Biopsychosocial factors in homosexual men with AIDS: A study of psychological distress, body image, physical symptoms and social support

In an attempt to better understand the variables affecting the psychological adjustment of people with AIDS, this study investigated select relationships among psychological distress, body image, social support and physical symptomotology in a sample of 100 homosexual men with AIDS. While some of the variables chosen for study have received limited attention in previous investigations, this research appears to represent the first attempt to investigate body image and visibility of physical symptoms in any HIV-positive population. All subjects completed sociodemographic and AIDS medical information questionnaires, the Brief Pain Inventory, Physical Symptom Checklist, Social Support Questionnaire-Short Form (SSQ6), Multidimensional Body-Self Relations Questionnaire, and a modified version of the Brief Symptom Inventory (Somatic scale omitted). Results showed that evaluations of appearance, health and fitness were significantly negatively associated with psychological distress. Appearance and health evaluations were also negatively related to number of current HIV-related symptoms, and health evaluations tended to be lower for subjects with pain than for those without. In addition, psychological distress was negatively correlated with satisfaction with social support and with number of current HIV-related symptoms. Only trends were observed between psychological distress and number of past HIV-related symptoms and presence of physically visible symptoms, respectively. Neither availability of or satisfaction with social support were found to be related to number or visibility of symptoms, nor appearance evaluations. Supplementary analyses revealed the additional predictive value of various demographic and treatment-related factors, such as race and use of various medications, and indicated significant differences between the present sample and a group of non-HIV-infected homosexual men on evaluations of appearance and fitness. The present research indicates that homosexual men with AIDS commonly experience alterations in body image and related symptoms of psychological distress. Also, physical symptomotology, particularly number of current HIV-related symptoms and pain, and satisfaction with social support appear especially important when identifying those individuals most at risk for psychological maladjustment. Finally, corroboration was found for previous theories on the importance of peer-based available and resilient support for gay men