Dr. Remien,

I'm hiv+ and healthy he is negative. We have had a great relationship for a little over 6 yrs now but the last three months have been very difficult. I love him very much and he loves me and is still in love with me. We have played safe in our activities (sex) since November 1997 when I found out but have not done anything in the last three months. He finally told me that that he is does not enjoy the activites as he cannot get the fact of my status out of his mind while engaging in sex. There are no others involved. I have asked him if he was worried about about catching hiv from me and he advised me he is not because we do not do anything that is unsafe. I have been patient and understanding but things have not changed with the sex life. I need the intimacy and it doesnt have to be much but none is not acceptable as I am not dead and have a future. I have told him that things must change or we must go our separate ways. I have been totally honest with my feelings and have cryed over this situation daily for several weeks and finally realized that this in not good for either one of us. The crying is over and the only thing I want to do is make him happy even if it means losing him. I have tried to move into the other room but he insists that I do not. I am desperatly trying to find out and to understand what is going on and save the relationship. I have also been really having a compulsive urge lately to fill the intimacy void and feel that I may stray if things dont change. I have been totally committed to him and never had the desire to stray. I feel extremely bad for thinking this way to the point of feeling sick and guilty about it. I know that outside help is a must but I would like your opinion and advise. He/We have agreed with getting help but would like your opinion/advise other than just getting outside help. We both have a psychology background and will be getting outside help. As you are aware its not easy to figure this out when you are the one who needs counseling. Any input you have would be greatly appreciated.

PS Thank you for this great site

Your situation is obviously a very challenging one and I can tell it is very painful for you. All of the feelings you describe are entirely understandable. While experiencing some anxiety about HIV transmission is normal, it need not prevent the ability to have comfortable, pleasurable and "safer" sex. There seems to be a bit of a contradiction in what I hear your partner communicating when he says that he is not worried about getting HIV, but can't get your status out of his mind. What ARE his feelings about your HIV status and what ARE his concerns? These may be difficult issues to talk about openly and honestly, but there could be tremendous benefit to both of you if you were able to do that.

I am concerned about the happiness and well-being of each of you. You deserve intimacy and satisfaction, including sexual satisfaction, as does your partner. As a couple you need to address the disturbance in the intimacy between you. There will likely be benefit for each of you to seek outside help individually, however I also strongly advise you to seek help "as a couple." Whatever the outcome of the relationship it would be useful for the two of you to address the tough and emotionally challenging issues that you face. Honest, open, and affective expression of what you think and feel will renew an important sense of intimacy between you. Then you will be in a position to figure out and decide what you both want to do about your relationship. If it is a relationship that you want to maintain then there will be things you can do to work on improving the situation. If you decide that it is not a relationship that can go forward then you can end it with honesty and respect between you. Either way, it seems you owe it to yourselves and the 6-year committment to confront the realities you face and move forward in some direction.

Good luck and I hope you both are able to confront what is real and happening to you so that your lives are more satisfying to you.