Combined effects of HIV-infection status and psychosocial vulnerability onmental health in homosexual men

The present study examines psychiatric symptomatology and syndromal depress ion among 174 HIV+ and 760 HIV- homosexual men enrolled in the Pittsburgh s ite of the Multicenter AIDS Cohort Study (MACS). A central study goal was t o determine whether men's psychosocial status in the areas of demographics, social supports, and coping, in combination with their HIV-infection statu s, was associated with mental health. Cross-sectional analyses indicated th at HIV+ men had significantly higher levels of psychiatric symptomatology a nd syndromal depression than HIV- men. However, multivariate analyses showe d that these associations only appeared among HIV+ men with certain psychos ocial characteristics. HIV+ men who were younger, lacked full-time employme nt, claimed relatively high support from their relatives, and demonstrated high use of active behavioral coping strategies were at greater risk for ps ychiatric symptomatology and/or syndromal depression. Further, sense of mas tery and frequent use of avoidant coping strategies were highly predictive of psychiatric outcomes irrespective of HIV status. The findings suggest th at knowledge of an individual's HIV status per se will be inadequate for va lid assessment of psychological risks. Rather, any association of HIV statu s and mental health will depend largely on other psychosocial characteristi cs that foster vulnerability or resistance to distress in these men.