Thoughts and Feelings about sex after your HIV diagnosis
Points to Ponder
- HIV stigma can impact how you feel about sex.
- Positive and negative feelings about sex are a normal part of adapting to HIV.
- Your HIV status does not take away your right to intimacy and pleasure.
- Enjoying your sex life contributes to your quality of life.
Your feelings about sex can be affected by your thoughts about the virus, how your diagnosis affects the way you see yourself and how these aspects combine to influence your sex life as an HIV positive person.
Although negative attitudes about HIV have changed over time, many of them have remained and contributed to the great stigma experienced by people living with HIV. Stigma is made up of negative attitudes, fears and prejudices about HIV. This can result in insults, rejection and gossip from people living with HIV.
In some cases, when people living with HIV suffer from the stigma, they begin to see themselves in a negative way and this can impact their sex lives. This is also known as internalized stigma and self-esteem - when people living with HIV start to have thoughts and beliefs that are contagious, undesirable and not worthy of experiencing pleasure and intimacy. Although many negative ideas about people living with HIV have not yet come to major medical discoveries, such as U = U, it is important that you know the facts about how HIV is transmitted (and how it is not) in order to feel empowered about your sex life.
Initial reactions to your diagnosis
The sex lives of different people are affected in different ways by the diagnosis of HIV. A strong initial reaction to an HIV diagnosis is often the feeling of wanting to 'get out' of the sex circuit.
Most infected people contract HIV sexually, and therefore sex can be associated with negative feelings. Not wanting to transmit HIV to a sexual partner is also often a reason to avoid sex altogether.
These feelings can be alleviated by knowing that after starting treatment and your viral load remains undetectable for six months or more, you may not be able to pass HIV on.
In contrast, your interest in sex can become stronger and more intense. You may find that you want to explore sexual desires without the fear of contracting HIV.
Whatever you are feeling is part of your diagnosis adjustment and need not be a cause for concern. The shock you experience after diagnosis is temporary and your response to living with HIV will change as you learn the best way to control it.
Feeling good while having sex
For many people living with HIV, becoming undetectable and knowing that they cannot transmit HIV has been a turning point in the way they view their sex lives. This allowed them to stop thinking about sex in terms of infection and risk and to focus on the pleasurable aspects of sex.
We now have several ways to prevent HIV transmission during sex. Adopting a proven prevention method, whether using condoms consistently and correctly or remaining undetectable, means that you must feel safe about having pleasurable, worry-free sex. It is important to know that you can have a healthy and pleasurable sex life without passing HIV to your sexual partners and that people living with HIV can have children who do not have HIV.
Good sex, intimacy and physical pleasure are essential aspects of well-being. This is no different if you live with HIV. People with HIV want the same things as everyone else - love, affection and the pleasure and satisfaction you can get and give when you have sex.
Sexual expression and pleasure are part of what makes you human. Having sex and relationships in your life will probably be just as important to you as it ever was, possibly even more so. Living well and staying healthy with HIV means taking care of yourself - and that also means your emotional self. Cutting yourself off from giving and receiving pleasure or human contact is not good for you. You may be isolated or depressed, which is also not good for your health.
Sex can be good, bring you closer to other people and satisfy a powerful desire. That is reason enough to continue to enjoy it as many times as you want. But there are also other recognized health benefits: sex can help you relax and sleep better; sex can be a very good exercise; sex can relieve pain, improve circulation and lower cholesterol levels. Having a healthy sex life contributes to your overall health and well-being.
This page was last revised in November 2020. It should be revised in November 2023.