What Women Need to Know About Sex and HIV

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For many women, being HIV positive causes feelings of shame or guilt that push thoughts about sexuality into the background. But most women will eventually desire a loving relationship again that includes sex. The good news is that you can have sex after an HIV diagnosis.

Once you are ready to resume sexual activity, there are a few important steps to take:

  • Talk to your doctor about precautions.

  • Educate yourself about HIV and sex.

  • Learn how to communicate with your sexual partner.

  • Keep yourself and your partner safe during sex.

  • Have a birth control plan.

Get Smart About Sex With HIV

Educate yourself with essential health information. Learn how HIV and other sexually transmitted diseases (STDs) pass from one person to another. Understand the risk factors and what you can do about them. Your doctor is an important resource, but here are some basics:

  • HIV is passed through semen, vaginal fluid, or blood.

  • Being on HIV drugs that lower the amount of virus in your system (your “viral load”) decreases the risk of passing on HIV, but does not eliminate it.

  • Kissing and touching are not dangerous; saliva isn’t likely to pass the virus.

  • An HIV-positive person receiving treatment can contract a second, different strain of HIV or another sexually transmitted disease.

  • Using a male or female condom correctly is the only way to have safer anal or vaginal sex.

  • Sharing sex toys is not safe unless they are cleaned and covered with a lubricated condom.

  • Having sex during your menstrual period may increase the risk of passing on HIV.

Talking to Your Partner About HIV

One of the hardest things about being diagnosed with HIV is talking to partners you’ve previously had sex with, and to people you’re dating and may have sex with. Yet, all past, present, and future partners have the right to know about your HIV status. Here are some guidelines:

  • Tell any current partner about your status, so he or she can get tested right away. If you are in a sexually active relationship, your partner should be tested at least once a year.

  • Tell future partners, such as people you’re dating casually, before you have sex.

  • Tell former partners and anyone with whom you shared needles.

  • If you have trouble finding or talking to a former partner, your local health department may be able to tell them for you without using your name.

The way others react to your HIV will depend on how well you know each other, their own HIV status, their own fears and knowledge about HIV, and how you tell them. You might want to have a counselor present if you’re concerned about your partner’s reaction.

Keep these points in mind as you plan the conversation:

  • Pick a comfortable time and place.

  • Anticipate your partner's questions and have answers ready.

  • Talk to other women who have gone through the process.

  • Be prepared to deal with your partner’s reaction.

  • Consider going to a counselor together to deal with feelings that arise afterward.

Exploring Your Sexuality Again

Once you’re confident that you can protect yourself and your partner, you might start to think about what type of sex you will both be comfortable with. Be honest with each other and remember that sexual intercourse is not the only way to be intimate. Use these guidelines as you resume your sex life:

  • Hugging, massaging, kissing, and masturbation are the safest ways to be intimate.

  • Low-risk sexuality includes sex with a properly used condom, condom-protected oral sex, deep kissing, and sharing a sex toy covered with a condom.

  • Always avoid unprotected anal, oral, or vaginal sex.

Key Takeaways

  • You can be intimate and have sex when you are HIV positive.

  • Learn as much as you can about HIV and sex before becoming sexually active again.

  • Think carefully about how to tell present, past, and future partners about your HIV.

  • Honest and open communication is the best way to approach sex and sexuality.

  • Intimacy is about more than sexual intercourse.

  • If you are struggling with sex after HIV, ask for help from your doctor or an HIV counselor.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 May 12
  1. When One Partner Is HIV+. aids.gov. http://aids.gov/hiv-aids-basics/prevention/reduce-your-risk/mixed-status-couples/
  2. Sex & HIV Positive Women. Australian Federation of AIDS Organizations. http://www.afao.org.au/living-with-hiv/positive-women/sex-and-hiv-positive-women
  3. Women, Children & Family. The Well Project. http://www.thewellproject.org/hiv-information/women-children-family

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