Many newly diagnosed folks wonder if they’ll ever have sex again—or if they’ll ever want to. You can get back in the game. Making love might not be quite the same as it was before HIV, but then again, it might be even better
By now, you’ve probably grasped that HIV is not a death sentence. Well, it doesn’t have to kill your sex life either. People who have just found out that they are positive often feel undesirable, even “dangerous or toxic,” as HIV positive New York City psychotherapist Michael Shernoff puts it. But HIV veterans and even some newbies will tell you that you can still have passionate, intimate sex and that it might even be better than before. “Sex is more intense since my diagnosis,” says health care educator Gregory Huang-Cruz, who was diagnosed positive in 1999. “It’s not about racing to get off.”
Putting It Out There
Telling a potential sexual partner you have HIV doesn’t have to spell disaster. “I started disclosing to people who hit on me, thinking it would scare them off. Many people said, ‘OK, we’ll just use protection,’” says Rick Witherspoon of Chesapeake, Virginia, who was diagnosed in 2005. To avoid hurt feelings, Shernoff recommends bringing up your status well before you get intimate. Disclosing to a lover also means you can share the responsibility for keeping your encounter safe. (In some states, you are obligated to disclose. See “Daring to Disclose”). Rejection, of course, happens. “Having no expectations is the safest way to protect yourself,” Shernoff says.
Talking honestly with your partner about which sexual activities you’re both comfortable with is an important way to minimize the risk of transmitting the virus. Anal and vaginal sex carry the highest risk, especially for the receptive partner, although the insertive partner can get HIV this way too. Oral sex is less risky, although condoms or dental dams make it safer. (For more about activities and risk, go to www.poz.com, click on HIV 101 and check out the Positive Sex guide.) Condoms “can make sex monotonous,” says HIV positive educator Debra Lyn McCarthy of Vacaville, California. “You have to come up with ideas to mix it up.” Dyane Haddock of Santa Rosa, California, diagnosed in 1994, likes to wear sexy lingerie and use sex toys. “It’s about trying different things,” she says.
Going All The Way
While HIV pushes some lovers away, it brings others closer. “I thought, ‘Having HIV will show me who really wants to be around me.’” says McCarthy. “I ended up getting back together with my husband.” Since her diagnosis, Haddock says HIV has deepened what sex means. “It’s not all about getting naked and getting in bed,” she says. “It’s about getting to know someone.”
DARING TO GO BARE
Can you ditch the condoms if you’re both HIV positive?
Even if you and your sexual partner have HIV, you’re both still at risk for sexually transmitted infections like herpes, HPV, gonorrhea, hepatitis and chlamydia. Having HIV makes fighting these pests more difficult; some of them can make your HIV more infectious. We also know that going “bareback” can lead to infection with a second strain of HIV (called “superinfection”). The jury is out on how risky this is. If you and your monogamous lover decide not to wear your raincoats, be sure you understand the possible dangers.
Whether you’re a man or a woman, just because you have HIV doesn’t mean you can’t have HIV negative children.
The right treatment can lower the risk of mom transmitting HIV to an unborn child to about 2% and in some cases even less. Pregnant moms should see both an HIV doc and an obstetrician with experience treating positive women to ensure proper care. You might have to switch meds or stop taking them during certain periods. During labor and delivery, mom gets AZT (Retrovir) intravenously; the newborn gets pediatric doses of AZT for six weeks. Most tots can be delivered vaginally.
Positive dads can ask for a process called sperm washing. This technique involves separating sperm from fluid and cells in semen that carry the virus. One hitch: Sperm washing is considered safe, but it’s also expensive and not widely available in the U.S.
Two mixed-status couples on sex and HIV
Gwenn Barringer, 31 (HIV negative) and Shawn Decker, 30 (diagnosed 1987). Together seven years, married in 2004.
Shawn: The good thing about sex with HIV is that there’s no second-guessing. You know what you need to do to protect yourself. My issue is that I’d like to have it more! But that has nothing to do with my status.
Gwenn: HIV hasn’t been a huge issue in terms of sex. Having sex with a condom is actually a little bit better: I like that I don’t have to deal with the mess! We won’t have intercourse without a condom, but we will engage in oral sex without one, but not with him ejaculating.
Tyler TerMeer, 23 (diagnosed 2004), and Charlie Gray, 26 (HIV negative). Together two years.
Tyler: No matter how safe you are, there’s always the “what if?” What if the condom breaks? What if something goes wrong? What if we are so in the moment that we just forget to put on a condom?
Charlie: I think the sex is better. We’re much closer than we were because of Tyler’s diagnosis—being strong for each other has made our relationship stronger. We love each other more, so sex means more and is more intimate.