Spared at Random: Survivor Reactions in the Gay Community1


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    Preparation of this article was supported by funding from the National Institute of Mental Health (MH42918) to Shelley E. Taylor and Margaret E. Kemeny. This research was also conducted in collaboration with the Multicenter AIDS Cohort Study (MACS) funded by the National Institute of Allergy and Infectious Diseases (N01-AI-72631). The first author was also supported by the National Institute of Mental Health (MH19200—Postdoctoral Interdisciplinary Training Program) for final preparation of this article. We would like to acknowledge the assistance of Valarie Hannemann, Michael Newcomb, Joanne Wang, and the Multicenter AIDS Cohort (MACS) staff and participants.

Correspondence concerning this article should be addressed to Margaret E. Kemeny, Department of Psychiatry and Biobehavioral Science, Box 9, University of California, 405 Hilgard Avenue, Los Angeles, CA 90024–1563.


Many gay men who have tested negative for HIV were sexually active prior to a general awareness of how HIV is transmitted. Based on the work of Lifton (1980), such HIV-negative gay men may be considered “survivors” since they have witnessed the deaths of many members of their community and have been spared. Survivors may be expected to manifest one or more of three survivor reactions: guilt about surviving (HIV-related guilt), anxiety about dying (AIDS-related death anxiety), and blunted affect. The present study employed structural equation modeling in samples of HIV-negative (N= 129) and HIV-positive (N= 95) gay men to assess psychological and behavioral variables predictive of the presence of a survivor reaction. Survivor reactions were uniquely predicted among HIV-negative gay men. The larger the number of sexual partners HIV-negative gay men reported having had prior to 1984, the more likely they were to experience a survivor reaction. Greater satisfaction with social support from gay friends, and, indirectly, gay-related community group involvement, was associated with being less likely to experience a survivor reaction.