Examining the multiple factors that can cause dysfunction and ruling them out one by one—did I just start a new med? Am I depressed?—can help. It’s important to figure out whether you’re unable to get it up or don’t feel like sex at all, Spinelli says. For example, ED drugs like Viagra don’t treat low libido, so they won’t correct for ED caused by lack of drive.
If your sex drive seems low, your doc might check your hormone levels. Testosterone supplements such as Androgel and Testim may painlessly help reignite your urges (though they may have some negative side effects of their own). There’s also Testopel, a newer therapy that embeds testosterone pellets right below the skin to deliver testosterone for up to five months. “Hormone therapy hasn’t helped immensely,” Spinelli warns, adding, “It’s a chronic problem that you just have to stay on top of.” At least you know you’re not alone. And if depression or other emotional issues are at the root of your problems, seeing a therapist can help.
For Otani, learning to live with erectile dysfunction has involved a learning curve. “My doc gave me a Viagra prescription, which I used until three years ago when California removed it from the state’s formulary.” Otani manages to get by with free samples from his doc, and he offers helpful pointers for others dealing with sexual dysfunction (see sidebar). “Being upfront with my partners has worked well,” Otani says. “I let them know that if I don’t get an erection, it is in no way a reflection of my not being into them.” Honesty might be the best aphrodisiac of all.
SEXUAL DEALING
We asked HIV-positive men with sexual problems for some insights on how they handle the issue.
Who: The Rev. Joseph Shore-Goss
Where: North Hollywood, CA
Problem: Low libido
Tip: Save up
“Avoid extracurricular sexual activity. If I save myself up, I’m more likely to respond to my partner. My right hand has had a long break from activity.”
Who: Will Aaron
Where: Detroit
Problem: Erectile dysfunction
Tip: Feel deeply
“When I am with a partner I truly
have that feeling for, I don’t always experience this dissatisfying problem.”
Who: Dale Marshall
Where: Jackson, MS
Problem: Low libido
Tip: Talk it up
“Keep communicating. Things weren’t working with my ex, but instead of talking, I kept hoping it would get better. [They didn’t.]”
Who: Jerry
Where: St. Petersburg, FL
Problem: Erectile dysfunction
Tip: Have an orgasm anyway
“ED isn’t the end of orgasms. Although I don’t get hard like
I used to, I can still [have an orgasm].”
Who: Lynn S.
Where: Southeast Missouri
Problem: Erectile dysfunction
Tip: Ask for help
“If you don’t find the help you are looking for, seek some more. When I finally found an understanding urologist, all it took was a simple injection of Trimix (a three-drug cocktail, used as a gel or injection,
to treat ED). I had a smile on my
face for two days.”
