Background: The prevalence of mood and trauma-stress-related disorders is disproportionately higher among people living HIV compared to individuals without the virus. Poor adherence to HIV treatment and heightened psychological distress have been linked to symptoms associated with these disorders. Objective: The objective of this exploratory pilot study was to develop and implement an intervention that combined individualized web-based attention training with evidence-based counseling to promote HIV treatment adherence and reduce psychological distress. The study targeted African American and Latino young men who have sex with men (YMSM), two population groups in the United States that continue to experience disparities in HIV treatment outcomes. Methods: Study participants with elevated symptoms of depression and suboptimal adherence to antiretroviral therapy (ART) were recruited primarily through referrals from Los Angeles health and social service providers as well as postings on social media. Participants enrolled in the four-week intervention received weekly counseling for adherence and accessed web-based attention training on a daily basis using their own mobile devices or computers. Individualized attention training provided participants with structured practice in reorienting their attention away their own from negative or emotionally-charged stimuli associated with poor adherence and diverting it toward positive or neutral stimuli linked to favorable adherence behaviors. Results: Of the 14 participants who began the intervention, twelve (86%) completed all sessions and study procedures. Using a pretest-posttest design, findings indicated significant improvements in depressive symptoms, ART adherence, and attentional processing speed. Conclusions: Findings support the feasibility of web-based attention training combined with counseling to improve ART adherence among patients with psychological distress. Future research should include a larger sample, a control group, and longer-term follow-up. (JMIR Preprints 19/02/2020:18328) DOI: https://doi.org/10.2196/preprints.18328

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