AIDS Behav (2009) 13:1054–1060 1057 HIV-negative, and HIV-serounknown partners across the three recall periods. Another participant expressed similar feelings when asked about his sexual future: In-Depth Interview Findings In qualitative interviews, we sought to contextualize the patterns observed in the quantitative analyses and to understand participants’ motivations for behavior change. Reducing the Total Number of Partners Engaging in sex with fewer partners was the most common strategy identiﬁed for reducing risk. For example, one participant who had ﬁve concurrent partners prior to diagnosis reported only one partner after diagnosis: I’ve always had like more than one partner. [But] I’ve just been more serious in our relationship than before. So I’m just trying to… And my HIV status. I don’t want to infect other people. (20 year old gay man, San Diego) Another participant reduced his partners from two to one: The two months before [diagnosis], I had sex with two people. […] And now I am just with [my part- ner]. I think I am still afraid to get anything out of my relationship with him, and… I don’t want to take a risk to hurt somebody else. I don’t want to do it, I don’t want to do it. So I would rather just not have it [sex]. (39 year old gay man, Providence) Temporarily Abstaining From Sexual Activity Some respondents described refraining from all sexual activity immediately after diagnosis. Their reasons for doing so were varied. Several were simply too ill or distressed: I’ve been too sick. No interest. No interest. Not even masturbation. None of that. […] You know, I haven’t thought about sex, and I usually think about sex once a day. I felt insecure enough without having HIV. (57 year old gay man, San Francisco) Fear of infecting others—or getting re-infected them- selves—prevented other respondents from having sex. For example, one participant went from an average of three to ﬁve partners a week to having none: It’s just lack of libido. That, and—and a concern, and like, you know…I could potentially kill someone. And I don’t think I could handle that. So I don’t. (26 year old gay man, New York) Well, I haven’t had any sexual feelings. I don’t—I’m sure probably later on I would, but now I haven’t really been having any sexual thoughts or anything sexual enter my mind now. […] You know, I know there’s condoms but—like, in August, the condom popped. I don’t want to have—or risk any—or put anybody at risk, and I think that’s what really bothers me as far as having sex, you know? (22 year old gay man, New York) Increases in Safer Sex Practices Participants described both increases in condom use and attendant decreases in speciﬁc risk practices. For example, one man spoke of a previous habit of ‘‘poking around’’ partners’ anuses with his penis, or having partners pene- trate him before applying a condom: Now, unsafe is really not an option. There’s no more poking around the outside. We can’t start sex without a condom and then put one on later. (35 year old gay man, San Diego) By contrast, other participants described challenges in changing condom use behaviors: Well, [my diagnosis has changed] two things. They’re related but separate. One is my sex drive, and the other is the lack of enjoyment I get from sex I have. Now my sex drive is kind of bad. I wouldn’t mind having sex three or four times a week, but I can’t…I don’t enjoy it very much. So I’ve been trying to ﬁnd condoms that are more sensitive and I’ve experi- mented with brands and types and it doesn’t seem to be helping, and it’s frustrating. I don’t know what it means for the long term. […] I’ve never found con- doms very satisfying. That was the primary reason that…that I started having lots of unprotected sex [before diagnosis]. (23 year old gay man, San Diego) Seeking New (or existing) Partners who are HIV Positive Diagnosis led a number of respondents to seek out partners who were HIV-positive. Most often, they found these part- ners through Internet proﬁles, introductions from friends, support groups, or other HIV social networks. Other partic- ipants returned to former partners whom they knew to be HIV-positive, or enhanced the intimacy of an existing rela- tionship with an HIV-positive long-term partner. Primary reasons for their partner selection were concern about 123