ABSTRACT Depression and other mental health conditions are disproportionately common in people with HIV and continue to compromise quality of life and impede achievement of optimal HIV care outcomes. Problem-solving therapy is a form of cognitive-behavioral therapy that has been shown to be efficacious at improving a range of mental health outcomes when used across diverse settings, including in Africa. Where, how and when problem- solving therapy is best implemented remains an open and critical question to advancing the scale-up of this evidence-based treatment— particularly in settings where resources are limited or there is high variation in patient, provider, or community wants, needs, and resources for mental health care delivery. This proposal aims to address these issues by leveraging stakeholder-driven methods to develop a stepped, or adaptive, problem-solving therapy implementation approach for people with HIV in KwaZulu-Natal Province, South Africa. Specifically, I aim to: 1) determine stakeholder preferences regarding the distinct features of problem- solving therapy implementation for PWH; 2) develop a contextually feasible, stepped problem-solving therapy implementation approach using the Implementation Mapping protocol; and 3) evaluate the feasibility of using a stepped problem-solving therapy implementation approach for PWH in a low-resource setting in South Africa. My overarching goal is to become an independently funded researcher who leads multi-disciplinary teams, and uses diverse, innovative methods (e.g., adaptive implementation strategies) to improve the mental and physical health of people with HIV in low-resource settings. This K01 award will build upon my strong foundation in advanced epidemiologic methods and applied experience conducting global mental health disparities and intervention research to address identified gaps in my training and expertise. In collaboration with my world-class mentorship team, I have designed an intensive 5-year training plan that incorporates didactic and other capacity-building activities (e.g., seminars, one-on-one mentoring meetings) with applied experience to achieve the following training goals: 1) Establish expertise developing interview and focus group discussion guides and conducting qualitative thematic analyses; 2) Gain a robust theoretical understanding of implementation strategies and community-driven program planning tools for the scale-up of mental health interventions; and 3) Develop expertise in the use and evaluation of multi-stage implementation strategies. The proposed research and training will ensure my successful transition to independence in the Division of Infectious Diseases at Washington University School of Medicine and provide the skills and preliminary data necessary to develop an R01 to further evaluate implementation and efficacy outcomes of adaptive problem- solving therapy implementation strategies for people with HIV in South Africa. Moreover, this work will...