with consideration for behavioral HIV research.