Background The prevalence of common mental disorders (CMDs) among people living with HIV and people who inject drugs is high worldwide and in Vietnam. However, few evidence-informed CMD programs for people living with HIV who inject drugs have been adapted for use in Vietnam. We adapted the Friendship Bench (FB), a problem-solving therapy (PST)–based program that was successfully implemented among patients with CMDs in primary health settings in Zimbabwe and Malawi for use among people living with HIV on methadone maintenance treatment (MMT) with CMDs in Hanoi, Vietnam. Objective This study aimed to describe the adaptation process with a detailed presentation of 4 phases from the third (adaptation) to the sixth (integration) of the Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT) framework. Methods The adaptation phase followed a qualitative study design to explore symptoms of CMDs, facilitators, and barriers to conducting FB for people living with HIV on MMT in Vietnam, and patient, provider, and caretaker concerns about FB. In the production phase, we revised the original program manual and developed illustrated PST cases. In the topical expert and integration phases, 2 investigators (BNG and BWP) and 3 subject matter experts (RV, DC, and GML) reviewed the manual, with reviewer comments incorporated in the final, revised manual to be used in the training. The draft program will be used in the training and testing phases. Results The study was methodologically aligned with the ADAPT-ITT goals as we chose a proven, effective program for adaptation. Insights from the adaptation phase addressed the who, where, when, and how of FB program implementation in the MMT clinics. The ADAPT-ITT framework guided the appropriate adaptation of the program manual while maintaining the core components of the PST of the original program throughout counseling techniques in all program sessions. The deliverable of this study was an adapted FB manual to be used for training and piloting to make a final program manual. Conclusions This study successfully illustrated the process of operationalizing the ADAPT-ITT framework to adapt a mental health program in Vietnam. This study selected and culturally adapted an evidence-informed PST program to improve CMDs among people living with HIV on MMT in Vietnam. This adapted program has the potential to effectively address CMDs among people living with HIV on MMT in Vietnam. Trial Registration ClinicalTrials.gov NCT04790201; https://clinicaltrials.gov/ct2/show/NCT04790201

BACKGROUND Prevalence of common mental disorders (CMDs) among people living with HIV (PWH) and people who inject drugs (PWID) is high globally and in Vietnam. Yet, few evidence-based CMD interventions for PWH who inject drugs have been adapted for use in Vietnam. We adapted the “Friendship Bench” (FB), a problem-solving therapy (PST)-based intervention which was successfully implemented among CMD patients in primary health settings in Zimbabwe and Malawi for use among PWH on methadone maintenance treatment (MMT) with CMDs in Hanoi, Vietnam. OBJECTIVE This manuscript describes the adaptation process, with a detailed presentation on four phases from the third (adaptation) to the sixth (integration) of the ADAPT-ITT (Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training-Testing) framework. METHODS The adaptation phase followed a qualitative study design to explore symptoms of CMDs, facilitators and barriers towards conducting FB for PLWH on MMT in Vietnam, and patient, provider, and caretaker concerns about FB. In the production phase, we revised the original intervention manual and developed illustrated PST cases. In the topical expert and integration phases, two investigators and three subject matter experts reviewed the manual, with reviewer comments incorporated in the final, revised manual to be used in the training. The draft intervention will be used in the training and testing phases. RESULTS The study was methodologically aligned with the ADAPT-ITT goals as we chose a proven, effective intervention for adaptation. Insights from the adaptation phase addressed the who, where, when, and how of FB intervention implementation in the MMT clinics. The ADAPT-ITT framework guided the appropriate adaptation of the intervention manual while maintaining the core components of PST of the original intervention throughout counseling techniques in all intervention sessions. The deliverable of this study was an adapted FB manual to be used for training and piloting to make a final intervention manual. CONCLUSIONS This study successfully illustrates the process of operationalizing the ADAPT-ITT framework to adapt a mental health intervention in Vietnam. The study selected and culturally adapted an evidence-based PST intervention to improve CMDs among PWH on MMT in Vietnam. This adapted intervention has the potential to effectively address CMDs among PWH on MMT in Vietnam. CLINICALTRIAL The study protocol, available at clinicaltrials.gov (NCT04790201), was approved by The University of North Carolina at Chapel Hill and Hanoi Medical University IRBs. All study participants provided written informed consent in Vietnamese.

Background Stigma around human immunodeficiency virus (HIV), injection drug use (IDU), and mental health disorders can be co-occurring and have different impacts on the well-being of people living with HIV (PWH) who use drugs and have mental health disorders. This stigma can come from society, health professionals, and internalized stigma. A person who has more than one health condition can experience overlapping health-related stigma and levels of stigma which can prevent them from receiving necessary support and healthcare, serving to intensify their experience with stigma. This study investigates HIV, drug use, and mental health stigmas in three dimensions (social, internalized, and professional) around PWH on methadone maintenance treatment (MMT) who have common mental disorders (CMDs) including depression, anxiety, and stress-related disorders in Hanoi, Vietnam.Please check and confirm whether corresponding author's email id is correctly identified.The cooresponding author's email is correct Methods We conducted semi-structured, in-depth interviews (IDIs) (n = 21) and two focus group discussions (FGDs) (n = 10) with PWH receiving MMT who have CMD symptoms, their family members, clinic health care providers, and clinic directors. We applied thematic analysis using NVIVO software version 12.0, with themes based on IDI and FGD guides and emergent themes from interview transcripts. Results The study found evidence of different stigmas towards HIV, IDU, and CMDs from the community, family, health care providers, and participants themselves. Community and family members were physically and emotionally distant from patients due to societal stigma around illicit drug use and fears of acquiring HIV. Participants often conflated stigmas around drug use and HIV, referring to these stigmas interchangeably. The internalized stigma around having HIV and injecting drugs made PWH on MMT hesitant to seek support for CMDs. These stigmas compounded to negatively impact participants’ health. Conclusions Strategies to reduce stigma affecting PWH on MMT should concurrently address stigmas around HIV, drug addiction, and mental health. Future studies could explore approaches to address internalized stigma to improve self-esteem, mental health, and capacities to cope with stigma for PWH on MMT. Trial registration: NCT04790201, available at clinicaltrials.gov.