You already know HIV can screw up your sex life. But we’re not talking condoms and disclosure. Studies show that men and women living with HIV experience sexual dysfunction: erectile problems, lack of interest or inability to reach orgasm. The condition, also caused by med side effects, is often left undiagnosed and untreated. Some sex squelchers (affecting both women and men) include:

  • Psychological issues—anxiety, depression and stress from life with HIV
  • Cardiovascular diseases and diabetes, common with HIV     
  • Low testosterone from HIV
  • Excessive estrogen in men on HIV meds
  • Low estrogen in women with HIV
  • Nerve damage from HIV and some of its meds, including Videx (ddI ) and Zerit (d4T)
  • Side effects of other meds—including antidepressants
  • Recreational drugs, alcohol and cigarettes
  • Low libido due to early menopause in women with HIV

But you can get the heat back in your sheets.

Have an intimate Chat—with your doctor, that is.
Nailing the root of sexual problems—along with counseling and support groups—can help restore your oomph. If your doctor prescribes an antidepressant, know that some, like Wellbutrin, have fewer sexual side effects than others.

Boost your circulation
Some problems stem from reduced blood flow to your penis or clitoris. Massages and warm baths can work as relaxing foreplay, sending blood where it’s needed most.

Help hormones and hearts
Testosterone injections, creams, gels or patches can normalize blood levels, stoking desire in men and women (who need much lower doses). DHEA, a hormonal supplement from health food stores, may lift energy, mood and sexual function (again, women need less). If heart disease is the root and you need a blood-pressure med, know that Diovan is said to aid sexual function.

Seek erectile support
Remedies for erectile dysfunction (ED), such as Viagra, Levitra and Cialis, can cause side effects—and Medicaid no longer covers the meds. Protease inhibitors boost ED-drug blood levels, so start with a low dose. Prescription meds Trimix and Caverject can help ED, but you inject them right into the penis, which requires training by a urologist. Injecting too much can cause dangerously prolonged erections (priapism), demanding an emergency room visit. Don’t mix these with other ED meds—your priapism risk will rise. Muse, a prescription pellet inserted into the penis (with a doctor’s guidance), can promote blood flow and erection.

Try some nightstand magic
Other strategies are a tad less clinical. A cock ring can help men attain better erections. For women with vaginal dryness from menopause, estrogen-containing vaginal preparations and water-based lubricants can work wonders—keep them close at hand to avoid mood-mashing trips to the medicine chest. Enjoy!