ABSTRACT
Jay, a man in his mid-thirties, who was an openly gay community leader, felt throughout his childhood that he was "different." After an adolescence spent in a religious all-boys school where he had numerous same-sex experiences, Jay fell in love and married a woman who shared his interests. A few years into the marriage, he met an openly gay man, fell in love, divorced his wife, and entered a monogamous relationship that was to last till his partner's death. Gianni was diagnosed HIV positive about six years after he and Jay committed to each other, and he died within two years, leaving Jay heartbroken and beset with guilt about surviving his beloved Gianni. As he emerged from a severe clinical depression, and seemingly having worked through his survivor's guilt, Jay started engaging in unprotected sex with a boy of his acquaintance who was a teenage prostitute. This exposed him to severe legal and financial risks, not to mention HIV exposure. As this behavior was being explored in treatment, issues about warded-off femininity, heterosexual longings, and self-hatred began to emerge, and Jay terminated therapy abruptly and unadvisedly. In his last session, he expressed his strong belief that nothing was going to prevent his dying of AIDS.
