AIDS PATIENT CARE and STDs Volume 21, Number 3, 2007 © Mary Ann Liebert, Inc. DOI: 10.1089/apc.2006.0077 Improvement of Psychosocial Adjustment to HIV-1 Infection through a Cognitive-Behavioral Oriented Group Psychotherapy Program: A Pilot Study ARACELI ROUSAUD, Psych., 1 JORDI BLANCH, M.D., Ph.D., 2 MARTIN HAUTZINGER, Ph.D., 3 ELISA DE LAZZARI, Ph.D., 4 JOSEP MARIA PERI, Ph.D., 2 OLGA PUIG, Psych., 2 ESTEBAN MARTINEZ, M.D., Ph.D., 5 GUILLEM MASANA, M.D., Ph.D., 2 JOAN DE PABLO, M.D., Ph.D., 2 and JOSEP MARIA GATELL, M.D., Ph.D. 5 ABSTRACT The present study evaluated the efficacy of a group therapy program in improving psychosocial adjustment to HIV infection, and tried to identify variables predictive of greater improvement. The outcome of 47 completing patients was analyzed, comparing the measures between T1 (1 month before therapy), and T2 (first session), and between T2 and T3 (last session) using the Wilcoxon matched-pairs signed-ranks test for each dimension of the Psychosocial Adjustment to Illness Scale (PAIS). The therapy consisted of 16 weekly 2-hour sessions following a struc- tured time-limited cognitive-behavioral group psychotherapy program. During the intervention (between T2 and T3) a significant improvement was observed in health care orientation, voca- tional environment, domestic environment, sexual relation, extended family relationships, social environment, and total PAIS. There were no changes during baseline (between T1 and T2) in any of the PAIS subscales, or in the total PAIS score. Sexual route of transmission was inde- pendently associated with an improvement in health care orientation (  2.525). Time since HIV diagnosis (  0.022) and being employed (  2.548) were independently associated with an improvement in adjustment to vocational environment. Men who have sex with men showed a poorer improvement in adjusting to family relations after the intervention ( 2.548). Finally, a lower CD4 count ( 0.005) and being employed (  3.054) were independently associated with an improvement in adjustment to social environment. Our psychotherapy program im- proved psychosocial functioning in a heterogeneous sample of HIV-1–infected patients referred to a consultation-liaison psychiatry unit. 212 INTRODUCTION S INCE RECENT PHARMACOLOGIC ADVANCES, par- ticularly the advent of highly active anti- retroviral therapy (HAART), have increased life expectancies for persons living with HIV in industrialized countries, 1 quality of life and psychosocial functioning have become impor- tant concerns. 2,3 Psychosocial adjustment is de- fined as the capacity of an individual to per- 1 Fundació Clínic per la Recerca Biomèdica-IDIBAPS, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Hos- pital Clínic de Barcelona, Barcelona, Spain. 2 Clinical Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain. 3 Clinical and Physiological Psychology Department, Eberhard-Karls-University of Tübingen, Tübingen, Germany 4 Epidemiology and Biostatistics Unit, Hospital Clínic de Barcelona, Barcelona, Spain. 5 Infectious Diseases and Microbiology Department, Hospital Clínic de Barcelona, Barcelona, Spain.