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Men having Sex with Men 

HIV AND SEX

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CAN I STILL HAVE SEX?

Yes. Sex can be enjoyed just as much after HIV diagnosis as it was before, with either long- or short-term partners. To enjoy sex without anxiety there are a few things that should be considered.

WHAT CAN I DO TO PROTECT OTHERS FROM HIV?

For it to be as safe as possible for your partner to not wear a condom, the following three provisions are essential:

  • You take combination HIV medication as prescribed

  • You have had an undetectable HIV viral load for at least six months

  • Both you and your partner are free from other STIs

If you haven’t started HIV treatment you should make sure you wear a condom during sex.

SHOULD I WEAR A CONDOM?

If the three provisions listed are followed, it is you and your partner’s choice to decide whether to use condoms.

WHAT ARE THE BENEFITS OF USING A CONDOM?

Condoms are the best way to protect you and your partner from HIV and other sexually transmitted infections (STIs). This includes bacterial infections like gonorrhoea or viruses such as herpes.

When both partners have HIV using condoms may not be front of mind, but there are considerations aside from other STIs or hepatitis C virus:

  • Your partner may have a resistant strain of HIV that your HIV medication does not protect you against

  • There are two types of HIV which are found within different communities: HIV ‘type 1’ and ‘type 2’. Although type 2 is rare, it is important to check that you both have the same type

SHOULD I TELL MY PARTNER?

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There are many benefits in talking to your partner about your HIV status:

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  • You and your partner can make informed choices about sexual activities

  • Being open and honest can do wonders to promote better emotional health

  • Often, the reactions from those whom you tell can be more positive than you may have thought

  • There may be a legal requirement in your country to disclose your status

  • One thing you (and they) may not realize is that if you’re on effective treatment and have an undetectable viral load, the likelihood of you passing on HIV to others is significantly reduced

  • If you’re newly diagnosed, you may wish to advise recent sexual partners to take an HIV test

 

ARE THERE ANY NEGATIVES?

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  • It is helpful to think about the different reactions partners may have to hearing about your HIV diagnosis

  • Hopefully your partner will be supportive but it's always possible that they may react negatively

  • They may not be aware that if you're on effective HIV medication and your HIV viral load is undetectable, the likelihood of you passing on HIV is significantly reduced

  • If your situation is particularly difficult and you’re concerned about domestic problems or violence, you should talk to your healthcare team about specialist guidance or support available to help you make your decision or manage negative reactions

CAN HIV AFFECT MY SEX DRIVE?

Possibly, but sex drive changes are common amongst people with or without HIV for reasons entirely unrelated to HIV. It is also more common as you age.

It doesn’t affect everyone living with HIV, however, HIV can increase the likelihood in the following ways:

  • Advanced HIV infection may cause lower testosterone levels in the body, which can affect sex drive and erections

  • An HIV diagnosis can often be stressful; stress can have an impact on sex drive and ability to get an erection

If you are concerned about changes to your sex drive or sexual performance, speak to your healthcare team for advice.

WHAT SHOULD I ASK?

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Ask your healthcare team…

  • Am I at risk of passing on HIV if I have sex without a condom?

  • How might my HIV medications affect my sex life?

  • How can I look after my sexual health in the future?

  • How should I tell partners that I am HIV positive?

  • Where can I learn about safe injection of recreational drugs?

HIV

SHOULDN’T STOP YOU FROM HAVING A SEX LIFE

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