Psychoanalytic and Behavioral Approaches to Drug-Related Sexual Risk Taking

Abstract

The topic of substance abuse among gay and bisexual men is of intense topical interest precisely because of the demonstrated co-occurrence of “recreational” substance use and HIV infection among gay/bisexual men. With the discovery of the Human Immunodeficiency Virus Type-I (HIV), it has been consistently shown that both prevalent and incident HIV infections are significantly associated with a history of substance use or abuse. In an attempt to integrate both cognitive-behavioral models and psychoanalytical understandings of our drug using/sexual risk-taking patients, the authors have engaged in the exchange of ideas and case reports over the past several years. This paper summarizes the results of those exchanges and utilizes two clinical case examples as the basis for identifying the utility of an integrated psychoanalytical and behavioral approach to clinical conceptualization and treatment.

Key Words:

• Drug use
• homosexuality
• cognitive-behavioral treatments
• psychoanalytical treatments
• HIV-risk
• escape coping
• sex-drug use