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Condom Anxiety (?)
May 17, 2010

Hello Dr. Frascino,

I am 54 and was diagnosed in 1995. I have an undetectable vl and an t-cell count of close to 400. Two and half years ago, came down with anal/rectal cancer, which I had surgery, chemo and radiation treatment. Gladly, no more cancer and continue to have negative results from all of the follow-up exams. WHEW!

My problem is this, ever since then I have had trouble maintaining an erection. My partner of 7 years this month is HIV negative and we have had reasonably good sex throughout the relationship.

Although we have had a nice sexual relationship, but whenever I put a condom on (as all good HIV poz boys should, I loose my erection. This has been an ongoing problem, but recently, after being diagnosed with major depression and general anxiety disorder, the problem has become worse. I know depression and GAD, can cause one to loose sexual interest, I think that has definitely happened in the past, but has been improving and actually get a good erection during foreplay. But my problem is more maintaining an erection while putting on a condom and especially if I'm going to be the top for the night. I recently started Cialis, but that does not seem to work well enough - like I said, I start out strong and end up limp.

Any suggestions? Is this a norm for someone who has been in the sero-magnetive relation? Is this purely performance anxiety? HELP!!!!


Response from Dr. Frascino

Hello W,

Erectile dysfunction problems are quite common in HIVers and can be caused by a variety of underlying conditions ranging from hypogonadism (low testosterone) to psychosocial issues (depression, being in a magnetic relationship, etc.).

I would suggest you talk to your HIV specialist as a first step. He'll begin a basic workup for erectile dysfunction, including checking a free testosterone level, performing a physical examination and taking a thorough history.

In the interim I'd suggest you and your partner read through the chapter on magnetic couples in the archives of this forum. You should then discuss this issue openly and honestly. This should help with performance anxiety issues.

Treatment or counseling from your depression and GAD may be helpful. You could also try a cock-ring. It's a simple device that may help maintain the wood in your woody.

Dr. Bob

anxiously preparing for 3 month post PEP test
Discordinant couple

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