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Psychoanalytic Treatment of an Asymptomatic HIV-Positive Gay Man

Abstract This paper describes the psychoanalytic treatment of an asymptomatic HIV-positive gay man. At present, the analysis is in its fifth year, and termination themes are apparent and central to the analysis, although a termination date has not yet been set. This patient presented a formidable challenge to psychoanalytic treatment, independently of his serological status. The patient's history of alcoholism, suicide attempts, depression requiring pharmacological maintenance, and his general proclivity to acting out, coupled with the restricted nature of his object relations, made the decision of whether to treat him with psychoanalysis versus psychoanalytic psychotherapy a very difficult one.