Sexual Behavior and Depression Among HIV-Positive Gay Men

As a result of medical advances seropositive men may expect to have a longer and healthier life span than in the past. It is therefore increasingly important to determine which factors are related to the mental health of seropositive gay men, as well as those associated with a satisfying, yet safe sexual lifestyle. This study examined sexual behavior, indicators of mental health, and determinants of AIDS-preventive behavior among a group of seropositive gay men and a control group of seronegative gay men in the Netherlands. Most seropositive men consistently practiced AIDS-preventive behavior. Nevertheless, if the definition of potentially unsafe sexual behavior is broadened to include oral sex to ejaculation, a sizable proportion of seropositive men had to be categorized as having had unsafe sex. Depression scores were higher among seropositive men than among the general population, but not significantly higher than among seronegative controls. Depression was not related to unprotected anal sex. The attitudes and the intention toward condom use were positive. Seropositive men used recreational (noninjection) drugs relatively often, but this was generally not associated with unprotected anal sex. Seropositive men attached more value to anal sex than seronegative controls, but again, this preference was not related to practicing unprotected anal sex. In the relatively few cases that unprotected anal sex among seropositive men did occur, it appeared to be related to lower behavioral control and to a weaker safe-sex intention. Perceived barriers to condom use and low perceived risk were also associated with unprotected anal sex among seropositive men. Although depression was not directly related to unprotected anal sex, seropositive men with higher depression levels were less motivated to use condoms and perceived more barriers to condom use.