ABSTRACT
In this chapter, Llorca explains that the HIV and AIDS epidemic since the early 1980s meant a dramatic change to gay men’s lives, their sexuality and how they relate as sexual beings. Antiretroviral Therapy (ART) development to treat HIV and PrEP to prevent it has brought new changes to gay men’s sexuality and sexual behaviour. This chapter provides sex and relationship therapists with key concepts, instruments and knowledge about the impact of ART on gay men’s sexuality, exploring how HIV trauma and the trauma of homophobia made a link between sex and desire with shame and death and how ART and PrEP are breaking this association. Most people with HIV in treatment have an undetectable viral load, meaning they cannot transmit the virus. This is transforming the definition of safer sex among gay men, changing the conversation and behaviour around HIV disclosure, stigma, sex negotiation, desire, assumptions, barebacking, condoms, secrecy and slut-shaming. With case studies and examples of creative therapeutic interventions, Llorca offers appropriate tools to allow the therapeutic process and alliance.
