High-risk sexual behavior is overwhelmingly the most common mode of transmission of HIV worldwide, but despite this fact, AIDS prevention research has neglected to focus on sexuality. Applying multidimensional scaling, clustering and semantic differential techniques to data obtained from a sample of 181 Flemish gay men, this article explores cognitive patterns in the domain of sexuality. A comparison of the cognitive maps of men who engage in HIV-related risk behavior versus those who do not suggests that while their basic cognitive structures are quite similar, significant differences exist with respect to how these men think about high-risk sexual practices. Among the men who practice unsafe sex, an emphasis on the pleasures of unprotected penetrative sex appears to override their risk-awareness and their knowledge of condom efficacy. The implications for intervention strategies are discussed.