What Gay Guys Need to Know about HIV and Mental Health

by | Gay Mental Health

“The lab results are in. You are HIV positive.”

Pause. Shock. Panic. Overwhelm.

What do I do now?

HIV is one of the most stigmatized health conditions there is. Starting from the emergence of the HIV/AIDS crisis in the 1980s up to modern day–HIV stigma is alive and well. 

The good news is that HIV is no longer considered a terminal illness when people are receiving care and treatment.

HIV is now considered a chronic and manageable health condition. People living with HIV can live full lives with modern antiretroviral medications. 

While the physical and biological side of HIV is often easily treated with a once-a-day medication regimen, there are certain challenges to mental health that can arise from having to manage a chronic health condition.

By outlining these challenges, my intention isn’t to further stigmatize HIV. Rather, it’s to let you know that if you’re struggling, you’re not alone in your experience, and that support is available.

A diagnosis of HIV can feel incredibly scary and daunting. But with appropriate support, your mental health can thrive.

In other words, you can live a full, rich and meaningful life AND have HIV.

When I work with clients with HIV, we often discuss the burden of managing a chronic illness. This can include the need to take medication daily, getting regular bloodwork done and seeing your healthcare provider regularly.

On paper these may sound like easy tasks, and for some they are. But for others, these tasks can bring up feelings of anxiety, annoyance or overwhelm.

If you feel depressed because of the diagnosis, it can be hard to find motivation to take medications or to leave the house to get bloodwork done.

Unfortunately, the healthcare system hasn’t always treated 2SLGBTQ+ people well, and has contributed to a “double discrimination” for folks who are gay and positive. As a result, it can feel very discouraging to access healthcare. Sadly, not all healthcare providers (or even therapists) are knowledgeable about HIV, and may even perpetuate HIV stigma.

Sometimes people take this stigma and turn it inwards.

When this happens, people can struggle with internalized HIV stigma and internalized homophobia. This internalized stigma can show up as beliefs like “I am worthless,” “I am dirty” and “I am broken.”

These beliefs can challenge your sense of self-worth and self-concept. At the end of the day, it can feel as if the HIV gets to determine if you’re a good person or not.

In therapy, I help clients see that an HIV diagnosis is just one aspect of your life – and that YOU get to determine your worth, not a health condition, or any judgemental person/ system. 

Dating and disclosure are also common sources of stress for people with HIV.

These are a few of the most common questions about dating and communication I’ve helped people navigate in counselling:

When and how do I tell a potential partner?

Should I tell my family my HIV status?

How do I navigate sex as a positive person?

Will anyone even want to date me?

What if my friends find out about my status?

If you’re struggling with these questions, it can be helpful to explore them with a trusted person in your life–an understanding friend, a peer support worker, a therapist or an HIV knowledgeable healthcare provider. 

HIV can feel overwhelming. But there are strategies that can not only help you cope, but grow.

Often gay men already have experience with coming out as gay, so they can draw from that experience and use similar skills in coming out as positive.

It can be a rough road, and there is the potential for rejection.

But there’s also potential for support, connection and breaking free of the shame or guilt that can show up when you’re living with HIV. 

HIV stigma doesn’t only impact people who are positive.

HIV stigma can also cause distress for people who are negative.

For example, stigma can make sexual encounters feel terrifying rather than pleasurable.

Stigma can also lead to having obsessive thinking related to potential HIV transmission, which may get in the way of your daily living and cause you to lose sleep.

These challenges can be complicated further by factors like having a needle phobia, which can make getting tested for HIV challenging.

Thankfully, therapy can be helpful in addressing these fears, as well as learning more about HIV transmission. There are many myths about HIV out there, so finding good, reputable sources of information is critical. 

So how do you work through HIV stigma?

Get educated.

The more you know, the less scary HIV becomes, whether you are positive or negative. 

If you’re HIV negative, there are several tools you may want to access that can help reduce the risk of HIV transmission – including condom usage, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and undetectable=untransmittable (U=U).

If you’d like to learn more about HIV, consider visiting CATIE’s website, a trustworthy source of HIV information.

If you’re looking for an HIV knowledgeable counsellor, click the button below to book a free consult with me.

Victor Wakarchuk Registered Social Worker (RSW) Master of Social Work (MSW) Bachelor of Social Work (BSW) British Columbia BC Gay Men LGBTQ Online Virtual Counseling Counselling Therapy Teletherapy


As a counsellor at The Centre for Gay Counselling, Victor excels at helping gay men find freedom from anxiety, stress and overwhelm so that they can start living life to the fullest again. Interested in working with Victor? Click the button below to get started.