Sex and HIV

Many women with HIV experience a temporary loss of libido or find sex painful. You may also experience anxiety about starting a new relationship or transmitting HIV, and fear of rejection on disclosing you have HIV. It is important to acknowledge that these feelings are real and then to seek solutions.

Your healthcare team may include a psychologist or counsellor who could help, but sometimes talking with a close friend or with others who have had similar experiences can be just as helpful.

Sex, desire and pleasure need not stop when you have an HIV diagnosis. You may want help on how best to negotiate safer sex or on how to use male and female condoms. Your healthcare team and support organisation can provide this help.

Preventing transmission of HIV

The risk of passing on HIV depends on many factors such as your viral load and the presence of other sexually transmitted infections.

Using male or female condoms consistently, not having unprotected vaginal or anal sex, not sharing injecting equipment, following the guidelines for a safe pregnancy and birth, and not breastfeeding are the key ways of not transmitting HIV to another person.

The risk of passing on HIV from oral sex is low. If someone is performing oral sex on you (also called ‘cunnilingus’, which means using the lips and tongue to stimulate female genitals) they can lower the risk even further by using dental dams (small pieces of latex). If you are performing oral sex on someone else, the only body fluid they have contact with is your saliva, so there is no risk of HIV being passed from you to them. The only possible risk would be if your mouth was bleeding.

Women are often vulnerable in negotiating safer sex for social and cultural reasons. If you have difficulty persuading a partner to use a condom, try using the female condom (Femidom), which puts you in control of safer sex and can give heightened sexual pleasure.

Talk to your healthcare team or a support organisation if you are vulnerable to exploitation for financial, social or immigration reasons and they will help you to find ways of managing the situation.

Sexuality and HIV

HIV-positive lesbians, women who have sex with other women but who don’t identify as being lesbian, and transgender people are likely to face stigma based on sexuality as well as HIV status.

The risk of transmitting HIV during sex between women is low, and it can be lowered even further by using dental dams for oral sex. If you and your partner use the same sex toy, you could pass on an infection (including HIV). To avoid this, put a new condom over it or wash it in warm soapy water between each use.