Psychosocial and psychopathological features of HIV-positive men who engage in high‑risk behavior

The aim: to assess the mental, psychological, and social characteristics of men with risky behavior in a cohort of people living with HIV (PLWH).
Materials and methods. 114 men infected with the human immunodeficiency virus (HIV) via male-to-male sexual contact were examined. The clinical-anamnestic method (medical record review), laboratory tests, and an experimental-psychological method in the form of questionnaires were used.
Results and discussion. According to our study, 76% of the men had higher, unfinished higher, or vocational/secondary education, and 90% were actively employed. The mean duration of follow-up at the Center for the Prevention and Control of AIDS and Infectious Diseases (AIDS Center) was 5.2±4.5 years. Virological success of antiretroviral therapy (ART) (HIV RNA<40 copies/mL) was achieved in 81% of patients. Current or past hepatitis C virus infection was detected in 23% of the men. A history of treatment for sexually transmitted infections (STIs) was reported by 78% of patients, of whom 61% had ever had various forms of syphilis. Ninety-three percent of respondents were aware of the possibility of post-exposure prophylaxis for STIs, but only 29% had used it. Group sexual practices were reported by 61% of the men, and 22% had experience of commercial sex. Sixty-eight percent of patients had been seen by a psychiatrist at the AIDS Center. Among psychiatric diagnoses, the most common were substance dependence syndromes (27%), neurotic and stress-related disorders (22%), and organic mental disorders (20%). Use of psychoactive substances (PAS) was acknowledged by 38% of the men; of these, almost half (41%) used synthetic cathinones for chemsex. At the time of the study, 20% of respondents were actively drug-dependent. According to the personality structure assessment (Mini‑SMIL), MSM predominantly demonstrated optimism (3.3±1.3), femininity (2.6±1.0), and impulsivity (2.6±1.0). Patients with casual sexual contacts less frequently exhibited schizoid personality traits (Mini‑SMIL) (p=0.02), less frequently reported emotional lability (p=0.03), more often had elevated mood (p=0.006), and more often used psychoactive substances (p=0.01).
Conclusion. HIV-infected MSM demonstrate low psychological resilience and require the development and implementation of comprehensive prevention and support programs.

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