HIV preventive counseling is a difficult task since very few context specific resources on sexuality issues of sexual minority are available to counselors in India. An improved understanding of the sexuality experiences of Men who have Sex with Men (MSM), and an appropriate therapeutic approach is crucial for creating a scientific reference base for effective counseling in targeted HIV prevention interventions. This paper discusses developmental and sexuality issues of Men who have Sex with Men (MSM) and highlights the need for a shift from stereotyped counseling practices to strength based counselling within targeted HIV prevention interventions to make therapeutic alliance more holistic. Counseling in targeted HIV prevention interventions, specifically designed for MSM population, needs to be redefined and thus should not be just restricted to HIV/AIDS and STIs.