The subject in the case study was a 32-year-old, unemployed, HIV-positive, bisexual male who was referred by a social worker describing him as hostile, resistant, and probably suffering from HIV dementia. The clinician evaluated this client for depression, dementia, sexual addiction, and dissociative behaviors. Chronic depression suffered by adult survivors of sexual abuse often leads to helplessness, lack of personal efficacy, lethargy, and self-destructive behaviors including engaging in HIV high-risk activities. The frequent revictimization of adult survivors makes it more difficult for them to insist on safe sexual practices with their partners. Sexual compulsiveness, another potential long-term effect of child sexual abuse, increases the number of sexual encounters and partners, and therefore, the risk of contracting HIV. Drug abuse among survivors impairs judgment and increases the probability of HIV infection. Recommendations regarding the psychotherapeutic treatment of HIV-positive adult survivors include helping clients secure basic necessities and stabilize their environment, helping clients explore and heal medically induced psychological trauma, addressing painful abuse issue in therapy, and addressing substance abuse issues. 30 references