Table 1 Blended motivational interviewing (MI) and problem solving therapy (PST) intervention

Session 1, Week 1 45 minutes

• Conduct screening/assessment of alcohol use

• Provide feedback on results of screening/assessment

• Increase knowledge of how alcohol use impacts on course of HIV

• Use MI to build rapport and develop readiness to change

○ Assess readiness to change (using readiness ruler)

○ Assess pros and cons of change (Decision-balance exercise)

○ Use MI to try and shift participant and elicit a commitment to change

Session 2, Week 1

Patient check-in (using MI)

50 minutes

• Build the Rationale for PST

• Explain the structure of PST

• Explain the link between problems and alcohol use, and the rationale for PST

• Establish positive problem orientation

• Describe the steps of PST

• Build the rationale for activity scheduling

• Describe the steps of Problem Solving

• First Problem Solving Session with counsellor (using the steps) and describe homework

Session 3, Week 2 50 minutes

• Patient check-in (using MI)

• Review homework from previous week and challenges/difficulties

○ Elicit positive change talk and affirm commitment to change using MI techniques

○ Review PST steps and affirm attempts to change

• Explain what can be done about problems that are not important (coping with negative thoughts)

• Second Problem Solving Session with counsellor and an exercise

Session 4 Week 2 45 minutes

• Review practice exercises from session 3

• Explain what can be done about problems that are important but cannot be solved 5 min (advancing the process of acceptance)

• Third Problem Solving Session with counsellor and recap

• Elicit positive change talk and affirm commitment to change using MI techniques