Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Ajzen, I., and Madden, T. J. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453–474.
Blower, S. M., and Van Griensven, G. J. P. (1993). Effect of differential mortality on risk behavior change in cohort studies. Journal of Acquired Immune Deficiency Syndromes, 6, 1364–1367.
Catalan, J., Klimes, I., Day, A., Garrod, A., Bond, A., and Gallwey, J. (1992). The psychosocial impact of HIV infection in gay men. British Journal of Psychiatry, 161, 774–778.
Centers for Disease Control. (1987). Revision of the CDC surveillance case definition for AIDS. Morbidity and Mortality Weekly Report, 35, 1S–15S.
Clement, U. (1992). Psychological correlates of unprotected intercourse among HIV positive gay men. Journal of Psychology and Human Sexuality, 5, 133–155.
Coates, T. J., McKusick, L., Kuno, R., and Stites, D. P. (1989). Stress reduction training changed number of sexual partners but not immune function in men with HIV. American Journal of Public Health, 79, 885–887.
Cohen, J. (1977). Statistical power analysis for the behavioral sciences (rev. ed.). New York: Academic Press.
Coutinho, R. A. (1984). Sexually transmitted diseases among homosexual men: Studies on epidemiology and prevention. Doctoral dissertation, University of Amsterdam.
Derogatis, L. R., and Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595–605.
De Wit, J. B. F., Sandfort, T. G. M., De Vroome, E. M. M., Van Griensven, G. J. P., and Kok, G. J. (1993a). The effectiveness of condom use among homosexual men. AIDS, 7, 751–752.
De Wit, J. B. F., Van Griensven, G. J. P., Kok, G. J., and Sandfort, T. G. M. (1993b). Why do homosexual men relapse into unsafe sex? Predictors of resumption of unprotected anogenital intercourse with casual partners. AIDS, 7, 1113–1118.
De Wit, J. B. F., and Van Griensven, G. J. P. (1994). Time from safer to unsafe sexual behavior among homosexual men. AIDS, 8, 123–126.
Dupras, A., and Morisset, R. (1993). Sexual dysfunction among HIV positive gay males. Sexual and Marital Therapy, 8, 37–46.
Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111, 455–474.
Gant, L. M., and Ostrow, D. G. (1995). Perceptions of social support and psychological adaptation to sexually acquired HIV among White and African American men. Social Work, 40, 215–224.
Gochros, H. L. (1992). The sexuality of gay men with HIV infection. Social Work, 37, 105–109.
Goldberg, D. P., and Williams, P. (1988). A users guide to the General Health Questionnaire. Windsor: Nfer Nelson.
Hays, R. B., McKusick, L., Pollack, L., Hilliard, R., Hoff, C., and Coates, T. J. (1993). Disclosing HIV-seropositivity to significant others. AIDS, 7, 425–431.
Higgins, D. L., Galavotti, C., O'Reilly, K. R., Schnell, D. J., Moore, M., Rugg, D. L., and Johnson, R. (1991). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. Journal of the American Medical Association, 266, 2419–2429.
Kaisch, K., and Anton-Culver, H. (1989). Psychological and social consequences of HIV exposure: Homosexuals in Southern California. Psychology and Health, 3, 63–75.
Keet, I. P. M., Albrecht-van Lent, N., Sandfort, T. G. M., Coutinho, R. A., and Van Griensven, G. J. P. (1992). Orogenital sex and the transmission of HIV among homosexual men. AIDS, 6, 223–226.
Kippax, S., Crawford, J., Davis, M., Rodden, P., and Dowsett, G. (1993). Sustaining safer sex: A longitudinal study of a sample of homosexual men. AIDS 7, 257–263.
Koeter, M. W. J., and Ormel, J. (1991). General Health Questionnaire. Nederlandse bewerking. Handleiding. Lisse, The Swets and Zeitlinger.
Martin, J. L., and Dean, L. (1993). Effects of AIDS-related bereavement and HIV related illness on psychological distress among gay men: A 7-year longitudinal study, 1985–1991. Journal of Consulting and Clinical Psychology, 61, 94–103.
McCusker, J., Stoddard, A. M., Mayer, K. H., Zapka, J., Morrison, C., and Saltzman, S. P. (1988). Effects of HIV antibody test knowledge on subsequent sexual behaviors in a cohort of homosexually active men. American Journal of Public Health, 78, 462–467.
Ostrow, D. G. (1994). Substance abuse and HIV infection. Psychiatric Clinics of North America, 17, 69–89.
Persson, L., Hanson, B. S., Östergren, P. O., Moestrup, T., and Isacsson, S. O. (1992). Awareness of HIV-seropositivity and psychosocial factors influence on the sexual contact pattern: A population study of HIV infected homosexual men, in the city of Malmö, Sweden. Journal of Psychology and Human Sexuality, 5, 105–131.
Remien, R. H., Carballo-Diéguez, A., and Wagner, G. (1995). Intimacy and sexual risk behavior in serodiscordant male couples. AIDS Care, 7, 429–438.
Sandfort, T. G. M., Clement, U., Knobel, J., Keet, R., and De Vroome, E. M. M. (1995). Sexualization in the coping process of HIV infected gay men. Clinical Psychology and Psychotherapy, 2, 220–226.
Schaefer, S., Coleman, E., and Moore, A. M. (1995). Sexual aspects of adaptation to HIV/AIDS. Journal of Psychology and Human Sexuality, 7, 59–71.
Schönnesson, L. N. (1992). Traumatic and adaptation dimensions of HIV infection. Journal of Psychology and Human Sexuality, 5, 1–12.
Schönnesson, L. N., and Clement, U. (1995). Sexual attitudinal conflict and sexual behavior changes among homosexual HIV positive men. Journal of Psychology and Human Sexuality, 7, 41–58.
Van den Hoek, J. A. R., Coutinho, R. A., Van Haastrecht, H. J. A., Van Zadelhoff, A. W., and Goudsmit, J. (1988). Prevalence and risk factors of HIV infections among drug users and drug-using prostitutes in Amsterdam. AIDS, 2, 55–60.
Van Griensven, G. J. P., De Vroome, E. M. M., Tielman, R. A. P., Goudsmit, J., Van der Noordaa, J., De Wolf, F., and Coutinho, R. A. (1988). Impact of HIV antibody testing on changes in sexual behavior among homosexual men in the Netherlands. American Journal of Public Health, 78, 1575–1577.
Van Griensven, G. J. P., Tielman, R. A. P., Goudsmit, J., Van der Noordaa, J., De Wolf, F., De Vroome, E. M. M., and Coutinho, R. A. (1987). Risk factors and prevalence of HIV antibodies in homosexual men in the Netherlands. American Journal of Epidemiology, 125, 1048–1057.
Wolitski, R. J., MacGowan, R. J., Higgins, D. L., and Jorgensen, C. M. (1997). The effects of HIV counseling and testing on risk-related practices and help-seeking behavior. AIDS Education and Prevention, 9(Suppl. B), 52–67.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
de Vroome, E.M., de Wit, J.B., Stroebe, W. et al. Sexual Behavior and Depression Among HIV-Positive Gay Men. AIDS Behav 2, 137–149 (1998). https://doi.org/10.1023/A:1022146913861
Issue Date:
DOI: https://doi.org/10.1023/A:1022146913861