A recent study in over 900 HIV-positive people using combination therapy (80% men, 20% women) found that 38% men and 29% of women reported a decrease in sexual interest. 29% men reported a decrease in sexual potency.

A wide range of medical and psychological issues can cause sexual dysfunction.

Treatments

Treatments for erectile dysfunction include counselling, vacuum devices, cockrings, surgery and treatments like sildenafil (Viagra), Muse, apomorphine (Uprima) and caverject.

Testosterone levels can be checked with a blood test. For men, the normal levels are 10-30nmol/l but this does not allow for changes in age. For levels lower than this, testosterone replacement treatment can be given by patch, gel or injection.

Testosterone treatment if effective will increase testosterone levels and should reduce depression and fatigue and increase sex drive. Testosterone (at much lower doses) is being studied as a treatment for sexual dysfunction in women. Emasculation (hair growth, deeper voice and clitoral enlargement) are side effects that require caution.

HIV medications interact with Viagra. Lower doses – usually one 25mg in any 48-hour period – are used for people using a PI or NNRTI based combination. Viagra and apomorphine (Uprima) are not currently licensed for women although some studies are underway.

How you feel about yourself and your body and how you feel about HIV can affect your sexual health. HIV-negative people and society in general can react in irrational ways to HIV, which can contribute to how you feel.

Dealing with an HIV diagnosis, whether or not you are on treatment, takes a lot of courage and perseverance. If treatments work well, you can be faced with new choices in life and if they are not working well and you are dealing with illness or side effects, you would expect this to impact on other areas of your life.