Collaborators in Massachusetts and Canada examined the relative contribution of mental health and HIV-related health indices in health perceptions and self-reported functional impairment among 79 MSM with HIV and trauma histories living in urban areas.  Participants were included if they reported sub-optimal engagement in HIV care.  In addition to a self-report assessment battery, trained clinicians appraised participants’ mental health, and recent CD4 and HIV viral load values were abstracted from electronic medical records.  On average, participants reported poor health, and functional disability was common.  48% reported childhood or adolescent sexual trauma, 56% childhood or adolescent physical abuse, 63% intimate partner violence, and 43% unwanted sexual experiences during adulthood.  Almost 52% met DSM-5 criteria for post-traumatic stress disorder (PTSD) and 42% endorsed a history of major depressive disorder.  Depression symptom severity accounted for the majority of variance in participants’ perceptions of their health, and both depression and PTSD symptom severity were influential in accounting for functional impairment.  Recent CD4 and HIV viral load did not explain significant variance in self-perceptions of health or functional disability.