HIV, sex and you
You may find that your feelings about sex change after you find out you have HIV. It could be that your interest in sex dips or goes away altogether for some or all of the time, or the opposite might happen. This could be due to natural fluctuations in your desire for sex and is something that you are prepared to put up with. Alternatively, it could cause you problems, particularly if it makes you unhappy or interferes with other aspects of your life.
Finding out you have HIV can make you feel differently about yourself. It may well be a shock and may result in you going off sex, at least temporarily. Some people say that having HIV makes them feel less physically and sexually desirable and they lose confidence dating or with their sexual partners.
Having HIV can make you to look at yourself and sex very negatively. It could make you feel bad about the kind of sex you had or are having, make you worry about the risk of infecting somebody else, or make you angry with the person or people who could have infected you.
An HIV diagnosis might also feed wider negative feelings you have about who you are. HIV has been used as a moral and political tool to criticise and stigmatise the groups most affected in this country – gay men, Africans and drug users.
It is important to remember that HIV is an infection - it is not a moral judgement nor a punishment.
Anxiety about infecting sexual partners with HIV is also common and this can mean that your desire to have sex or your sexual performance dips.
An additional source of anxiety may be telling your past, present or potential sexual partners that you have HIV. This can be daunting and you need to decide yourself whether you tell none, some or all of your sexual partners.
Infecting somebody with HIV after having unprotected sex could have serious legal implications. See the section, HIV and the law.
Think about how and when you are going to tell people that you have HIV, and how you would react if somebody rejected you. Although many HIV-positive people have HIV-negative long-term partners or casual partners, people are rejected because they have HIV. It can hurt (or even in some circumstances put your personal safety at risk) and it is important that you develop strategies to cope if this happens to you.
Many HIV-positive people have partners who are HIV-negative. Many couples are able to have protected sex all the time, but others find this difficult or impossible and are willing to accept the risk of the uninfected partner contracting HIV. In some circumstances power imbalances in a relationship can mean that even though one partner wants to have safer sex, the other partner insists that condoms are not used.
HIV can also lead to a loss of sexual intimacy in relationships. Enjoying and valuing intimacy in ways other than sex might be valuable if this occurs.
Some HIV-positive people choose only to have sex with people who also have HIV - this is sometimes called 'serosorting'. This can be motivated by a wish not to risk infecting a partner with HIV. Another reason might be a wish to have unprotected sex with other HIV-positive people. This can be pleasurable and intimate, but there can be health risks including sexually transmitted infections, infection with hepatitis C and possible reinfection with another strain of HIV. These issues are discussed in greater detail in the rest of this section.