Stress and coping theory (9) provides a framework for understanding how psychological responses to stressful life events may increase suicide risk. HIV-positive persons commonly experience a variety of chronic, uncontrollable stressors that can cumulatively contribute to the perception that living with this stigmatized illness is intolerable. Precipitating events are conceptualized as specific stressful life events that are linked to increased suicide risk. These can be general (e.g., bereavement) or HIV-specific (e.g., the experience of ART-related side effects and HIV disease progression) stressors that often revolve around the themes of harm or loss. Individuals actively evaluate or appraise their environments to determine the nature of stressful events (primary appraisals) as well as the internal and external resources available for managing stressors (secondary appraisals). Primary appraisals of precipitating events as harmful and uncontrollable coupled with secondary appraisals of resources as lacking can promote cognitive-behavioral disengagement. Cognitive-behavioral disengagement is characterized by reliance on cognitive and experiential avoidance as a means of coping. Avoidance of thoughts and feelings related to stressful events is often accomplished by a narrowing of oneâs attention focus to sensations in the present moment. These cognitive changes promote behavioral disinhibition, which places one at elevated risk for suicidal or parasuicidal behaviors and may also increase engagement in other risk-taking behaviors, such as substance use. Over time, this pattern of cognitive-behavioral disengagement may lead directly to feelings of hopelessness and a pervasive sense of pessimism, which in turn increase suicide risk. The relevance of cognitive-behavioral disengagement is supported by an investigation that found that greater escape-avoidance coping is associated with suicidal ideation (10). However, these cognitive-behavioral vulnerabilities do not universally lead to increased suicide risk. Sources of psychological resilience (e.g., social support) can buffer the deleterious effects of precipitating events and promote the search for meaning (e.g., spirituality/religiosity) that is crucial to reappraising events and building resources for managing life events that were initially viewed as intolerable. Resilience factors that bolster coping self-efficacy (secondary appraisals), enhance positive reappraisal coping efforts, and decrease cognitive-behavioral disengagement may reduce suicide risk (3, 10).