cropped gay therapy la logo

Help for When You Receive a Positive HIV Test: Why Do You React the Way You Do?

As a licensed psychotherapist in West Hollywood with over 20 years’ experience specializing in working with gay men and people living with HIV, I’ve helped many guys cope in the early days after receiving a positive HIV test.  Often, my new clients have just been to their doctor’s office, visited the AHF mobile testing van, or done a home test.  They can be worried, scared, ashamed, tearful, angry, frustrated, numb, or any number of emotions in those first few sessions.  I understand all the varied emotions, and I help my clients identify, cope, and move forward with any and all of them. What I often need to discuss to understand is, WHY is this person feeling the way they do?

I understand you might be feeling lots of different things at once, and that your feelings might be strong.  I don’t mean to invalidate your feelings or make you feel bad for having them, but I do want support and help you to cope with negative feelings, because I have a hunch that part of your having negative feelings about a positive status is based on mis-information, and you don’t deserve to suffer needlessly.  Maybe I can help with that:  Let’s de-construct some common negative feelings, and look at them with a discerning and critical eye:

Fear – What exactly are you afraid of?  A truncated life expectancy?  Maybe that was true for many years during the height of the AIDS crisis, and that was a sad and scary time, but that’s not really true now, here in the United States and especially in Los Angeles.  Research has shown that an HIV-positive person with access with to proper treatment could have the same life expectancy as someone who didn’t have HIV – we’ve come that far, and we are very grateful for that.

Are you afraid people will reject you?  Especially gay men for sex or dating?  While that might be true to some degree, because some gay men indulge in a mean-spirited “HIV Neg for Same” or “DDF – UB2” mentality on gay websites or social media, do you really want to date ignorant, elitist, stigmatizing gay men?  Or live for a lifetime with one as a partner?  I doubt that.  Don’t be afraid of losing the opportunity to date someone you wouldn’t want to be with in the first place.

Are you afraid that you will be sick, sore, and unhappy?  Again, with proper medical treatment (through your health insurance, or for free through places like AHF or the LA Gay & Lesbian Center, among other clinics), you are not likely to be “sick”.  You might have some HIV-related conditions that need to be treated, or you might not.  But there isn’t a reasonable fear that your quality of life will be destroyed.  Inconvenienced, yes – as a person who has lived with HIV successfully myself for over 22 years, I can attest to that.  HIV prevention is important because going to doctors, giving blood for lab work, visiting the pharmacy (Warren Labs), and taking medications on a daily basis is a pain.  But that instills a sense of annoyance in me – not actual “fear”.

Shame – What are you ashamed of?  That you made a sexual mistake that exposed you to HIV?  Well, lots of people make mistakes.  Lots of people even make sexual mistakes.  There are things like unplanned pregnancies.  Someone else might get another kind of STD.  Someone might act on impulse, and violate a monogamy agreement in the heat of desire.  The fact is, lots of people, besides you, for actually THOUSANDS of years, have made sexual mistakes based on impulse that they regret.  I wouldn’t put a lot of time into shame about this; instead, I would put that time and emotional energy into forgiving yourself.  If you expect to get through life without ever making a mistake, including some serious ones you really regret, then you have unrealistic expectations of yourself and of life.  All humans make mistakes.  Making mistakes – and having to take responsibility for them, and trying to make amends for them whenever you realistically can – is part of life, and accepting this as soon as possible will serve you well.  Instead of shame, embrace a sense of responsibility and self-empowerment, to learn from the experience, and let that experience help you grow as a person.

Are you ashamed that you’re now “one of those people” who “got” HIV, that you used to look down on?  If that’s the case, may I suggest that you take this opportunity to re-examine your values.  Maybe the tragedy isn’t so much that you have “joined the ranks” of people you used to look down on; maybe the issue was that you shouldn’t have been looking down on anybody (except perhaps people who are truly mean, evil, and guilty of wrongdoing, which people with HIV are not, based on that alone).  Forgive yourself for this, too, and let yourself become a more mature, tolerant, and compassionate person toward people in EVERY group we encounter.  These are always good qualities for all of us to strive to improve.

Anger – Who or what are you angry at?  If you became exposed to HIV because someone lied to you about their status, sure, it’s easy to be mad at someone who was dishonest with you.  But you also (in most cases) let yourself have unprotected sex based on relying on what someone else said, often without any proof or real evidence they were telling the truth.  They might have even thought they were negative themselves.  Anytime we have unprotected sex, we have to be prepared that we might be exposing someone or being exposed to HIV, unless certain conditions are met (such as very reliable discussion about the relative risk of the situation, which is something called “Negotiated Safety”, that was developed many years ago in Australia).

Are you angry at Life?  Even if you were exposed to HIV through a sexual accident (condom breakage, which by the way is very rare when used as directed), it may be understandable to be Angry at Life, but the most happy, productive, successful people in our society are never Angry at Life people.  Instead, they find things to be grateful for under ANY circumstances, including challenging ones.  I’ve had two hip replacements due to some very long-term bone issues related to HIV (which you are not likely to have; don’t be scared).  And even then, as inconvenienced as I was, I found ways to be grateful for access to an expert orthopedic surgeon, health insurance, a partner/husband who helped me, a (hot, by the way) physical therapist, effective pain medications, and even decent hospital food!  Whenever you find yourself Angry at Life, it’s time to start making a Gratitude List in your head – anywhere, anytime.

Panic – Why are you panicking?  Don’t you realize that there is expert supportive counseling, either with a licensed, experienced expert like me in a private office, or with a competent trainee/intern at a local HIV service organization (free or low-cost)?  Don’t you know about HIV support groups?  Don’t you know about medications that will preserve your health and your life?  That there are friends  and family (usually) who care about you?  That hundreds of thousands of people in the United States alone live productive and full lives, all while living with the same HIV you have?  There really is no need to panic.  Having concerns that need to be addressed, and needing emotional support for the adjustment to a diagnosis, yes – but not panic.

There many online resources available such as, and countless other websites, affinity groups, and Facebook fan pages, all for technical and emotional support.  There is no need to panic when you can access supportive resources for meeting many – MANY – different emotional and practical needs, for people from all walks of life.

So while there might be many emotions – including Fear, Shame, Anger, and Panic – try to keep your wits about you, and dissect the situation rationally.  Try to regulate the affective states (emotions) you find yourself in.  When the going gets tough, the tough get going.  Getting a positive HIV test might be unwelcome and even scary news, but fortunately, in the United States in general and in Los Angeles/West Hollywood in particular, there are many resources to help you survive and thrive.


If you still need help, and you want to talk to someone to get support for your individual and specific situation, I’m here for you.  Call me at 310-726-4357, or email me at  At the website, there are also dozens of other articles on how to successfully live with HIV for many years (like me), and there is also an inexpensive e-book of my collected articles, “Positive Outlook:  Successfully Living with HIV Today”, which is available on Amazon, here:



Leave a Comment