Fear of HIV: Counselling for Gay Men

sign to confession and counsellingI’m so worried about HIV I can’t enjoy sex…
… every time I say ‘that’s the last time I bareback’, but then I do it again…
…I’m thinking about going on PrEP.

Fear of becoming HIV positive remains a significant source of anxiety for many gay men. If you are worried during or after gay sex, talking it over could help.

It’s just over 2 years since I started this blog and today I realized I hadn’t posted anything about a topic that comes up quite often in both my online therapy and Sydney clinic practice: Anxiety around HIV.

I started my professional career talking about sexual health and HIV with gay and bi guys. Over the last 25 years, scientific knowledge about HIV has grown steadily. Accessibility of treatments mean that many gay men now describe their HIV status as ‘undetectable’. Others are using medication like Truvada as PrEP (Pre-exposure prophelaxis) to protect themselves from HIV.

Yet fear of contracting HIV through gay sex continues for successive generations of men. The anxiety experienced by some guys after sex can be debilitating and disruptive to the functioning of their lives. And whether the sex itself is low risk or not, anxiety can still be present.

So why, when there is so much information around about how to have safer sex, do some men experience such anxiety?

Gay Shame and Risk-Taking

In my experience, it’s not only risk-taking that can lead to fears about contracting HIV, shame plays a huge role as well. This is particularly the case with penetrative sex between men. Feelings of shame get in the way of negotiating sex but also in seeking help or support when something risky has happened.

When people feel bad about what they have done, they are more likely to imagine others judging them and less likely to seek out help.

When gay and bisexual men do seek help they might encounter prejudice (yes! Even in Sydney!). Some medical practitioners, and – it seems terrible to write this – some psychologists and counsellors, respond to anecdotes of risk by treating the person as a pathology. Many of my clients have told me they were diagnosed with a sex addiction when their sexual lives did not match up to a professional’s ideas of what was ‘normal’.

Obviously this feeds shame as well.

We make sense of our lives through telling stories to ourselves and others about something that has happened. It helps us to decide what to do next. So when a man cannot talk about the sex he is having, or what he would prefer to be happening, it makes it much harder to make changes. When professionals are judgemental or show a lack of acceptance about gay sex, or barebacking, gay and bisexual men become reluctant to talk.

The Cycle of Worry about Sex

I’ve found this with men of all ages including young guys in their twenties who are starting to have sex and men in their forties and fifties who are coming out of straight marriages. A lot of men try to sort out their anxiety on their own. And it is not uncommon for gay men to cycle through phases: An occasion of sex leads them to worry (a bareback experience, for example), so they decide to be celibate, only to suddenly abandon that when it becomes unsustainable.

While it might seem embarrassing to begin with, talking over your choices with a non-judgemental professional can lead to more sustainable ways of managing your sexual desires. Taking extreme measures might seem the only option but is usually unrealistic. And deciding how to handle different scenarios in advance can leave you free to be in the pleasure of the moment while avoiding the worry that comes with regret.

Advances in HIV prevention mean that there are now more choices available to men who have sex. PrEP, a medication that has been shown to be effective against HIV transmission when taken as instructed, is one way some guys are choosing to protect themselves. But to work out what is right for you, it can be worth having a chat to a sympathetic GP or counsellor.

For more information about my services, or to make an appointment to see me in Sydney or online, contact me.

Holding the Man: Finding Your Way To And Back to a Gay Relationship

Ryan Corr and Craig Stott in Holding the ManIs it possible for guys to fall in love?
Can two men have a successful relationship?
Do gay relationships last?

In my work providing counselling and therapy for gay and bisexual men, clients still ask these questions. That’s a sad reflection on how rarely we see gay relationships depicted in movies and on tv.

But now we have the film adaptation of Holding the Man, which along with Priscilla and The Sum of Us (1994), Head On (1998) and Walking on Water (2002) comprise the few internationally recognised gay Aussie feature films from the last thirty years.

It’s about time isn’t it? After a decade of virtual invisibility we finally have a love story that will (hopefully) get people talking. I reckon that most gay men in their thirties and over in Australia have heard of Holding the Man. We’ve read the original memoir Holding the Man by Tim Conigrave and many have seen the play by Tommy Murphy which has been staged in the Australian capitals as well as in London, San Francisco and LA. Ten years we have a film which is arguably more accessible and potentially of more influence than the book or play. And while most of the mainstream press is presenting the film from a marriage equality angle, I’d suggest they are missing the point. Holding the Man isn’t simply Tim Conigrave’s contribution to the gay romance genre. It is his confessional.

My Tim Story (because everyone’s got one!)

Right now everyone seems to have a story about Tim Conigrave. So I’ll keep mine brief. It’s 1989, I’m twenty years old living on the Gold Coast and a few months into my first professional role. I’m paid to lure gay guys to afternoon teas where I dispel myths about HIV and we chat about safe sex using bananas and condoms as props. Tim and his colleague who run the Fun & Esteem Project at ACON in Sydney have crashed-trained me one weekend along with a bunch of other ‘peer educators’ from across the country. And I’m channeling his presence with men twice my age. He’s a big man who can do both camp and authoritative on a turn. I’m carrying his confidence to conceal my shyness and compensate for my age. And now he is calling me to offer me an interview.

“What you’ve been doing there is really impressive,” Tim tells me over the phone from Sydney.
“But how likely is it I’ll get the job?” I ask.
“All I can say is get yourself down here.”

When you’re twenty, there’s a lot of reassurance and good feeling in hearing this from a man ten years senior. I was a boy from the ‘burbs of Brisbane. Sydney meant sophistication and sex packaged up in rows of terrace houses, beaches, bars and saunas. But I never went to the interview. I had a boyfriend who preferred to stay put. Ironically we broke up shortly afterwards. A few years later I applied again and ended up doing Tim’s job at ACON.

Two men kissing in a lift

Making Gay Lives Visible

Timothy Conigrave was passionate about social issues as well as performance. His commitment is kept alive not only by these creative works but initiatives like The Institute of Many, a platform for HIV positive people to share experiences. But Holding the Man honours him less by justifying marriage equality than by reminding us of the devastation that public ignorance does to the lives of LGBT people. In this respect it parallels Torka Aldrig Tårar Utan Handskar, Jonas Gardell’s amazing work about HIV in Sweden in the 80s and 90s. On the same weekend that Holding the Man opened in Sydney, the NSW government banned Gayby Baby, a film about same sex parenting. Given what we should have learned about the importance of making LGBT lives visible, that is disturbing.

Aside from dispelling myths and changing attitudes, the significance of Holding the Man is really in the personal story Tim has to tell.

Is it possible for guys to fall in love?
Yes, absolutely, but don’t expect it to always be comfortable.

Can two men have a successful relationship?
Define ‘successful’. Are how will you maintain that relationship when those around you might not understand it? Or when you and your partner want different things?

Do gay relationships last?
Go and see the film and tell me what you think then.

Want to talk about gay relationships? You can make a counselling appointment with me in Sydney or online.

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