Objective: This study evaluated psychological and behavioral aspects of quality of life and medical care utilization in a population of gay men whose intake records at a New York City agency indicated the presence of an AIDS-defining opportunistic infection at least three years before entry into the study. Methods: Fifty-three men participated in a standardized psychiatric assessment of current mood disorders, psychiatric distress, future outlook, quality of life, and physical functioning using several clinician-ad self-rated scales ad a semistructured interview. Results: Almost all of the men bad experienced more than one episode of life-threatening illness, ad many had been led to believe that they had only months to live. Nevertheless, low rates of current syndromal mood disorders and psychiatric distress were found. Degree of physical impairment was unrelated to psychiatric distress or life satisfaction, although men with more limited physical function were less optimistic about the future. Conclusions: Nearly all study participants displayed an extraordinary psychological resiliency ad shared the conviction that good times lay ahead ad that life continued to be worth while.