Clinical Psychology and Psychotherapy Clin. Psychol. Psychother. 8, 49 – 58 (2001) Predicting Health Distress and At-Risk Sexual Behaviour in a Group of Italian Asymptomatic HIV-infected People Claudio Sica, 1 * Caterina Novara, 1 Giampiero Carosi, 2 Salvatore Casari, 2 Stella Dorz, 1 Paola Nasta 2 and Ezio Sanavio 1 1 Department of General Psychology, University of Padova, via Venezia, 8, 35131 Padova, Italy 2 Department of Infectious and Tropical Diseases, University of Brescia, Italy One hundred and one asymptomatic seropositive subjects (66% intra- venous drug users, 22% heterosexuals and 12% homosexuals) were evaluated on demographic, medical and behavioral variables, using the Coping Orientations to the Problems Experienced and Medical Outcomes Study — HIV, together with questions on perceived social support. The homosexuals, those using coping strategies involving poor control of the situation, those with fewer years of seropositivity and the younger and less educated subjects more frequently adopted at-risk sexual behavior. Avoidance and problem-oriented strategies were predictive of health distress, whereas a positive attitude and the search for support appeared to offer some degree of protection against stress. No medical variable among those considered turned out to be linked to health distress. This study suggests that, in asymptomatic seropositive people, coping and social support are essential in man- aging the disease and of moderate importance in predicting at-risk sexual behaviour. Copyright  2001 John Wiley & Sons, Ltd. A patient’s management of a chronic and/or lethal disease is influenced by several psychosocial variables. In particular, coping strategies and the degree of available social support have a certain influence on the patient’s level of psychopathology and positive or negative perception of health and overall quality of life (e.g. Carver et al., 1993; Revicki et al., 1995). HIV infection gives rise to several psychological problems, due both to the special progress of the disease and because of the social stigma surrounding it (Antoni and * Correspondence to: Claudio Sica, Department of General Psychology, University of Padova, via Venezia, 8-35131 Padova, Italy. E-mail: sica@psico.unipd.it Contract/grant sponsor: Istituto Superiore di Sanit` a, Roma, IX Aids Project; Contract/grant number: 9404-35. Emmelkamp, 1995; Emmelkamp, 1996) Indeed, it is not implausible to assume that lengthening of the asymptomatic phase of the disease, as a result of improved medical progress, is beneficial to those who succeed in managing the disease itself in an effective manner. Thus, study of the role of coping strategies, social support and the quality of life in seropositive subjects may be useful in identifying variables linked to health distress. The particular modes of transmission of HIV and the only partial efficacy of prevention campaigns (e.g. Desenclos et al., 1993; Kelly et al., 1995) mean that study of the personal characteristics of seropositive subjects who continue to adopt high- risk behaviour is essential. Knowledge of certain characteristics linked with high-risk behaviour may help in improving prevention strategies. Copyright  2001 John Wiley & Sons, Ltd.