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unprotected sex

Sep 29, 2003

I tested positive two months ago. It was no surprise, as I had unprotected sex on a few occasions before that. I understand completely about the virus, and other STDs, and why it is so important to use condoms, etc. But no matter what I know about any of this, I cannot stop having unprotected anal sex. I physically have difficulty using condoms, which is not a copout -- I have tried every type of condom and every type of lube, and as a bottom, it hurts too much to do, and as a top I lose my erection. Psychologically during sex, I lose all interest at the mention of a condom, and prefer to just stick to oral and mutual masturbation. This is not something I have been able to control -- I have tried psychotherapy and hypnosis to no avail. I wish I could change this but I just do not know how anymore. Immediately after having unprotected sex, I feel extremely guilty and disappointed in myself for doing it. I am not promiscuous at all, but I guess subconsciously I feel that a condom makes the intimacy of anal intercourse feel fake and guarded, and this will go along with my emotions and inhibitions. I hope that your answer to this will NOT just be "wear a condom" because it is not nearly as simple as that. As I said, I am extremely educated in all facets of disease, safe sex, etc, but I just cannot get past this obstacle. I am extremely concerned for two reasons: 1) I am concerned about talk of reinfection of HIV, and getting other diseases, and 2) As a relationship-oriented person, I am afraid that I will fall in love with a negative man and be unable to have anal sex with him simply because I cannot physically or psychologically use a condom. Please help, and understand that I know the risks of barebacking, I do not need to be told that, I need more assistance than just a safe sex lecture.

Response from Mr. Shernoff

The issue you are describing is indeed very complex and there is not a simple solution, if indeed there is any solution. Many people have trouble maintaining their erections while wearing a condom and don't like the feel of bottoming with a person wearing a condom. The most responsible thing to do then is just to forego anal sex, which you say you are not able to control yourself to abstain from.

I can not really counsel you about this other than to suggest that if you have not already done so, try consulting with a good and very skilled gay positive therapist to see if working on this in therapy may either help you to learn that as a POZ guy, using condoms is a different kind of intimacy than anal sex without them. You are not alone in feeling that anal sex without a condom is not as intimate as anal sex with a condom. This is one of the most frequently cited reasons why men in couples, whether of same or mixed antibody status, report that they do not use condoms for anal sex.

There are a variety of sex therapy techniques to help you learn to erotocize condom use. These include finding porn that you really think is hot and begin masturbating to it, only at some point put a condom on and try to continue.

Best of luck, with a really difficult and painful situation.

Michael Shernoff, MSW



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