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HIV/AIDS Blog Central

Answering Questions About Sex

By River Huston

October 21, 2009

Since I started speaking in 1992, it seems that everyone wants to take me aside and ask me questions about sex. It doesn't matter where I am, from the office of the IRS (Internal Revenue Service) to the Archdiocese of Paterson, N.J.; people have questions about sex, love, relationships, body image and plumbing. My mailbox is full of questions every day. After lectures I often find little slips of paper with inquires hastily scribbled out.

I was thinking about how I came to know so much about sex. I know about sexual wounding after surviving several sexual assaults, some brutal, while others were more emotionally devastating.

I spent several years as an escort and then as a dominatrix or as I like to say, a fantasy facilitator (I'll write all about this in a future blog!). I wrote a sex column for POZ magazine for 10 years and have been teaching safer sex for almost two decades since I found out I was HIV positive.

I have a degree in health education, but I think I learned more in the dungeon than anywhere else. The line I use in my performance is -- "I thought I was just a slut, little did I know it was all research!" It always gets a laugh.

In reality, I have slept with more men and women than I could possibly keep track of, but I guess that gives me the Ph.D. in sexuality.

Sex is a funny, popular, scary, interesting, shameful topic. Actually you can put any adjective behind that sentence and for someone that is his or her truth.

It seems my destiny is tied up with sex and sexuality (no pun intended), I accept this role with open arms and tired fingers. I have opened my website to questions and in my lecture I offer the option of texting me on stage with questions. Although I have about 400 questions that I still need to answer, feel free to send your inquiries in or check my questions archive in my website

Here are a couple of questions from this week:

Is it normal for a 16-year old guy to jerk-off five times a day?

Let's start with normal. There has never been a study that has determined what is "normal" sexual behavior. We have been conditioned through the media; religion and society as to what type of sexual behaviors are "normal".

In reality, our sexuality is as unique to each individual as are our fingerprints. For some people, masturbating five times a day would reduce them to the same state as a wet noodle. For others, it means they are done with their morning masturbation session and ready for the afternoon games to begin.

I think that you need to find out what is comfortable for you. Put aside the outside influences mentioned earlier and check with yourself, your body, and your emotional state. Decide what you need and what you are comfortable with.

I know that when I was a young girl I used to masturbate all the time (still do). I didn't know if this was acceptable behavior. After every session I would promise myself that I wouldn't do it again. I remember the freedom I felt when I said to myself that I could do it as much as I wanted. This liberation allowed me to truly indulge in masturbatory pleasure to the point that I was really making love to myself.

I don't think of masturbation as a substitute for "not getting it," but just another part of my sex life. If you feel that masturbating five times a day makes your life unmanageable or causes you emotional distress, then it is important to address the reasons for your discomfort. Sometimes just understanding why you do something eases the emotional stress.

Do you think that it is necessary for HIV-positive people to tell a one-night stand partner that they are infected before engaging in safer sex?

That is really up to the individual. But in most states there are laws that can send you to jail for a really long time. The laws vary state to state and you can read more on the legality of being HIV positive and having sex without disclosing here.

Personally I think that at this time in our history, people who engage in sexual activity are aware of the risks. It is necessary for both partners to take responsibility for their actions.

I remember watching "America's Most Wanted" one night. On the show they had this guy in leg chains and handcuffs (I kind of like that stuff myself), but he did not look too happy. He was arrested in 1995 for having unprotected sex with two women, knowing he was HIV positive. He didn't tell either woman about his diagnosis. Both women became infected. They were interviewed from behind a screen.

I kept thinking, why aren't they in leg chains? What is their responsibility when it comes to having consensual sex when by now, we should all know the risks? Sounds harsh, but come on, we all have to take responsibility for our actions.

Don't get me wrong. I find it horrendous and despicable when someone knowingly infects another person because of anger, revenge or whatever, but there is a simple way to defend against this behavior, unless of course it is rape, and that is protect yourself each and every time.

In my past life, before matrimony, when I wanted to have adventurous sex, I would tell the person simply because I felt more comfortable. Also, since I am a public person, I was afraid they would find out in a not-so-sensitive way -- like seeing me on television.

I know that sometimes I wanted to forget all about HIV and just have a good time. I tried it once (totally safe sex, so don't go nuts here, and the statue of limitations has passed) and I was so plagued with doubts, I couldn't enjoy the experience.

I tried to make it as casual as possible when I told people about my diagnosis. Especially if my goal was to just get laid. I try not to make a big production and scare them off. In the beginning, I can remember crying every time I disclosed. Not very erotic! I often used humor and always assured them that they're safer with me than anyone. At least with me, they knew what they were dealing with and wouldn't take any risks that they might have if they didn't know that I was HIV positive.

I am HIV positive and have no desire to have sex. I don't even masturbate anymore. I have not had any serious illnesses. Could this be a mental problem?

It could be a mental problem, but I would first look at the physical issues at hand. Often when we go to the doctor, they ask how we are feeling. They look at a basic blood and chemical panels. Rarely, do they ask about our sex lives unless they are afraid we are infecting others or have a sexually transmitted disease. They never ask about arousal, unless we bring it up, which many HIV-positive people are reluctant to do.

I am not sure if it is because medical professionals are embarrassed or they don't think it's relevant. Because of this practice, many HIV-positive (and HIV-negative) people go for years without having any libido, when the culprit could possibly be a physical one.

Numerous people with HIV, both men and women, have low testosterone levels. For older women who have survived any years of life with HIV, we get to experience the joys of menopause, which also affects our libido.

Testosterone levels definitely should be checked, especially because it can be treated so easily. The recommended therapy for men is to apply a testosterone patch to the scrotum. For women, they are using testosterone cream on the clitoris. I know people who have had this treatment and are so happy with the results they are shipping out cartons of testosterone to friends and family for Christmas, Chanukah and birthday presents.

If it turns out that your hormone levels are normal, there are often drugs, in particular, antidepressants, that can turn off your sexual desires or if you have the desire, make you unable to experience orgasm.

Speak to your doctor about changing these antidepressant meds. There are some that have less impact on arousal. Also diabetes, arthritis and weight gain can also be culprits in diminishing your sex drive.

If all checks out physically, then you might look into the mental aspects of your sexual deficit. There are many emotional problems that affect our libido, from guilt, shame and the feeling of being undesirable, to depression. Sexual ardor is an important part of life -- even if you are not sexually active (with yourself or others). A sexual appetite gives you vitality and passion. We can use our sexual energy in many ways that has little to do with coupling or orgasm. It fuels creativity, productivity and desire to live.

So whatever the reason behind your lack of carnal enthusiasm, it is a good idea to remedy the situation. Don't sit back and think that it is just a part of being HIV positive. There is counseling, therapy and self-therapy. Take the time to explore your body, use vibrators and other sex toys. Explore what turn you on. You can watch porn, read erotica until you hit on something that gets you going. Don't give up! Our minds are the biggest sex organ we have. If we continually believe we have no libido, we are validating that belief and we will not have any libido. So open your mind and change the tape to one of curiosity and creativity.

I am an HIV-positive woman and was wondering when is the best time to disclose this information upon meeting someone new?

There is no optimum time, unless you have gun or the person is in a coma. Also you can always find willing partners in cancer wards and leprosy colonies (just kidding). Actually, I have thought about this quite a bit. Every situation is different.

I know of one woman who didn't disclose until after she was married. It was rough going for a while, but they eventually worked things out. I really don't recommend what she did since you can end up hurt or even in jail! (For more information on legalities of disclosing and sex go here.)

Some women feel if they disclose right away that a relationship would never have a chance to even get started. I know from experience that things can be going just peachy and when I disclosed, suddenly there is all this hemming and hawing.

In the long run, I noticed that I could talk people into going to bed with me easier than I can talk them into a commitment (but that happens HIV or not!) It is just more difficult with this illness. (OK a lot more difficult...)

Eventually what worked for me was always telling people upfront. Boom! If he can deal with that, then he can deal with me. If you are looking for a long-term relationship, this technique weeds out a lot of people who will not be able to handle it.

Though I have to say that sometimes at first they freak out, but then come back after they have gotten over the shock to ask questions. I always think back to how shocking it was for me, so, of course, some people may not react well at first.

We need a thick skin with this disease and we need to accept the role of educator, even if it means just educating the person you want to sleep with.

I give people a second chance. Most the time they just want more information or to talk about it and then they're fine or they're not fine.

My current husband is HIV negative and it has never been an issue except when I was dying, which then, of course, it was very sad. But he took it in stride when I disclosed and we have been together for nine years.

To contact River, click here.

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Reader Comments:

Comment by: Leona (CA) Fri., May. 21, 2010 at 10:10 am UTC
My husband said he was positive a month after we started living together. At first I felt really bad as I thought he should have said it earlier and I felt a little bit cheated. But at that point I just loved him so strongly, I just couldn't do anything. And I stayed with him, we are still happily together. :)
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Comment by: Alena (washington) Fri., Feb. 12, 2010 at 3:15 am UTC
I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.

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Comment by: Fasela (Nigeria.) Mon., Nov. 2, 2009 at 6:52 am UTC
Dear River, I read your stories with interest. Nothing else eases our hurts as appreciating our inadequacies and then turning to the one that offers relief in form of mercy as forgiveness. The Balm of Gilead,a result of divine forgiveness completely removes every guilt of sinful habits the moment we cry to christ, the lord in repentance. I have tried it and it worked! Everything else is full of vanity and vexation of spirit. Nothing sooths the soul like knowing you are forgiven. I john 1,vs9.
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Comment by: Nijour (MD) Sat., Oct. 31, 2009 at 4:44 am UTC
I love being able to read from survivors and those addressing this condition one day at a time, the best way they know how.

I do want to weigh in on something River, if I might. While "everyone" should know the dangers of unprotected sex; they do not. People are so busy burying their self righteous heads in the sand; they are embracing risky behavior all the while claiming they are Disease Free.
One look at Craigs List Casual Encounters & it is evident that safe sex is a myth. I often find myself contacting these individuals and asking them to Please, Play Safely..many respond back CLUELESS that someone would be dishonest about their but true. And, their ages vary from young to old.
We are going to see a large atypical increase in those infected with HIV and it will be due to their lack of knowledge & denial.

It hurts my heart when I see an ad from a 20 yo inviting any woman to come over to receive oral sex and yet he is not using protection. The word dental dam is not even in their vocabulary. While it does take two to tango, one needs to disclose thier STD status regardless of what the other person choses to do.
This country NEEDS sex education in our schools. Anything less is criminal.
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Comment by: River Huston (Upper Black Eddy, PA) Sun., Oct. 25, 2009 at 9:28 am UTC
Dear David,
Guilt is a behavior that makes you feel bad so that you change your behavior but as an ongoing emotion it has no purpose.

The 1st step, which you have done,is recognize the behavior that makes you feel guilty-unprotected sex that put people at risk. Step 2, stop that behavior (which you have). Then instead of continuing self-flagellation turn guilt into a constructive emotion-action.

Many of us experienced guilt over the fact that we might have infected other people. We were given faulty information, didnít know we were HIV positive and some didnít care. I suggest making an amends. You might not know the people or some have died so you cannot do so in person but you can write them letters. This will help you deal with the grief as well. You can also do some kind of service like being an educator or volunteering to do something that helps people in the community. Amends is a healing action, not punishment.

It's time to move on. It does not happen over night but you can get on the road of dealing with it. Acknowledge the behavior making you feel bad. Know you will not be repeating that behavior, do an amends and over time the guilt will dissipate.

I am a big fan of masturbation but if you are doing it as penance and want to have sex with other people, please do! It is about being able to communicate, safety, creativity, & intimacy. Itís not always easy but in many ways it takes us to a deeper level of understanding about ourselves and our sexuality. HIV improved my sex life because it made me talk. If I am going to all the trouble of bringing out the equipment, laying out my emotions and being vulnerable by disclosing my diagnosis, I am going to have an orgasm and this is going to be fun! I have sex guilt free when I disclose. Whatever we decide to do is between 2 consenting adults who know the facts.

You are allowed to forgive yourself & move on to the life you deserve which includes great sex with yourself and others.
Best wishes
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Comment by: Ingo Seifert (Maseru / Lesotho) Sun., Oct. 25, 2009 at 5:26 am UTC
Dear River
My wife and me are HIV+ activists in Lesotho Southern Africa. We have regular Radio programs and a column in a weekly newspaper talking about HIV/AIDS issues. There is one topic which seems to be unchangeable: Once you are HIV+ you always have to practice save sex! (Condom Use)
Many couples here are HIV+ and are on ARV's. Do they really have to use condoms all the time to prevent reinfection with a new strain? What's about PrEP or PEP (Pre Exposure Prophylaxis or Post Exposure Prophylaxis) Aren't 2 partners on HAART practicing Prep & PEP and denying a new HIV strain to develop in the body?.
What is the chance if the viral load is undetectable in both partners to get reinfected. I hope you know about some research which has addressed these issues or diplomatic ways of how these couples should behave.
It would be so nice to provide some sexually liberating news to the people here specially to faithful HIV+ couples.
Please answer to the following Email Addresses. &

Ingo & Matseliso from Lesotho
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Comment by: Manu (EU) Fri., Oct. 23, 2009 at 3:42 am UTC
We not need just a thick skin but also a long breath.
Does being HIV positive mean that you have all the (sex-)knowledge? I don't.
I really can get tired of answering the same questions over and over and over and over...
Talking about HIV also means they want your butt on the table. First many questions about your sex life - who, what when, still? The last question is often asked because they even can't imagine you're still having sex.
Then they want to know if your partner, your child have HIV. Finally they end up asking how you are doing. A question which I wished to have been asked first.

After living 22 years with HIV I developed a thick skin, but I sometimes miss the long breath.

One solution though for positive people who don't want to discuss their sex life: just return the (sometimes impolite and private) questions being asked. If they don't wish to answer those, why should you?!

Or just add some humor. Once someone asked me if having sex with an African man was really different from having sex with a white guy. I answered: "How could I tell? I never slept with yours."

Stay well an God bless you River. You?re my hero!
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Comment by: jeremy (SpainNice ) Fri., Oct. 23, 2009 at 1:55 am UTC
Nice one River..........You are hitting the spot with your views on hiv infection. To be diagnosed is probably the hardest thing we have to deal with in our certainly has been for me. The good news is that if you can deal succesfully with living with hiv.......then anything else that life throws in your path is a piece of cake. Keep writing, your humour and outlook is refreshing.
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Comment by: David F (Tsfat Israel) Thu., Oct. 22, 2009 at 2:01 pm UTC
You go girl, I liked your article. I do have a question for you.How do I shake the feeling of guilt? Let me explain I was infected in 78 or 79. I was told that until they came up with a cure that certain activities were ok. They were wrong! Now I live with the guilt that I probably infected many people without knowing I had the virus. In 1985 I found out from my lover that he was positive. I began having safer sex then. I often go over all the names in my head that died and I lived I have known for sure that I was positive since november of 89. I have lived with the specter of HIV since 1983. I hear of people that recently became positive. I just got so guilty I masturbate but haven't had sex for 3.3 years. At least that was my solution to stop the guilt.
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A River Runs Through It

River Huston

River Huston

River Huston is an award-winning poet, journalist, performer and activist. She travels through the United States speaking on issues related to sexuality, communication, overcoming challenges and change. She has been featured on Good Morning America, Showtime, Nightline, CNN and ABC Up To The Minute. River has written three books of poetry as well as The Goddess: A Guide to Feminine Wisdom and A Positive Life: Portraits of Women Living With HIV. She wrote and performed a one-woman show, Sex, Cellulite and Large Farm Equipment: One Girls Guide to Living and Dying off off Broadway and is currently working on a second show, The Dominatrix Next Door. For more information about River you can go to

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Recent Posts:

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Articles by River:

Sex, Cellulite and Large Farm Equipment: One Girl's Guide to Living and Dying (October 15, 2008)

I Feel Good! Attaining Survival Through Illness (March/April 2008)

Goddess in a Muumuu: AIDS Changes Sexual Self-Image (December 1999)

A Positive Life: Portraits of Women Living With HIV (October 1999)

Interviews With River:

White Women and HIV (April 1999)

A Brief Disclaimer:

The opinions expressed by's bloggers are entirely their own, and do not necessarily reflect the views of itself.