Sex – Will I, Won’t I?

All men, regardless of our HIV status, have the right to healthy and satisfying sex lives.

Men who have been diagnosed with HIV will respond differently when it comes to decisions about having sex. Some men may choose not to have sex for a while. Others may have lots of sex. Some choose to have only casual sex. Others seek HIV positive partners.

There is no single correct choice and the choices you make may change. Many people find that having HIV has no impact on their sex lives while others find it difficult to form sexual relationships because of the prejudices or fear they feel or experience.

Whatever the situation, it is important to become and remain informed about pleasure, desire, and safer sex. Knowing about the many aspects and complexities of HIV and sexuality makes it easier to negotiate the sex that you want, regardless of your HIV status.

It Takes Two

It’s not always easy to relax and just get into sex.

As a man living with HIV, it may often feel like you are held solely responsible for avoiding the further transmission of HIV. While you do have responsibility, you are not solely responsible. Everyone involved has an individual and collective responsibility.

In order to become and remain comfortable with the choices that you make, it may be good to spend some time thinking through issues, perhaps talking to other HIV positive men, friends or partners.

Speaking through some issues with a support worker or counsellor may help. For example, issues such as; responsibility for decisions around safer sex, talking about the sex that you want, enjoy, and are comfortable with, and disclosure. Reading about all of the health issues associated with sex is not exactly hot reading. On this site and through the HIV + Sex Booklet we have tried to present the information in a way that will help you to make the right decisions for you.

Not all questions can be answered. You need to make decisions based on the information that you have, and you need to feel comfortable with your decisions. That way you can feel most comfortable with your partner(s), and ultimately have better sex.

Relationships

Relationships, good social support network, peer support.

These can be important in maintaining self-esteem and self-confidence, particularly when newly diagnosed with HIV. Relationships cover a range of issues like affection, intimacy, support, having someone to care about, and somebody who cares about you.

Relationships may vary greatly: for some men, they may mean:

  • long-term intimate relationships with only one person;
  • loving relationships with one partner and sexual activity with others;
  • a series of casual sexual relationships with different people.

Regardless of HIV status, relationships have their challenges, but can also be very rewarding. For some men, the HIV status of their partner is unimportant; for others, it can be a very important factor. For some couples it can feel as if there are three of you in the relationship – You, him, and HIV.

If you are in a relationship when you receive a HIV positive diagnosis, don’t assume that your partner might also be HIV positive. The only way to know for sure is if your partner gets tested.

A relationship where one person is HIV positive and the other is HIV negative (sometimes referred to as a sero-discordant relationship) has its own set of challenges and anxieties. Initially, there may be the issue of disclosing (telling the other person you are HIV positive). This may bring up a number of concerns for you both. The fear of transmitting HIV is a concern for some. You may need to renegotiate your relationship boundaries in relation to the types of sex you both want and enjoy. You should both be aware of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) and the benefits of being undetectable.

Some men living with HIV find that by having a HIV positive sexual partner they have a less anxious sex life. You may choose not to use condoms because you enjoy the intimacy of condomless sex. This brings its own challenges, including possible health implications.

Anonymous or casual sex is a significant part of the lives of many men who have sex with men. If you enjoy casual sex with someone you don’t know it might be useful to discuss and agree on sexual boundaries before you engage in sexual activity.

Whatever relationship you desire; it is important that decisions made about future relationships are not based on HIV alone. How you feel, if it works for you, and if it’s what you want and enjoy, are all better reasons for making decisions.

Tests: what you need to know