Maintaining a fulfilling sex life

The psychological and social effects of having HIV can directly result in a temporary or sustained loss of interest in sex. Some men are unconcerned by this change and consider having a wank is enough of an outlet. For others, sexuality is a huge part of who they are and how they express themselves.

There is a direct relationship between how we see ourselves and our ability to function sexually. If you feel “infectious” or unattractive because of your status then your sex life may suffer. Many people with HIV have found specialised counselling in this area useful. Others find that by talking with friends and sharing their concerns they find they are not alone and the problem doesn’t seem so huge.

If your appearance has changed through medication or illness, you can look at it two ways. Accept the physical changes and find people who like you because you like yourself. Or exercise and pay attention to diet. Body image within the gay community is often more ideal than real, however many positive men have found exercise makes them feel and look better. It can also increase your appetite and help you gain weight.

While often taken for the opposite effect, recreational drugs (speed, for example) can have an adverse affect on sexual arousal and performance (see Drugs and Sex page 6). So too can some prescribed antidepressants. Some people with HIV report that certain treatments hamper their sex drives. Changing their combination may be an option. Equally, many people with HIV who have benefited from the latest combination therapy [1]Highly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. report an increased interest in sex.

There are medical treatments that can sometimes assist when sexual performance is affected for physical reasons. Viagra (sildenafil) is probably the best known. Some gay men who have difficulties maintaining erections when using condoms find that Viagra makes it easier to stick to safe sex.

Most people go through periods in their lives when sex is less or more important. So, if you are happy with your current sex life (or lack of it) then, fine. If you are not, then consider some of the options above.

“I felt that I just didn’t have the physical energy for sex. It was becoming a real issue in our relationship. I encouraged my partner to seek outside sex partners to take the pressure off. Then I got jealous. We went to relationships counselling and I found that the issues were more psychological than physical. We’ve learnt ways to occasionally reincorporate romance into our relationship and then I have no problems getting turned on!”

“I had been very unwell and I looked it. When I got better I still looked sick but my sex drive was as healthy as it had ever been. But not looking healthy is – not surprisingly – not an attractive look. I can accept that – but I can’t accept the open hostility that seemed to be directed my way just because I dared to go to sex venues when I looked unwell. And often I wasn’t interested in having sex myself – I just wanted to be in a place where it was happening.”

“Chasing sex used to be how I spent most of my spare time. Then I stopped having sex altogether. It took some getting used to. I really worried about it in terms of ‘who I was’. However, after counselling, I came to accept the loss of my sexuality and I now have a lot more time for other pursuits. But now I’m at the point where I’d love a good root again!”

“I was on some of those new anti-depressants. I couldn’t get it up. I saw advertisements in a gay paper about sex problems when you’re on antidepressants. I rang the number. They weren’t much help – but the advertisement gave me the idea that something could be done. I asked around, got a referral and after a lot of effort and some treatment I now have a satisfactory sex life again.”

“I used to blame HIV for the loss of my sex life. Since starting antiviral [2]A medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. treatments I have my body image and energy back. But I still have far less interest in sex than I used to. I think it’s both getting older and HIV.”