Objective: Investigate the relationships between pain, stress, social support, and sleep disturbance among a diverse sample of HIV-positive adults. Method: Participants (N = 146) completed self-report measures on pain, stress, social support, and sleep disturbance. CD4 T-cell count was obtained from medical records. Results: Greater pain and stress were associated with greater sleep disturbance. Greater assistance from friends was associated with greater sleep disturbance, whereas greater understanding from friends regarding participants' HIV-related stress was associated with less sleep disturbance. Conclusion: As expected, pain was significantly associated with sleep disturbance. Additionally, psychosocial variables were strongly associated with sleep. The type of support from friends differentiated whether the support was positively or negatively associated with sleep problems. Social support, depending on the type, may not always be helpful for adults living with HIV/AIDS. Future studies need to examine factors that may mediate the relationship between psychosocial constructs and healthy sleep. (C) 2004 Elsevier Inc. All rights reserved.