Although it’s not certain to happen, many people find that their feelings about sex change after they find out they have HIV. It could be that your interest in sex dips or disappears altogether for some or all of the time – or, conversely, that your interest in sex becomes stronger, more intense. Either of these changes could be due simply to natural fluctuations in your desire for sex, or your opportunities for having sex, of course. But such changes in your desire for sex might cause you problems, particularly if they make you unhappy or interfere with other aspects of your life.

Finding out that you have HIV can make you feel differently about yourself. The diagnosis may come as a shock to you, and it could make you go off sex – at least temporarily. Some people with HIV say they feel less physically and sexually desirable than they did before, and that they have less confidence with their sexual partners.

Having HIV can make you look at yourself and sex in a negative light. It can make you feel bad about the kind of sex you had or are having, or angry with yourself, or the person or people who could have infected you.

An HIV diagnosis might feed wider negative feelings you have about who you are. HIV has, for example, been used as a reason to stigmatise further some of the people most affected in this country – gay men, Africans and drug users.

You may feel anxious about infecting your sexual partners with HIV, and this can cause your desire to have sex or your sexual performance to drop.

The thought of telling your past, present or potential sexual partners that you have HIV can also cause anxiety. You need to decide for yourself whether you will tell none, some or all of your sexual partners.

Although many HIV-positive people have long-term partners or casual partners who are HIV negative, sometimes people are rejected because they have HIV. This can be very hurtful (or can even, in some circumstances, put your personal safety at risk). You might also be concerned about whether someone you tell will keep your status secret from other people. It is important that you develop strategies to help you cope if it happens to you.

You could discuss these issues with a member of your healthcare team, such as a health adviser or counsellor, with a sympathetic GP or with a support agency. They could help you think about how and when you might tell people that you have HIV, and how you would respond if any of them react badly. Good friends may also be able to help you think this through.

Some HIV-positive people choose only to have sex with people who also have HIV. Sometimes this is because they don’t want to take any risk of infecting someone else. Another reason might be that they want to have sex without using condoms. This can be pleasurable and intimate, but there are still some health risks for you both, such as the risk of getting another sexually transmitted infection or hepatitis, for instance. These can have a negative effect on your health, and possibly on your HIV treatment. And there is also the risk, thought to be much smaller, of reinfection with another (and possibly drug-resistant) strain of HIV.