Psychosocial stressors and behavioral interventions in gay men with HIV infection

Homosexual men who are diagnosed as HIV-1 seropositive may face major psychosocial changes including multiple, chronic, uncontrollable stressors, and losses in familiar sources of social support. This combination of events may overwhelm previously learned coping strategies resulting in a loss of perceived self-efficacy, feelings of hopelessness and depression, and increases in maladaptive behaviors such as unprotected sexual activities and substance use. These sequelae may, in turn, compromise future mental and physical health status. This population may benefit substantially from behavioral interventions that increase self-efficacy, encourage emotional expression, and increase social support resources in a supportive group environment. It is plausible that such increases in self-efficacy, adaptive coping and social support may reduce the likelihood of distress and depression, sexual risk behaviors and substance use with potential benefits as well for immunologic status and clinical health. Recent work, though preliminary, supports the utility of such behavioral interventions and it appears that further larger-scale investigations are warranted.