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Toby sound bleak when he scribed the Christian lerature she regularly sent him about the evils of homosexualy and how gays were beg plagued by AIDS as punishment om God. After more than three s of safer sex msag agast the backdrop of gay men sickeng horribly and then dyg, new medil treatments have stemmed the ti of the panmic and offered real hope for longer-term survival to people wh HIV. Queer theorist Tim Dean (2000) wr: "In view of statistics on new seronversns, some AIDS tors have begun to acknowledge that, unlikely though may seem, remag HIV-negative fact pos signifint psychologil challeng to gay men" (p.

To those who have not been workg the gay men's muny for the past 25 years, this statement might seem absurd, but is te that HIV-negative gay men face unique challeng that make seem almost easier to seronvert.

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San Francis Bay area psychologist Walt Ots (1995) was one of the first mental health profsnals to qutn why gay men who had th far ped beg fected wh HIV were placg themselv at risk for beg so. Ots scribed HIV-negative men who stggled a world and gay muny that, however untentnally, nsired their difficulti nsequential as pared to those of men who were fightg for their liv.

Some have suggted that durg the '80s, gay men unnscly llud wh the general public's equatn of a gay inty wh an AIDS inty (Ots, 1995; Rof, 1996). New York social worker Steve Ball (1998) scrib how durg the height of the AIDS epimic HIV-negative gay men often found themselv the role of regiver, mourner/widower, or outsir, due to their not beg fected wh HIV.

In 1988, I wrote about how fear was one large ponent of what propelled gay men to change how they were havg sex (Shernoff & Jimenez, 1988). Gay men who were recently surveyed about their failure to e ndoms durg anal sex repeatedly told rearchers that current AIDS preventn msag do not feel relevant to them and do not nvey an urgency about why ndom e is important (Halkis, Parsons, & Wilton, 2003; Carballo-Dieguez & L, 2003; Mor et al., 2003).

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For many younger gay men and for newly sexually active gay men, AIDS is associated wh the past (Van Ven, Prtage, Knox, & Kippax, 2000). Brish psychologist and rearcher Michelle Crossley (2001, 2002) wr that one factor might be a crease the effectivens of the "health promotn" mpaign to change gay men's sexual behavr.

Crossley suggts that is impossible to evaluate the efficy of safer-sex msag and of themselv sce ncurrent to when they first began appearg, gay men were overwhelmed by the terror that they might be fected by the then-new disease that was rapidly killg their iends and lovers. They reported beg thrilled to be able to participate a procs that helped them reclaim the joy and fun of gay sex amidst all of the sex-negativy and sex-equalg-ath msag that were undatg them.

There are numero theori for why gay men engage unprotected sex, and rearch has explored a wi variety of possible ratnal for the behavr. As psychologist and former rearcher at the CDC Ron Stall was quoted as sayg an article the Manhattan gay newspaper Gay Cy News, "There are studi that monstrate a variety of psychosocial health issu, cludg prsn, antigay vlence, childhood sexual abe, or substance abe, n lead gay men to have unsafe sex" (Stall, quoted Osborne, 2002, p. In my own practice, I have intified several factors that appear to lead to sexual risk-takg: lonels, beg HIV-posive, havg unmet timacy needs, feelg alienated om the gay muny, beg love, and a cravg for eper timacy and tst.

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