We have been married since 1961, As a result of an accident in 1974, he contracted AIDS from blood transfusions. We did not know he had AIDS until 1988. Now, at age 68, he is on massive amounts of testosterone and wants sex all the time with me. I am 64, and frankly I am afraid of contracting the disease. He does not comprehend my anxiety and makes me feel foolish about my feelings. He does use all precautions, but frankly, the sex desire is just no longer there for me.

Your feelings are understandable, but there are some steps you can take to help the situation. First, I assume your husband is in treatment with a physician. If so, then he must be monitoring his viral load. If his treatment is effective, hopefully his viral load is undetectable. With an undetectable viral load, the likelihood of transmitting the virus through vaginal intercourse is extremely low, and if you use condoms, of course, you should be totally safe from infection with HIV. You can also speak to his HIV physician about post-exposure prophylaxis in the event of a broken condom. This would add additional protection, but needs to be discussed and arranged in advance to be most readily available.

As for your lack of sexual interest, this is a problem that can also be addressed if you like. Loss of interest in sex may be caused by depression or, in your case, your fears about HIV may have caused you to feel inhibited about sex. If your fears are somewhat allayed by the suggestions above, then perhaps you can start to feel more at ease and the interest may return.

You can also consider seeing a psychologist or psychiatrist to talk about your loss of sexual interest. As I said, it may be related to depression, or to your feeling that your husband has been insensitive to your fears, or other factors that you may be able to identify and work on.