Youngpositive : information : sexuality and relationships



	for and by young people with HIV
	sexuality and relationships There is no reason why HIV should prevent you from experiencing your sexuality. If you have HIV, sex may now play a different role in your life than before. If you become infected, you may even (temporarily) lose all your desire for sex. HIV can also have an impact on your current relationship or future relationships. Some people experience even more of a need for intimacy with someone else. These feelings can vary from person to person.
	sexuality You have HIV and your partner doesn't. Or maybe it's the other way around: your partner has HIV and you don't. The technical term describing a steady relationship in which one of the partners has HIV and the other does not is 'serodiscordant relationship'. Serodiscordant couples often have to deal with the fear of infection. The person with HIV might be afraid of infecting his or her partner and feels guilty in advance. The person without HIV might be afraid of getting infected. This can put pressure on sex between the two of you. You can take away that fear of infection by making clear agreements with each other. If you keep to those agreements, there is much less reason to be afraid. We will spell it all out here once more.
	safe sex HIV is transmitted through blood (including menstrual blood), through sperm and mother's milk, and to a lesser extent through preseminal fluid (pre-cum) and vaginal fluid. Although very small amounts of the virus are also present in other bodily fluids, such as tears, saliva and sweat, experience has taught us that infection can only take place if infected sperm, blood, vaginal fluid or mother's milk from one body enters the other body. Besides safe acts such as kissing, caressing and masturbation, there are also unsafe acts such as anal and vaginal contact without a condom. The condom not only offers protection against HIV, but also protects both of you against many other infections and STIs (sexually transmitted infections) such as chlamydia, syphilis, gonorrhoea, and genital and anal warts. Bleeding gums, the presence of little aphthous ulcers in your mouth or on your tongue, little sores or chancroids from an STI in your mouth all increase the chance of infection with HIV. Injuries to the skin and the mucous membrane of the mouth, penis, vagina or anus or the presence of other STIs also increase this chance. Moreover, a high viral load means an added risk. Make sure, therefore, that no sperm, vaginal fluid or (menstrual) blood gets in your mouth if you have oral contact. To be really safe, doctors advise the use of a condom or a dental dam during oral contact. There are safe condoms with flavours: strawberry, chocolate, champagne.... Even when masturbating, you should avoid any contact between infected sperm, vaginal fluid or blood and the mucous membranes in the mouth, eyes, glans (i.e. head of the penis), vagina or anus of the HIV-negative partner. Scientific uncertainties and the difficulty of evaluating these circumstances and factors can diminish the reliability of safe sex. We are talking here about the 'grey zones'. The correct use of a condom or a dental dam during oral sex offers protection in that respect. Discuss with your partner what your limits are and how you both look at this. In case something does go wrong, despite your good precautions - for example if a condom breaks - you can contact your HIV Treatment Centre or the ARC to ask for PEP (post-exposure prophylaxis) for your partner. PEP involves taking an anti(retro)viral therapy over the course of several weeks in order to prevent an HIV infection from taking place (see also 'Medical info and health'). Also look with your doctor at the possibilities for getting vaccinated against hepatitis. With regard to relationships and sexuality and the responsibility that you can assume with regard to those, you can read the standpoint of Sensoa (in Dutch) on the following link: sensoa.
	anonymous My girlfriend and I clearly choose to have safe sex. I know that she is HIV positive, but as long as we take the necessary precautions, that's not a problem. Though if we want to have children later, we are obviously going to have to see how we go about doing that.
	soa STIs and HIV form a dangerous duo. If you are infected with HIV, you run a much greater risk of becoming infected with STIs, because your resistance is lower. For the same reason, an STI also heals less easily in people with HIV (see also 'what is HIV?' - 'HIV in combination with other STIs'). There is also a greater chance that you (being HIV positive) will infect someone else with HIV if you also have an STI, since your viral load will be higher in that case. STIs cause tiny injuries in the mucous membrane of the penis, the vagina, the mouth and/or the anus. Through these injuries, you can become infected yourself or you can infect someone else. STIs often occur together. When you go to your doctor for an STI check-up, he or she will usually check you for various different STIs. In fact, one of the following kinds of contact is necessary for STIs to be passed from one person to another: contact between two mucous membranes contact between a mucous membrane and vaginal fluid, (menstrual) blood, sperm or preseminal fluid (pre-cum) Specifically, this means that the following sexual contacts carry a risk of infection with STIs (if one of the partners is infected with STIs): Vaginal sex The transmission of STIs is possible both from the man to the woman and from the woman to the man. Viruses and bacteria from the vaginal fluid or menstrual blood can enter the penis through the mucous membrane of the glans or head of the penis. Viruses and bacteria from sperm and preseminal fluid (pre-cum) can enter a woman's blood through the mucous membrane of her vagina or cervix and infect her in that way. Anal sex The walls of the anus and rectum are subject to tiny tears during anal sex, which increases the risk of infection with HIV and STIs for both the receiving ('passive') partner and the penetrating ('active') partner. Moreover, it turns out that the rectum is especially quick at taking in the virus. Viruses and bacteria from sperm and preseminal fluid (pre-cum) can easily enter the bloodstream of the 'passive' partner through these little cuts. Also the 'active' partner runs a risk during anal contact. Viruses and bacteria from anal fluid and blood can enter the penis through the mucous membrane of the glans or head of the penis. It is this sexual technique that led to the rapid spread of HIV within the gay community. Oral sex STIs such as herpes, syphilis, gonorrhoea and genital warts can easily be transmitted through oral sex with an infected partner. So if you have an STI, it is important to get it treated as soon as possible and not to suck or lick anyone in the meantime.
	condoms Choosing condoms Always use good quality condoms. You can recognise them by the CE label on the packaging: that is the European standard of quality. Buying condoms You can find good quality condoms in every pharmacy and nearly every drugstore or supermarket. You can also buy them at The Body Shop, through mail-order businesses or on the Internet. Keeping condoms Condoms should be kept at room temperature. If you keep them in your wallet, they will only stay good for a couple of weeks. Friction will soon damage the packaging. Even if the condom itself looks fine: if the packaging is broken, the condom will dry out. Using condoms Check first to make sure the expiration date has not passed. Be careful not to damage the condom while you are removing it from the packaging. Watch out for fingernails, teeth or other sharp objects. When the penis is hard, first pinch the little reservoir at the top of the condom between your thumb and index finger. This reservoir is designed to catch the sperm and will reduce the chance that the condom will break. For anal contact, always use plenty of water-based or silicon-based lubrication. You can usually buy lube wherever you can buy condoms. When the penis grows soft, pull it out. Hold the condom tight against the base of the penis while you are withdrawing. Otherwise it may slide off or sperm could leak out from the condom. A rule that holds for all condoms is: never use the same condom more than once. Also, never use two condoms on top of each other, because the friction between them will cause them to break more easily. Lubricants Use only water-based or silicon-based lubricants. Oil and grease will damage the condom and make it porous. Avoid using things like Vaseline, body lotion, suntan lotions, massage oils, butter, whipping cream and yoghurt. Water-based lubricants: Wet stuff, KY jelly, Sensilube, Hot Rubber Lubricant and Durex Lubricating Jelly. Silicon-based lubricants: Erotikum, Slim and Eros.
	relationships Being HIV positive, you may have the feeling that it is difficult - if not impossible - to have a relationship or sex anymore. But you are still the same person you were before your diagnosis. Your life - also your relational life - doesn't have to end with HIV. The fact that you are HIV positive will no doubt make some things a bit more difficult. How and when do you tell someone that you are HIV positive? Should you start a relationship with someone who is HIV negative, or should you look for someone who, like you, is HIV positive? What is really safe and what isn't? How do I deal with sex? HIV will change your emotional and sexual relationships, but that doesn't mean they will become impossible. Relationships and sex are part of life. The need for intimacy, love, sex and relationships doesn't just disappear with HIV. The impact HIV can have on a relationship is complex. An awful lot of topics suddenly pop up with the diagnosis: anger, feelings of betrayal, of being dependent or of being or becoming ill, your sexuality. You might start asking yourself questions like: Is my partner also infected? Will we still be able to have or raise children? (for more on this, see 'The desire to have children') Can I still have a relationship without my HIV making it all too complicated? Will I still be able to just flirt? Will I be able to have a relationship with someone who doesn't have HIV?
	anonymous At the moment, I have no standing relationship with anyone, and I feel that that becomes more difficult for me to open up to other people. I keep people at a distance and I've built a sort of wall around myself. This is really a contradiction because I really have a need for affection and for a relationship. I make this more difficult for myself to make new friends.
	a partner Some people who are HIV positive initially have absolutely no desire to be in a steady relationship. They still need time to give their HIV a proper place in their lives. Sooner or later, the desire for a partner will return. Just like you, your partner will probably need time to get used to the situation. Make sure you take the time to talk about HIV and about the feelings that you or your partner's infection brings with it. Talk and negotiate about sex: what is safe, what feels good, what is definitely not allowed, how can you both enjoy each other without running any risk in the process? Talk about your feelings. Pay attention to and respect each other's anxieties and limits, but don't forget to have pleasure and fun with each other. Keep in mind that if you plan to wait to tell your partner that you have HIV, that will become more and more difficult as time goes by. Your emotional bond with your lover will grow, as will your fear of losing him or her. If you wait too long to tell, your partner might feel betrayed and start to wonder why you weren't open about it right away. On the other hand, if you tell a potential partner at a very early stage, you might be afraid of scaring him or her off. You have to decide for yourself what the best moment is. Some HIV-positive people choose to tell every new partner about their status right away. They consider this to be the most honest option and a way of avoiding problems later. Others don't think this is necessary and choose instead for disclosure (mentioning your HIV status) to a more steady partner but not to a one-night stand. If you can't decide what to do, talk about it with someone you can trust: someone who is in a similar situation (HIV-positive), your doctor, nurse, a psychologist or your best friend.
	Penny, 28 years In the seven years since I've been positive, l've come to believe that a relationship is not so easily come by anymore because the time will come when you must reveal all. But yeah, when is the right time? Should it be real soon, or should you wait a while until your partner can get to know you as a person, instead of just "that girl with HIV"? My moto is to reveal all as soon as possible because then you know what's in stall for you. If the other person doesn't feel comfortable with this, then it says more about them than me. On the other hand I realise this is a way I protect myself because if i fall in love with someone with whom I confide, and he can't deal with it, I'm afraid of feeling down. So I say it right away. I'm fed up with men I meet, with whom I fail and who are not honest about their motives for leaving. I'd rather hear from people that they can't deal with HIV. But then again, they are often afraid of hurting me and therefore don't ask me anything about my HIV. I rather like it when people are interested or ask questions. Read another personal story: woman of African origin, 19 years
	telling people There is no 'perfect' moment for telling someone that you have HIV. If you are open about it from the beginning, he or she could well decide to pull away. If you wait to tell, your partner might feel betrayed. If you are in a steady relationship, keeping silent about your HIV status will be difficult in the longer term. Often there is medication that needs to be taken at regular intervals. Your partner might also want to stop using condoms at some point. How, when and who you tell is your own choice. From a legal perspective, you are under no obligation to tell your partner about your HIV status. Obviously you can always have safe sex regardless of whether or not you mention your status. Keep in mind that, if you wait to tell, this can become more and more difficult as time goes on. Your emotional bond with your lover will grow, as will your fear of losing him or her. By waiting too long, your partner can feel betrayed and start to wonder why you weren't open about it right away and why you didn't trust him or her. It is impossible to predict how your partner will react. He or she might be frightened, need some time to get used to the idea, be afraid of becoming infected, or be full of prejudices about HIV. He or she might end the relationship…. But it is also possible that your partner will react with love and understanding and ask about your feelings. If you have problems dealing with it together, talk to an 'expert': someone who is also HIV-positive, your doctor, your nurse, a psychologist or your best friend (see also 'when and how to tell').
	David, 23 years I once told it to a girl I'd met before I met M. That girl and I were hitting it off pretty well, but when I told her that I had HIV, she was totally shocked. Read more personal stories: Rudi, 28 years Tine, 24 years Dirk, 24 years