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Sex and HIV

Sex, desire and pleasure need not stop when you have an HIV diagnosis. Women continue to be sexually active and to have fulfilling sexual and emotional relationships.

Many women with HIV experience a temporary loss of libido (the desire for sex) after they have been diagnosed. Sexual problems, such as pain during sex, can be more common in women with HIV, and can also be connected to other conditions, such as mental health problems or diabetes, or treatment for other conditions. You may also experience anxiety about starting a new relationship or passing on HIV, and fear of rejection on disclosing you have HIV. It is important to acknowledge that these feelings are real and then to seek solutions.

Your healthcare team may include a psychologist or counsellor who could help, but sometimes talking with a close friend or with others who have had similar experiences can be just as helpful.

You may want help on how best to negotiate safer sex or on how to use male and female condoms. Your healthcare team and support organisation can provide this help.  

Preventing transmission of HIV

The risk of passing on HIV depends on many factors such as your viral load and the presence of other sexually transmitted infections.

Maintaining an undetectable viral load, using male or female condoms consistently, not sharing injecting equipment, following the guidelines for a safe pregnancy, birth, and infant feeding are the key ways of not passing on HIV to another person.

The risk of passing on HIV can vary depending on where you are in your menstrual cycle. The levels of HIV in vaginal fluid vary. They are likely to be highest around the time of your period, when cells containing HIV are most likely to be found in vaginal fluid, along with blood.

The risk of passing on HIV from oral sex is low. Someone giving you oral sex (also called ‘cunnilingus’, which means using the lips and tongue to stimulate female genitals) will be at higher risk of HIV infection around the time of your period, if they have bleeding gums, sores or wounds, or a sore throat, inflammation or untreated infection in the mouth. If someone is performing oral sex on you they can lower the risk even further by using dental dams (small pieces of latex). If you are performing oral sex on someone else, the only body fluid they have contact with is your saliva, so there is no risk of HIV being passed from you to them. The only possible risk would be if your mouth was bleeding.

You can find out more about all these topics in NAM’s booklet HIV & sex.

Women are often vulnerable in negotiating safer sex for social and cultural reasons and some women have difficulty persuading a partner to use a condom. One option which puts you in control of safer sex is the female condom (Femidom), which can also give heightened sexual pleasure.

Talk to your healthcare team or a support organisation if you feel you are vulnerable, if your partner is violent towards you, or if you are experiencing problems related to your financial, social or immigration situation and they will help you to find ways of managing it.

Sexuality and HIV

Lesbians, women who have sex with other women but who don’t identify as being lesbian, and transgender people who are HIV positive may face stigma, or fear stigma, based on sexuality as well as HIV status.

The risk of transmitting HIV during sex between women is low, and it can be lowered even further by using dental dams for oral sex. If you and your partner use the same sex toy, you could pass on an infection (including HIV). To avoid this, put a new condom over it or wash it in warm soapy water between each use.

HIV & women

Published July 2014

Last reviewed July 2014

Next review July 2017

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.