ABSTRACT
The dominant psychological models for understanding unsafe sexual acts and practices have ignored psychoanalytic conceptualizations and have instead focused on those derived from cognitive science and cognitive-behavioural therapy to inform preventive and clinical work. This chapter contributes additional understanding from a psychoanalytic perspective to the underlying, and argues largely unconscious, motivations and possible aetiology for sexual risk-taking. Theoretical frameworks hitherto employed to inform work in this area have almost exclusively been either cognitive or behavioural. Many were originally derived from generic psychological models of attitude and behaviour change such as the Health Belief Model (Becker, 1974) and the Theory of Planned Behaviour. Human sexuality is a complex of biological impulses and psychological processes in the context of particular social constructs and taboos. Freud's contribution to the understanding of the diversity and vicissitudes of human sexuality was extended by the ideas of Klein and those who further developed her work.
