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Can't get it up!

Mar 14, 2003

Well, since coming out of the closet in 1990, I've been like most men I guess and have had literally over a thousand sexual partners. So, no fault but my own, I ended up with HIV, a fairly logical conclusion to many who lived the way I did. But after years of endless anonymous sex partners, sometimes 5 a week. I can no longer maintain an erection. I've been POZ since Winter of 1997. I'm still on the same regimen, Combivir and Viramune. I've never been detectable, I've never had T-Cells lower than 800. I have normal Testosterone levels, no organic fatigue related illnesses, I was depressed years ago and on Pamelor, but have not felt depressed in years. I do get erections in my sleep because I wake up with them. In fact, the only time I seem to be able to keep an erection anymore is when I ######## to ####, and I usually come within minutes. During sex with my lover, I cannot get aroused anymore without having poppers. It's not just my lover, it's been with anyone. So, since everything organic about me checks out, do I need to seek psychological help again? Am I a sex addict who has just OD'd so to speak and can't get aroused by sex anymore? I've tried viagra, and while it does help get me hard, I am still not aroused by sex really. I am sick and tired of feeluing so down about not being into sex, and my lover and I really want to get rid of the poppers. So any of your feedback will be helpful. I wonder if maybe my physiology needs higher amounts of testerone, and even though it shows normal, maybe it's not for me. I don't know anymore. I just know I have no idea who to ask for help for such an embarrasing problem.

Response from Mr. Shernoff

First of all erectile difficulties are nothing to be embarrassed about. It is a legitimate problem.

There are two routes you can go. You can try to locate a sex therapist to try and get help for what is a diagnosable sexual dysfunction. But be careful, there are not a lot of openly gay certifed sex therapists. You will need to carefully interview any one you are thinking of working with about about three issues. 1) Are they certified to do sex therapy by AASECT, (The American Society of Sex Educators, Counselors and Therapists); 2) be certain to ask questions about if they have experience working with gay men and what their views of homosexuality and gay sex are; and 3) How do they feel about HIV+ people remianing sexually active? Unfortunately there are plenty of professionals out there who would NOT be willing to help a POZ man regain sexual functioning.

It would be impossible for me to assess what the problem is, but there obviously is a problem that is not physiological since you do have morning erections. Seeing a therapist who is very skilled with sexual problems but not AASECT certified may also be a possibility, but you need to be a very careful consumer while shopping for the right person to work with on this issue.

Michael Shernoff, MSW

Slow Progression
Therapist in Palm Springs, CA

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