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SynopsisThe aim of this study was to determine whether HIV infection is associated with increased psychosocial distress in the asymptomatic and early symptomatic stages of disease and to determine the factors associated with reporting health symptoms. Subjects included 61 gay men (41 HIV −, 20 HIV +) who were assessed at the time of requesting their first HIV test and again 12 months later. Measures included a detailed standardized psychiatric interview (Present State Examination, PSE), a range of psychosocial self-report measures and a physical symptom checklist. There were no differences between the HIV + and HIV − groups in terms of self-reported symptoms. Multiple regression analysis showed that the symptom reporting was not associated with clinical or immunological markers of disease progression but was associated with measures of psychosocial distress. Although both groups showed elevated levels of psychosocial distress at the time of HIV testing, there were no differences between serostatus groups at follow-up. Multiple regression analysis indicated that the best predictors of PSE scores at follow-up were baseline PSE score and a history of psychiatric illness. Early HIV disease is not associated with increased psychosocial distress and symptom reporting is more closely related to psychological measures than to clinical or immunological markers of disease.

It has been suggested that HIV infection is associated with an increased risk of suicidal behaviour. This paper reviews the literature on suicide in patients with HIV disease and discusses methodological problems encountered in studying the incidence of suicide in this population. A snowballing method was used to identify cases of suicide in patients who were receiving treatment for HIV disease in a central London health district. The possible under detection of suicides among AIDS patients is considered. The six case reports are described to illustrate the clinical and psychosocial characteristics of suicides, and they are discussed in relation to other findings on suicide in patients with HIV disease and other physical illnesses.

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