Adapting the "Do More, Feel Better" Intervention for Older People Living With HIV

More than half of people living with HIV (PWH) in the United States are 50 years of age or older. Older PWH have a 2.3-fold increased risk of depression compared to their peers without HIV. The investigator team has developed a streamlined lay-delivered behavioral activation intervention called "Do More, Feel Better" that has been shown to decrease depressive symptoms among older adults obtaining services in community senior centers. The investigators propose to (1) identify barriers and facilitators to improving mental health among older PWH by using this intervention in the context of Ryan White case management services, (2) adapt and enhance the intervention to meet the needs of older PWH, and (3) conduct a pilot randomized controlled trial to determine the acceptability, feasibility, and appropriateness of the adapted DMFB intervention.

Inclusion Criteria: * ≥50 years of age * living with HIV * English-speaking * elevated depressive symptoms (PHQ-9 ≥10) * resident in Washington for ≥1 year * assigned to a Ryan White case manager * willing to undergo all study procedures Exclusion Criteria: Participants in the Aim 1 and 2 work (interviews and theater testing) and those who serve as certification participants (for interventionist training) will be excluded from the trial. Other exclusion criteria include: * active suicidal ideation * a diagnosis of bipolar disorder, schizophrenia or psychosis * dementia or Telephone Interview for Cognitive Status-modified (TICS-M) scores \