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SUMMARY
This article explores a variety of interpersonal, intrapsychic, and communal dynamics that have an impact on gay men's safer sex practices. Therapists working with gay men who have condomless sex can have a greater influence in helping them to facilitate change and to understand the meaning of their behavior. This can be done through a non-judgmental and harm reduction approach which eschews holding preconceived ideas about how gay men should conduct their sexual lives. Depression, loneliness, intimacy, HIV status, substance abuse, and love may influence gay men's choices about sex. Using clinical case examples, therapeutic strategies for working with individual gay men and couples are discussed.
