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One of the consequences of the AIDS epidemic is a phenomenon seen with increasing frequency in a therapeutic setting: the exaggerated and somewhat unreasonable fear of heterosexual men that they have been infected with the AIDS virus. Though AIDS is a horrific disease and its transmission insidious, such complaints possess a somewhat excessive, irrational and obsessive quality. When questioned more closely, such men can claim only the flimsiest of risks or evidence for thinking themselves in danger, and the consideration of reality factors has little effect in assuaging their anxiety. In the larger context of their symptoms and characterology, their fears are most profitably conceptualized as obsessions, which they resemble in their curious “nagging” quality and in the displaced nature of their underlying meaning. This diagnosis becomes more convincing when the complaints of such men are contrasted with the worries of sexually active homosexual men who may be seriously at risk. Apart from thrill-seekers and dangerously self-destructive compulsives, most healthy homosexual men maintain a realistic sense of risks. Their sexual behavior is “safe,” as defined by nationally promulgated guidelines, and accidents or an occasional impulsively unwise episode are thought about rationally. The results of HIV tests have a substantive authority. For such men, worries about HIV infection are realistic and do not present notable obsessional aspects.
Consider, on the other hand, the following three examples of heterosexual preoccupation with AIDS:
SS is a thirty year-old heterosexual businessman, successful in his father's businesses and an ornament to the ethnic community to which he claims allegiance. Handsome, intelligent, generally speaking “a good person”
Page 343with plenty of money to spend on dates, he is baffled that he has been unable to find a woman suitable to marry and is becoming anxious since he has passed the age at which most men in his group establish a family. In additio