Coping Strategies,Substance Use,Sexual Activity,and HIV Sexual Risks in a Sample of Gay Male STD Patients1

The relationships of coping strategies with levels of substance use and sexual activity, and with HIV sexual risks, are examined in a sample of gay male STD clinic patients (n = 416). Previous research has suggested that use of problem-focused coping strategies should be negatively related to levels of substance use, levels of sexual activity, and HIV sexual risks; use of emotion-focused coping strategies should be positively related to these outcomes. It is argued that substance use and sexual activity clearly fit within a coping perspective, but that the HIV sexual risks/coping relationship is less clear. In multivariate analysis, the problem-focused strategy of advice seeking is negatively related to the number of types of drugs used and to the number of sexual partners; the problem-focused strategy of support seeking is negatively related to the number of days using drugs; and the use of emotion-focused strategies is positively related to the number of types of drugs used. Problem-focused coping strategies are less directly related to engaging in HIV sexual risks when measures of substance use and of sexual activity are included in the prediction; emotion-focused coping strategies are more stably related to HIV risk. Indirect effects of coping on HIV risk are also identified through the effects of coping on the number of types of drugs used, number of sex partners, and number of times having sex. It is proposed that the relationships between coping and levels of substance use and sexual activity reflect the use of these activities as ways of relieving strain, but that relationships between coping and HIV sexual risks involve less clearly understood direct and indirect relationships.