"I'm like a whirling leaf in the wind," said one of Dr. Lena Nilsson SchOnnesson' s patients, and another "I'm in the claws of HIV." Their voices and those of other HIV-positive patients frame the humanistic and scholarly discussion in this impor tant book. Dr. SchOnnesson, a Fulbright scholar at the HIV Center for Clinical and Behavioral Studies, Columbia University in 1995, has unusually extensive clinical experience in counseling HIV-positive gay men. Her work with 38 such patients treated between 1986 and 1995 is discussed in the pages that follow. Dr. SchOnnesson's longitudinal approach to clinical data is extremely unusual in the psychotherapy literature generally, and in the literature on counseling HIV positive men in particular. Building upon the experience of such recent scholar clinicians as Klitzman, Isay, Schaffner, and others, Dr. SchOnnesson adds some thing unique by analyzing her ongoing detailed notes of the psychotherapeutic process in a systematic quantitative as well as qualitative manner. The analysis of her data is further informed by her coauthor, Dr. Michael Ross, a therapist and investigator whose contribution to the clinical and research literature on the psychotherapeutic treatment of gay men has already been substantial.

Preface. Acknowledgements. Foreword. 1. Living on the Boundary. Part I: The HIV Scenario. 2. The Impacts of Chronic and Terminal Illness. 3. HIV Testing and its Impact. 4. HIV-Related Threats. 5. The Insidious Persecutory Drama of HIV. 6. The Impact of HIV Infection on Psychological Functioning and Quality of Life. Part II: Psychological Landscapes. 7. The Existential Context. 8. HIV Adaptation Processes. 9. The Shattered Self. 10. Autonomy, Boundaries, Control, and Death. Appendix. Index.