Rates of hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM) appear to be high and rising. In other demographic groups, HIV/HCV-coinfection is associated with poor physical and psychological outcomes. In this study, we examined health-related and psychosocial correlates of HIV/HCV-coinfection in a clinic sample of MSM. Cross-sectional data were collected from 171 MSM. One-third of the sample was coinfected. Higher rates of depressive and PTSD symptoms were observed in coinfected patients. Coinfected men were more likely to report perfect 30-day medication adherence, but exhibited lower CD4 cell counts and more past year emergency room visits. Despite consistent engagement with care and higher rates of medication adherence, HIV/HCV-coinfected MSM exhibited significantly more mental health problems. Medical and mental health providers should be especially attentive to the mental health status of HIV/HCV-coinfected MSM, despite adequate health behaviors and physical health status.