HIV, PrEP and mental health: support for gay and bi men
Living with HIV, starting PrEP or worrying about exposure can weigh on your mind. Here’s how mental health fits into sexual health.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
HIV care and prevention have changed dramatically. PrEP prevents HIV very effectively when taken as prescribed, and people living with HIV who maintain an undetectable viral load don’t transmit the virus sexually. Even with these advances, HIV can still carry a heavy emotional weight for many gay and bisexual men.
Where mental health comes in
Anxiety about testing, exposure or results.
Lingering shame or stigma, even in an affirming city like San Francisco.
Depression or isolation after an HIV diagnosis.
Grief and trauma connected to the generations lost during the AIDS crisis.
Stress about disclosure with partners, family or employers.
Caring for your whole self
Regular testing and talking openly with your healthcare provider about PrEP or HIV treatment are acts of self-care. So is getting support for the feelings that come with them. Depression and anxiety can make it harder to keep up with medications and appointments, so treating mental health often supports physical health too.
Medication coordination
If you take HIV treatment or PrEP and are considering psychiatric medication, your psychiatric provider can review interactions and coordinate with your HIV or primary care provider so your plan works together safely.
San Francisco has excellent HIV and sexual health resources, including the San Francisco AIDS Foundation and city sexual health clinics. If you’re struggling emotionally, affirming therapy can help you process stigma, fear or grief with someone who understands.
Care in San Francisco and across California
Wellthy Psychiatry is an LGBTQ-owned practice led by Earl Johns, MSN, PMHNP-BC, a board-certified psychiatric nurse practitioner offering medication management and therapy in San Francisco and by telehealth across California. If you’re looking for a gay or LGBTQ+ therapist in San Francisco, LGBTQ+-affirming psychiatric care in San Francisco, or affirming therapy anywhere in California, we’d love to help. Book a free 15-minute consult.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. He sees clients in San Francisco and by telehealth across California.
Keep reading
Related posts
Finding a gay therapist in the Bay Area
Why working with an LGBTQ+ provider can make a difference, and how to find a gay or queer-affirming therapist in San Francisco and the Bay Area.
Finding your chosen family as an adult
Why chosen family matters so much in LGBTQ+ life, and practical ways to build deep, lasting friendships.
Feeling stuck? Where to start when you’re tired of feeling this way
Small, real first steps for when you feel stuck, anxious or far from yourself.
Finding care where you don’t have to explain yourself
What affirming, integrative psychiatry looks like, and the questions to ask a new provider.