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Sexually Frustrated
Jun 11, 2008

Let me begin by saying that I am a HIV negative male who is in a relationship with a HIV positive male. We have been in a loving relationship for over a year now. Since before we started dating, I knew he had HIV and I am very comfortable with the fact that he has the disease and I do not. Since we first started dating we have had sexual intercourse quite regularly. By that I mean as often as 1-2 times a week. Either he or I initiated sexual intercourse. If I was to draw out a timeline I would have to say that our sexual encounters have become less and less after about 5 months passed in the relationship. To be more specific, less means about having sex once in about 2-3 weeks. As time has gone on, sex has become less and less to the point months can go by. I have asked him if there was something about me that may be causing it and he assures me that it isn't me. In fact, as a couple, there has not been any changes in our behaviours in loving each other that is non-sexual. Medically, he is doing excellent and his doctors are very impressed with his tests everytime they see him. Given the fact that he has told me time and time again that I am not the root of his lack of sexual drive it still baffles me. I have tried asking questions but he can't seem to figure it out himself. I've asked him to talk to a professional about it and if it's ok with him I would attend the meeting with him. Unfortunately, his next meeting isn't for a while.

In the end, you can only imagine how sexually frustrated I am. We were very sexual for a long time and it has dwindled to the point that we have only had sex twice in 5 months. It doesn't seem to concern him but it does with me. Keep in mind I am not being self-centered but I am overly baffled cause we had sex quite routinely in the past and prior to me he was extremely sexual which is what caused him to acquire HIV to begin with. If it's worth mentioning, he is 34 and I'm 36 years old.

Can you give me some hints/suggestions or thoughts as to what may be happening to him and if there is something I can do to help him? I look forward to hearing from you.

Response from Dr. DeJesus

Thanks for posting your question. You are not alone in this problem. There are many HIV + patients, on or off meds that loose significantly sexual drive. There are many potential explanations for this to occur, including various social and emotional issues, but also common are hormonal problems.

HIV by itself and its treatments have at times been associated with hypogonadism, a condition in which insufficient sex hormones are produced by the sexual organs (in men this means low levels of testosterone produced mainly by the testicles), causing sexual dysfunction such as impotence, body changes, reproductive problems, mood alterations and decreased libido. HIV rarely has also been associated with some "resistance" of the body to respond to normal testosterone levels. Those patients then require higher than normal testosterone levels to respond normally.

There are many reasons why a person can develop low testosterone levels. As I mentioned, HIV itself, some HIV treatments, and even a past use of an anabolic steroid, or a transient testosterone supplementation, used by many men to enhance body mass, can affect the endogenous testosterone levels.

I am not suggesting that hypogonadism is the only explanation for your partner's lack of libido, but it is certainly a place to start to investigate this problem. Have him discuss this openly wit his HIV provider. If he does not feel comfortable discussing this issue with his provider, he needs to find someone that he feels comfortable discussing this issue with, because this is very important, and potentially unhealthy.

I have referred your question to another member of our faculty for more advises. Thanks for posting your question and goof luck to you and your partner.

respose to *SO* glad he started
Should I stay on abacavir

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