title: Concealment of homosexual identity, social support and CD4 cell count among HIV-seropositive gay men.
abstract: OBJECTIVE
  Previous research has indicated that the concealment of homosexuality is related to poorer health among gay men with HIV. This study explored mechanisms by which concealment of homosexuality may be related to HIV disease status by examining associations between concealment of homosexuality, social support, social constraints, depressive symptoms and CD4 count among HIV-seropositive gay men.
  
  
  METHODS
  Questionnaires assessing concealment of homosexuality, social support, depressive symptoms and social constraints were administered to 73 HIV-seropositive gay men. Medical charts were accessed to gather HIV disease information including CD4 counts. Regression analyses were conducted to examine associations between psychosocial variables and CD4 counts.
  
  
  RESULTS
  Concealment of homosexuality was associated with lower CD4 count, greater social constraints, greater depressive symptoms and less social support. The association between concealment of homosexuality and CD4 count varied according to level of social support. Among participants with higher levels of social support, those with greater concealment had lower CD4 counts than those with lower concealment. Concealment of homosexuality was not related to CD4 count among participants reporting low social support.
  
  
  CONCLUSIONS
  Concealment of homosexuality among HIV-seropositive gay men is associated with lower CD4 counts, depressive symptoms and strained social relationships. In addition, the benefits of being open about homosexuality may be most evident under conditions of greater social support.
authors.affiliation: Department of Psychology, University of Iowa, E-11 Seashore Hall, Iowa City 52242, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Ullrich
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
authors.forename: Jack T
authors.initials: JT
authors.lastname: Stapleton
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D003863:Depression; D015658:HIV Infections / Q000276:immunology* / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012044:Regression Analysis; D012924:Social Conditions; D012944:Social Support; D014342:Truth Disclosure