Something I have observed among gay men that I have been acquainted with, it is also something I have observed with alcoholics - many of them have a "suicide" wish. Through their behavior, they end up killing themselves "an inch at a time".
I've had close relatives that absolutely drank themselves to death, despite the efforts and prayers of those who loved them. I've seen gay men (not that familiar with many lesbians) engage in dangerous sex practices despite knowing the risks. They eventually come to a tragic end. I don't know if it is something in their make-up, or if it is a symptom of a deep mental illness - but it is like they are hell-bent on self-destruction. And it is very sad to have to watch...helplessly.