HIV and Gay Men
The Psychological Complexities of the HIV Positive Man
By: Jim Weinstein, M.F.T.
Therapists love to label, to categorize, and to diagnose. It’s a way to reduce the infinite variety of human experience into discreet segments that seem graspable, knowable, and (when necessary) even fixable. It is tempting to oversimplify a short article about the psychological effects of HIV. Yet the truth is that an essential part of understanding HIV’s emotional impact is to recognize that it is as complex as the disease itself.
Accordingly, I’ve decided to list a baker’s dozen of the major issues I’ve encountered in talking with hundreds of HIV positive men over the past decade. These are the variables that determine the unique, personal shape of the disease’s shadow on their lives. I believe that only through the process of understanding and honoring their individual circumstances can that shadow be lifted, and healing occur. In the interest of simplicity, I will be referring primarily to how HIV/AIDS impacts gay men, as they form the bulk of my clinical practice and are also the vast majority of the readers of this publication.
AGE: HIV’s psychological impact can be vastly different on a man in his 20s than on a man in his 40s. For a younger man, the diagnosis is generally much harder to take. Not only does it complicate the “my best years are ahead of me” thinking, but it can feel much more isolating. Older men often find some solace in the memory of friends and lovers who’ve suffered before them, a comfort seldom accessible to the younger guy, who may not know anyone who’s openly positive or who’s died of the disease.
ANXIETY: It’s hard to imagine a condition more anxiety provoking than HIV. In addition to the worries about declining health, bodily deterioration, and the possibility of premature death, there are anxiety-producing situations that someone who’s HIV positive may confront many times on a daily basis: Did I remember to take my pills? How far is the nearest toilet? Should I tell this guy that I’m positive? Not to mention longer-term worries: is my face looking gaunter? If I lose my job, what will I do about medical insurance? Should I worry about planning for retirement?
