Assessing Maladaptive Responses to the Stress of Being at Risk of HIV Infection among HIV-Negative Gay Men in New York City

The aim of this study was to examine the psychometric properties and preliminary validity of a newly developed 16-item measure to assess maladaptive responses to the stress of being at risk for HIV infection among HIV-negative gay men. The measure consisted of three factors: (a) fatalistic beliefs about maintaining an HIV-negative serostatus, (b) reduced perceived severity of HIV infection due to advances in medical treatment of HIV and AIDS, and (c) negative affective states associated with the risk of HIV infection. A total of 285 HIV-negative gay men at a counseling program in New York City participated in the study. Confirmatory factor analyses supported the three-factor model as an acceptable model fit: non-normed fit index = .91, comparative fit index = .92, goodness-of-fit index = .90, and root mean square error of approximation = .07. The measure and its subscales obtained in this sample achieved adequate internal consistency coefficients. Construct validity was supported by significant and positive associations with internalized homophobia, depression, self-justifications for the last unprotected anal intercourse (UAI), and actual UAI with casual sex partners. Understanding the dynamics of maladaptive responses to the epidemic and intense anxieties elicited by HIV risk among HIV-negative gay men living in a place of high seroprevalence provides useful information to guide psychosocial interventions in the population.