Feelings about sex after your HIV diagnosis

Image: Domizia Salusest | www.domiziasalusest.com

Key points

  • HIV stigma can impact how you feel about sex.
  • Both positive and negative feelings about sex are a normal part of adjusting to having HIV.
  • Your HIV status does not take away your right to intimacy and pleasure.
  • Enjoying your sex life contributes to your quality of life.

Your feelings about sex may be affected by your thoughts about the virus, how your diagnosis affects the way you see yourself, and how these aspects come together to influence your sex life as an HIV-positive person.

While negative attitudes about HIV have changed over time, many of these have stuck around and have contributed to the large amount of stigma experienced by people living with HIV. Stigma is made up of these negative attitudes, fears and prejudices about HIV. It can result in people living with HIV being insulted, rejected and gossiped about.

In some instances, when people living with HIV experience stigma, they start to view themselves negatively and it can impact their sex lives. This is also known as internalised stigma or self-stigma – when people living with HIV start to have thoughts and beliefs that they are infectious, not desirable and not worthy of experiencing pleasure and intimacy.

While many negative ideas about those living with HIV have not yet caught up with important medical findings, such as U=U, it is important for you to know the facts about how HIV is transmitted (and how it is not) in order to feel empowered about your sex life.

Initial reactions to your diagnosis

Different people’s sex lives are affected in different ways by their HIV diagnosis. A strong initial reaction to an HIV diagnosis is often the feeling of ‘going off’ sex. Most people who are infected acquire HIV sexually and thus, sex may be associated with negative feelings. Not wanting to pass HIV on to a sexual partner is also often a reason for avoiding sex altogether. These feelings can be eased by knowing that once you have started treatment and your viral load is undetectable for six months or longer, you are not able to pass HIV on.

In contrast, your interest in sex could become stronger and more intense. You may find that you want to explore sexual desires without the fear of contracting HIV.

Whatever you are feeling is part of your adjustment to your diagnosis and it does not need to be cause for concern. The shock experienced after your diagnosis is temporary and your response to living with HIV will change as you learn how best to manage it.

Feeling good about having sex

For many people living with HIV, becoming undetectable and knowing that they cannot transmit HIV has been a turning point in how they view their sex lives. It has allowed them to move away from thinking of sex in terms of infection and risk, and to focus instead on the pleasurable aspects of sex.

We now have numerous ways to prevent HIV transmission during sex. Adopting a proven prevention method, whether it is using condoms consistently and correctly or remaining undetectable, means that you should feel secure about having sex that is enjoyable and free from worry. It’s important to know that you can enjoy a healthy, pleasurable sex life without passing HIV on to your sexual partners and that people living with HIV can have children who do not have HIV.

Good sex, intimacy and physical pleasure are integral aspects of wellbeing. This is no different if you are living with HIV. People with HIV want the same things as everyone else – love, affection and the pleasure and satisfaction you can get, and give, by having sex.

Glossary

stigma

Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.

diagnosis

The determination that a patient has a particular disease or condition, through evaluation of their medical history, clinical symptoms and/or laboratory test results.

undetectable viral load

A level of viral load that is too low to be picked up by the particular viral load test being used or below an agreed threshold (such as 50 copies/ml or 200 copies/ml). An undetectable viral load is the first goal of antiretroviral therapy.

association

An association means that there is a statistical relationship between two variables. For example, when A increases, B increases. An association means that the two variables change together, but it doesn't necessarily mean that A causes B. The relationship isn't necessarily causal.

virus

A micro-organism composed of a piece of genetic material (RNA or DNA) surrounded by a protein coat. To replicate, a virus must infect a cell and direct its cellular machinery to produce new viruses.

 

Sexual expression and enjoyment are part of what make you human. Having sex and relationships in your life are likely to be as important for you as they ever were, possibly even more so. Living well and staying healthy with HIV means looking after yourself – and that means your emotional self, too. Cutting yourself off from giving and receiving pleasure or from human contact isn’t good for you. You may become isolated or depressed, which is also not good for your health.

Sex can feel good, bring you closer to other people and satisfy a powerful desire. That is reason enough to continue to enjoy it as often as you wish. But there are other recognised health benefits too: sex can help you relax and sleep better; sex can be very good exercise; sex can relieve pain, improve circulation and lower cholesterol levels. Having a healthy sex life contributes to your overall health and wellbeing.

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