Psychological sexuality features in people living with HIV with and without substance use as a determinant of the HIV epidemic growth were explored. The study involved 136 respondents (2 groups of 50 people with different infection routes: blood-borne infection route and heterosexual transmission; 36 individuals without HIV). The following research methods were used: a specially developed clinical map, an original author’s questionnaire « Infection risk and the disease situation» (allows to register the main characteristics of the life situation of the disease), the incomplete sentences test of Sachs - Levy, Freiburgh Personality Inventory, I-structure Ammon test. Data processing included the Fisher criterion (Fisher angular transformation), ANOVA, content analysis. Significant negative effects in sexual sphere related to gender and the presence of HIV were revealed in the study. It has been established that people living with HIV with and without substance use differ in the frequency of concealment of HIV st