Combined effects of HIV-infection status and psychosocial vulnerability on mental health in homosexual men.

The present study examines psychiatric symptomatology and syndromal depression among 174 HIV+ and 760 HIV- homosexual men enrolled in the Pittsburgh site of the Multicenter AIDS Cohort Study (MACS). A central study goal was to determine whether men's psychosocial status in the areas of demographics, social supports, and coping, in combination with their HIV-infection status, was associated with mental health. Cross-sectional analyses indicated that HIV+ men had significantly higher levels of psychiatric symptomatology and syndromal depression than HIV- men. However, multivariate analyses showed that these associations only appeared among HIV+ men with certain psychosocial characteristics. HIV+ men who were younger, lacked full-time employment, claimed relatively high support from their relatives, and demonstrated high use of active behavioral coping strategies were at greater risk for psychiatric symptomatology and/or syndromal depression. Further, sense of mastery and frequent use of avoidant coping strategies were highly predictive of psychiatric outcomes irrespective of HIV status. The findings suggest that knowledge of an individual's HIV status per se will be inadequate for valid assessment of psychological risks. Rather, any association of HIV status and mental health will depend largely on other psychosocial characteristics that foster vulnerability or resistance to distress in these men.