I'm a 47 year old male. I've only been poz since I was 43 but had only 75 t-cells when diagnosed. I was NEG just 3 years earlier. I'm on Atripla, HZTZ, Lisinopril, Lexapro, Trazodone, Acylovir, Androgel. I have nearly no sex drive. Is there anything I can do?

In assessing loss of libido (sex drive), there is the difficulty in defining what is normal. It is certainly normal for sexual drive to diminish with the passage of years, but the degree is highly variable.

Often loss of libido is situational; a recent diagnosis of HIV, fear of transmission to others, and fear of getting other infections may all be relevant. Perhaps the "spark" is ebbing from your relationship or sex has become mundane and unimaginative. It is important to talk to you partner about this and take time for thinking about sex and spending time being affectionate and erotic with your partner. This may help get you back in the "habit" of desiring sex.

Depression and chronic illness as well as high alcohol and drug intake are often associated with loss of libido. It is a common side effect of antidepressants like Lexapro and trazodone. Perhaps you can talk to your doctor about the need for both these drugs or whether lower doses can now be considered.

It is unlikely to be hormonal, especially as you are already on a testosterone supplement. Low blood pressure and blood pressure meds sometime interfere with erectile function, but not libido.

Kind regards,

Dr Moyle