Cultivating a healthy sex life after HIV diagnosis can be difficult for people with HIV (PWH), as stigma and concerns for transmission may act as barriers to sexual activity. Addressing these obstacles is a necessary part of psychotherapy when helping PWH reincorporate sexual activities. However, mental health providers may be unprepared to discuss factors that impact sexual functioning with their HIV-positive clients. Currently, there are no gold-standard evidence-based treatments developed specifically for HIV-positive individuals. Therefore, this article focuses on using cognitive-behavioral techniques to address sexual concerns in PWH. Cognitive-behavioral therapy has been effective at improving sexual health in other medical populations and can be adapted to optimize sexual functioning in PWH. In this article, we discuss cases of common concerns PWH experience and how cognitive-behavioral therapy techniques (e.g., challenging automatic and maladaptive thoughts) can be incorporated into psychotherapy to cultivate a healthy and fulfilling sex life. (PsycINFO Database Record (c) 2020 APA, all rights reserved).