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I am positive, my girlfriend is negative, and it's affecting our sex life
Jul 26, 2011

Usually I do not use condoms with my partner. However, after I got diagnosed as positive, and my partner is negative, we have had to use latex. Naturally she is not comfortable and relaxed making love and does not respond the way she used to because she is scared of infection. This affects my performance as my erection goes down. We thought it was the use of condoms, but I have gone ahead and tried using condoms with other females to be sure I don't have a problem getting "it" up, and in such cases I have performed excellently and the ladies ask for more. So why do I not have the same performance with my partner? In my country therapists do not abound so do not suggest we meet one. I need you to counsel me like your patients: tell me the steps to take and what to tell her. Note that I am not on ARV because my CD4 is over 500 - my doc prescribed an immune booster.

Response from Dr. Fawcett

Thanks for your question. As you know, it's important to keep your viral load as low as possible because that does reduce the risk of transmission. I'm glad you are using condoms but, even with them, there is a slight chance of failure and exposure.

Sexual issues are common in serodiscordant couples. Unfortunately I can't give you a precise checklist of steps to take because the issues for each couple are different. There are, however, some common concerns. The most important is good communication between the two of you, which involves both expressing feelings as well as really hearing those verbalized by your partner. Good communication enables the two of you to work as a team to make informed decisions together about negotiating specific sexual behaviors, the risks involved, and personal limits.

Other relationship issues, often concerning trust, can be complicated by serodiscordant status. For example, I'm not sure what arrangement you have with your girlfriend but you mention having sex with other ladies. She may have feelings about that which may also be affecting your sexual relationship.

Many couples in this situation, with patience and communication, have reclaimed very satisfying sexual intimacy. Good luck.

-David



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