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The writer describes the AIDS epidemic in terms of four major issues which it raises for our culture; sex, sexuality particularly homosexuality and the issues which it raises for our culture, disease and disability particularly in young people, and death. After arguing that this represents a 'catastrophic' change (Thom) in our perceptions of sexually transmitted diseases, he goes on to describe the treatment of a convinced homosexual who died of AIDS.
The treatment lasted for nearly two years until the patient's death. During that time some of the issues underlying his sexual choice were explored and linked to the disease process. The patient wished to understand his existential situation and to be helped with living as positively as he could until his inevitable death. Transference and countertransference issues are described in detail and the problems which this type of treatment poses for the analyst are explored. The writer suggests that this is very taxing but appropriate work for psychoanalysts to undertaken, but that it is essential to have a reference group or workshop for support.