The Body: The Complete HIV/AIDS Resource Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol

Coping with AIDS Terror: A Guide for the Urban Gay


"It left just as if someone turned off a light. Joy is gone from my life."

"I don't understand it. All of a sudden, sex makes no sense to me."

"I thought I worked out all those fears when I was coming out. But now I am beginning to think that being gay is wrong."

Each of these men is terrified of AIDS. This terror is eroding the core of his identity, affecting his perceptions of himself and his world. Fortunately, when he acknowledges this fear, and identifies what it is he fears, he can take active measures to win back whatever terror has eroded,

There have been over 14,000 confirmed cases of AIDS in the United States. But those stricken by the disease are not its only victims. AIDS is a dark cloud casting a pall over the gay community, and those who live in its shadow, the medically well but scared, have been referred to as "the worried well."

This phrase is catchy but inaccurate because it is much too broad. With the daily newspapers carrying hysterical story after hysterical story about this disease, everyone is frightened and concerned, however "worried and well." But there are those among the numbers of the worried-well who are so preoccupied that the worry itself becomes a central part of their lives. And there are those who may not even be worrying but whose behavior and life so show the effects of fear, anxiety or depression that they lead lives vastly and unnecessarily changed from the one they once led, lives now mostly sad, joyless and unsatisfying.

Each of the quotes at the beginning of this article qualifies the speaker as AIDS-terrified. The following is a list of behaviors or attitudes which these or other men could exhibit as "symptoms" of AIDS terror and are offered here as a guide for "self-diagnosis."

  1. A once sexually active man decided that the only way to be safe from AIDS is to stop having sex; or
  2. Just isn't as interested in sex any more;
  3. Suddenly begins to have sexual difficulties, such as erection problems or inability to ejaculate;
  4. Withdraws from social contacts that were once satisfying or spends increasing time alone -- and does not enjoy it;
  5. Completely withdraws from gay friends and the community out of a fear of contracting AIDS;
  6. Is depressed, anxious or sad for no apparent reason;
  7. Constantly worries about his health and refuses to believe his physician's assurances that he has no medical condition;
  8. Becomes more self-doubting and self-deprecating, or begins again to think that there is something wrong with being gay;
  9. Experiences increased sleeplessness and nightmares;
  10. Loses his appetite.

Several points deserve stressing. To qualify as a "symptom," all should involve changes in behavior or attitude and occur more or less simultaneously with the knowledge of AIDS. For some this may have been only a few months ago, for others it may have been as long ago as five years, when AIDS was first reported. For example, a man who always had difficulty sleeping should not be concerned if that is his only symptom. A man for whom sex never was an important part of his life need not fit this pattern if he often went a considerable length of time without sexual contacts.

Secondly, these items might occur without conscious thoughts or feelings about AIDS. Sometimes, the mental process called "denial" keeps troubling thoughts our of awareness, even though the person behaves and acts as if wracked by worry. This is as true for a person troubled by AIDS as in any other emotionally difficult situation.

Clearly, there is a difference between appropriate fear of AIDS and AIDS terror. Today, almost everyone is afraid of AIDS. This fear is reasonable, concrete and is an emotion signaling danger to be avoided. It is an emotional call to do something to reduce the perceived danger of AIDS. The kind of feeling and behavior to be concerned about are those that do not help solve the problem of the danger and are an irrational, self-defeating response to AIDS.

Now, once identified as a victim of AIDS terror, what can you do? The hardest task may be over. Recognizing the effects of AIDS terror is the difficult part of this process. In fact, this in itself may establish the momentum that will make the rest seem easy by comparison. The next strategy is twofold. First the person should consider the following active suggestions:

  1. Since anxiety thrives where there is ignorance, combat your worry with information. Get a complete medical check up.
  2. Reduce your risk of contracting AIDS. Practice safe sex and know what practices are low risk. Healthy sex guidelines are available through the local AIDS community service organizations. Familiarize yourself with them and enjoy sex. Since abstinence itself could be stress inducing, resume your sex life, safely and intelligently.
  3. Reduce your risk of contracting AIDS. This suggestion is so obviously important that it its repeated. If you use intravenous drugs, be sure to use clean needles and do not share them or other drug preparation paraphernalia, e.g., cookers.
  4. Recognize that there are other threats to your life that have even predated AIDS. Reduce your alcohol, drug and tobacco intake. Evaluate your diet.
  5. Medical treatment for AIDS can be catastrophically expensive. If you are worried about medical bills, or even if you are not, get medical insurance and disability income insurance. If you are presently insured, have your policies reviewed by an insurance professional.
  6. Identify and reduce the stresses in your home and work life.
  7. Assess your emotional supports, friends, family and community and do whatever is necessary to increase these supports.
  8. Increase what is joyful and life affirming to you.
  9. Give yourself permission to be afraid. AIDS is a horror, and not to fear it is cause for worry in itself!
  10. Learn to relax. Simple breathing exercises, meditation and visualizations are all simple to learn and may themselves bring you calm amid the turbulence of AIDS terror.

The second aspect of this suggested strategy is more subjective. Each of you should look closely at your life, what you do that is enjoyable and is not enjoyable. What is satisfying and what is taxing. Try making a list with two columns and label the joyful side "healthy" and the taxing side "unhealthy." The criterion for the list is however you define what is "healthy" and "unhealthy" for yourself. Next, compare the "healthy" and "unhealthy" columns. Which column has the most items? The task then is for you to do whatever is necessary to be sure that this inventory is weighted in favor of the healthy column. The inventory should be evaluated and updated weekly.

If these suggestions seem difficult to follow, if they are even difficult to consider, or if they have been tried and have not helped your "symptoms," then another approach may be needed. Though sometimes isolated, AIDS terrified people are still part of the gay community and they can use the community as a resource. Throughout the country numerous AIDS service community organizations have been formed in response to this health emergency. Many of them, as well as other gay community social service organizations and private practitioners, offer groups to help the worried well. Merely being with other men in similar situation and talking about all the issues and concerns, may make it easier to deal with these feelings.

Terror of AIDS, AIDS induced anxiety and AIDS itself may stir deeper rumblings than this article has dealt with. Sometimes, stress induced by a present situation reawakens old demons that need to be looked at with more attention. If that seems to be the case you can always call for a consultation with a well trained psychotherapist who has experience working with gay men.

These suggestions should not be considered as easy as these cookbook like steps may suggest. In fact, they may involve real struggle and efforts at increased self-awareness. If this struggle is too difficult, then it might be the time to consult a mental health professional. Especially during this health emergency, no one should be self conscious in asking for a psychotherapist's help. Local AIDS service and gay community social service organizations should be helpful in finding a psychotherapist familiar with this problem. We are all in this war together and no one need suffer it alone.

Michael Shernoff, MSW is a psychotherapist and author in Manhattan who is also adjunct faculty at Hunter College Graduate School of Social Work. He coedited (with Walt Odets) The Second Decade of AIDS: A Mental Health Practice Handbook, and has just completed editing an anthology entitled Gay Widowers Speak: Surviving the Death of a Partner to be published in 1998 by Harrington Park Press. He can be reached via e mail at or at his home page

Daniel Bloom, MSW is a psychotherapist in private practice in Manhattan.

Published in In Style for Men, Jan/Feb 1986 by Michael Shernoff, MSW & Daniel Bloom, MSW
©1986 Michael Shernoff & Daniel Bloom

Permission is granted to copy or reproduce this article either in full or in part, without prior written authorization of the authors on the sole condition that the authors are credited and notified of reproduction.

It is a part of the publication In Style for Men.
See Also
10 Things You Can Do to Enhance Your Emotional Well-Being
More Advice on Coping With HIV/AIDS