Physical and psychological factors

If there is something going on in terms of your experience of sex or your sexual behaviour, you are the only oneseks problemen who can say whether or not it is a problem. If it does not bother you in any way, it is not a problem. With many sexual problems, physical and psychological factors play a role. For example: physical pain can reduce your appetite for sex. And of course your relationship can also have something to do with it. It is often difficult to distinguish causes from consequences, especially if problems have already existed for some time. And one sexual problem may lead to another sexual problem. Having a dry vagina or having problems getting or maintaining an erection can result in less desire for sex, for example.

A pretty good sex life
After a while, most people with HIV will have a pretty good sex life. There are some people who never experience any changes in their sexuality resulting from their HIV. But many others are a bit more inhibited in that regard. People commonly find it difficult to have dates or enter into relationships. They dread having to tell the other person about their HIV or they are afraid of passing the virus on to others. In some cases, they might end up abstaining from sex altogether, though they still have a need for sexuality and intimacy. That is often a real struggle. All the worrying that goes along with that can also lead to sexual problems: erection problems, a dry vagina, being less able to let yourself go during sex, or feeling pain during sex.
Loek Elsenburg, HIV nurse

Nine questions about sexual problems

Below you read nine questions which can help you to clarify what the issue is if you experience a sexual problem.

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Desire for sex?

Less or no desire for sex
Having less or no desire for sex is very common for people with HIV, but also for those who do not have HIV. Only you can say whether or not you experience ‘having less of an appetite for sex’ as a problem. If someone’s sexual appetite is much less than normal, that could be due to depression, for example. Depression often goes together with chronic fatigue and less desire for sex, though a lower sex drive can also be unrelated to that. Although it is uncommon, another reason why some peopple have less desire for sex could be that they have too little testosterone. In that case, it can make sense for them to take testosterone in the form of capsules, gel or injections. That can sometimes make people much more energetic and bring back their sex drive.

 

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Questions about little or no appetite for sex

Questions that you can ask yourself if you have little or no appetite for sex:

 

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Orgasm, erection or pain a problem?

Problems with having orgasms
There is still a lot that we don’t know about orgasms. What we do know is that they are your brain’s way of rewarding you for having sex. Orgasms are experienced in very different ways, but they are always peak experiences of intense pleasure. It is as if they carry you to a different level of consciousness. You get a feeling of release, and your pelvic diaphragm, your anus and – in women – your uterus all start contracting. You are considered to have a problem with having orgasms if, after normal sexual stimulation, you are unable to come, can come only with difficulty, or come too quickly and if you experience that as a problem.

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Healthcare and sexual health

If you have a problem, it is advisable to do something about it. Thinking about it all on your own will rarely help solve it. You can talk about it with people who are close to you. But there are also caregivers who can help you ifzorgverlening you have a sexual problem. Regardless of whether it has anything to do with your HIV, you can talk about it with your family doctor, with your HIV nurse or with your HIV doctor. They might be able to offer you support themselves, but they might also decide to refer you to a sexologist or a psychologist. It could be a good idea to choose a caregiver who is familiar with HIV. You can ask your HIV nurse if he or she can recommend someone. You can also contact the Servicepunt of the Hiv Vereniging (servicepunt@hivnet.org - 020 - 689 25 77 on mon, thu, thurs - 14.00 22.00 hrs.) for advice.

 

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What does a caregiver do?

Make a diagnosis
An important first step is making the diagnosis. The caregiver will discuss the situation with you in order to identify what the problem is. That discussion can give you more insight into your own situation and can often help you on your way towards finding a solution. In many cases it will be unnecessary, but the caregiver might propose that you undergo a physical examination or blood tests. If the caregiver gives you a physical examination, you can assume that he or she will give you control over the situation and will respect your boundaries. To be able to make a proper diagnosis, the caregiver could also ask you to fill in a questionnaire. And he or she might ask you to examine your body yourself at home. That self-examination can also help make you feel more familiar with your body.

 

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Contact

Hiv Vereniging Nederland

Eerste Helmersstraat 17

1054 CX AMSTERDAM

020 6 160 160

servicepunt@hivnet.org
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Servicepunt

020 689 25 77
servicepunt@hivnet.org


For questions about living with HIV. Available monday, tuesday and thursday from 2 PM till 10 PM

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