Sex problems and HIV Your feelings about sexIf we were to believe everything we see on TV, in the gay papers or on the internet, we’d all be having fantastic sex every day. For most of us, this isn’t how it is. Nor is there such a thing as a ‘normal’ sex life. ‘Normal’ is just what’s right for you, on your own or with someone else. A normal sex life is different for different people. It may include: Whatever gives you and your partner enjoyment Having sex 5 times a week or once a month, or more, or less Cuddling, kissing or holding hands without needing to continue to sexual intercourse Wanking Using sex toys Losing interest in sex at certain times in your life –this may be caused by stresses such as illness, financial worries or a broken relationshipThe list could be endless. But none of this really matters as long as you feel happy with your sexuality and sex life.If you are in a relationship and you and your partner feel comfortable with your sex life, then reassure yourself that things must be ‘normal’ for you both. Just feeling close to someone and knowing that they’re there for you, no matter what, is far more important than having great sex all the time. Likewise, it doesn’t necessarily take being in a sexual relationship for your sex life to be ‘normal’. While we don’t have data on how often gay men with HIV have sex, we do have some statistics on how many partners men with HIV have in any year. In a survey of HIV positive gay men conducted by GMFA in 2004 we found that the average number of men that HIV positive men had sex with in the previous year was 28 . Having said that, the number of partners ranged from none to numbers up in the hundreds, so there’s no ‘normal’ number of sexual partners that HIV positive gay men have. However, it is not unusual for people who have been diagnosed with HIV to feel that they aren’t in control of their feelings and attitudes towards sex, and this can have a negative impact on their life, their sexual choices and their partners. You may even be feeling less attractive and that HIV has somehow ‘tainted’ you. This isn’t at all surprising given that sex is the route by which most gay men become infected with HIV. "At first, my diagnosis totally changed the way I thought about sex. I spoke to a close friend who told me not to worry and that, with the complete head fuck of being diagnosed, it wasn’t surprising that I was finding sex difficult. He suggested that I should take my time to get used to the fact that I was positive, and not to be so down on myself. As time went by my diagnosis became less and less consuming – it wasn’t on my mind 100% of the time day and night any more – and with it I found that I became more comfortable with sex again." (David, 45) Only you can decide whether or not you are comfortable with your sex life and the important thing to remember is that there’s no shame in feeling differently about sex, or not feeling able to have the sex you want. There’s no need to suffer in silence though and reaching out to get help now could enable you to put any problems you are having about sex behind you. If you’re not happy with any aspect of your sex life in any way, you can always speak to your doctor or arrange to see a sexual health counsellor at your clinic. For details about any other counselling services that may be available and suitable for your needs, call THT Direct on 0808 802 1221. You may also find it helpful to take an assertiveness training course and again the advisers at THT Direct should be able to help you find something suitable. There are also other issues which you may have concerns with. To get more information on any of the below topics, simply click on the "Read More" button. Losing your sex drive Read more Losing your sex drive is not uncommon. There are plenty of HIV positive guys who have felt differently about sex after they were diagnosed, and some that continue to do so. Remember that we all go through periods where we’re not as up for it as usual, and this is only natural. If you’re normally shagging every cute guy in sight but you don’t feel like it at the moment then try not to worry. No one can shag 24/7 forever, however much they’d like to think they could. Remember that you should never feel pressured into anything, and you don’t need to have sex if you don’t feel ready. However, if your lack of sex drive is distressing you there may be reasons for it that can be fixed. There are all sorts of psychological reasons for losing your sex drive that are related to living with HIV, such as guilt or anger about having HIV, receiving an HIV diagnosis, fear about passing HIV on or loss of your self confidence. There could also be a physical reason; it could be hormonal and to do with decreased testosterone levels. Low testosterone levels can be caused by HIV, especially if it is at a fairly advanced stage, and can also leave you feeling very tired. However, problems with low testosterone levels can be treated with testosterone therapy. Excessive intake of alcohol or recreational drugs can also decrease your desire to have sex, as can some prescribed drugs. In particular, drugs that are prescribed for depression such as Prozac and Seroxat can reduce your desire for sex. If you have any concerns at all, speak to your doctor. Too much sex Read more There’s nothing wrong with having lots of sex, if that’s what you want. Having hot horny sex with loads of guys as often as possible is great if you’re doing it safely and feeling in control at the same time. But if you’re not feeling in control but find you can’t stop, it can have a negative effect on your life. If you’re feeling lonely, unattractive or lacking self-confidence, possibly because of having HIV, sex can for a short time help you to forget these negative feelings and make you feel good about yourself. However, not being in control of the sex you’re having can lead to a reinforcement of any negative feelings you may have. It’s also not uncommon for men who are feeling this way to use more recreational drugs than they really want to at the same time as having more sex than they want. Often men can feel that their drug use and sexual appetite are out of control but can’t see a way out of the situation. Drugs and sex can be used to block out your feelings about having HIV, just as much as they can be an addiction. If you’re unhappy about the amount or kind of sex you are having then taking some time out to speak to a counsellor may help you get back in control of your sex life. Problems getting hard Read more Not being able to get or maintain an erection (known as erectile dysfunction) is not uncommon, however it can be hugely frustrating and have an impact on how you feel about yourself. If this is something that has happened since your HIV diagnosis, as with loss of sex drive, it could be that you’re struggling to come to terms with the fact you have HIV. Other factors, such as stress, anxiety, depression, recreational drug and alcohol use and even your hormone levels can all play a part. Erection problems can also be due to physical reasons. HIV itself, or the side effects of certain anti-HIV drugs, can sometimes cause damage to the nerves associated with getting an erection. Whatever the reason, the problem can usually be sorted out, possibly through counselling or the use of drugs such as Viagra or Cialis. If you are having erection problems then speak to your doctor or arrange to see a sexual health counsellor. This may make you feel quite shy or embarrassed, but your doctor or sexual health counsellor will be experienced in treating men who have problems getting or maintaining an erection. "I never had a problem with getting hard. Never even thought about it. Even after I was diagnosed I still had no problems at all, until about 18 months ago when I was with this guy who I really fancied and when we got down to it nothing happened. I was really embarrassed and left soon after. After that, it played on my mind and it started to happen again and again. I was too shy to talk to my doctor about it so I did nothing for months. Eventually I plucked up courage to open up. My doctor was really understanding and referred me to the sexual health counsellor, who has really helped. I just wish I’d gone to see him sooner." (Samuel, 22) References Read more 1 Richard Harding, King's College; Tim Molloy, GMFA. Positive Futures Survey of HIV Positive Gay Men, 2006.