He Has No Desire for Sex. What If His Libido Doesn’t Return?

Brian Rzepczynski Brian Rzepczynski • 9/25/14

Reader Question:

I’ve been with my current boyfriend for a little more than six months. He is HIV positive and I love him.

When it comes to the bedroom, he tells me he’s tired from working all day. Alternatively, if I try to come on to him, I usually get pushed away. He tells me his HIV meds take away his desire to have sex.

What if his libido doesn’t return? Maybe he’s just not sexually attracted to me.

We have had sex several times, and when he is able to maintain an erection, it’s great. However, I’m a little confused since he tells me it’s his HIV meds that are causing his ED and not me. Then why can I get him hard when I’m giving him head but as soon as he tries to put himself inside of me, he starts to go soft?

If the problem is his meds, then maybe sex can return to normal. However, if it’s me and he’s just trying to keep from hurting my feelings, what then?

-Patrick (South Carolina)

Brian Rzepczynski’s Answer:

Hi Patrick!

The most important thing for you to hold on to here is that this is not your fault and likely has nothing to do with his attraction for you.

From your description, it sounds like he’s very invested in his relationship with you and is concerned about your feelings. If he wasn’t into you, the compassion and empathy would be missing.

The biological and psychological implications HIV can have on a person’s sexuality are extremely complex, and decreased libido and erectile difficulties can be one aversive side effect to HIV medications.

The stimulation of oral sex often helps with erection, but from the moment the penis leaves the mouth to penetrate the partner’s back-end, the erection can quickly subside, particularly when condoms are being used.

In addition, there could be a lot going on in your partner’s head during sex, which can distract from his arousal.

Fears of infecting you, low self-esteem, body image issues surrounding his HIV status and fears about being able to perform can create anxiety that is an instant hard-on killer.

Especially if he knows you’re worried and unsatisfied about your sex life, this can create a lot of pressure that can interfere with his ability to relax and enjoy being with you.

My advice is to take the emphasis off the performance aspects of sex and focus more on being sensual with each other.

This will reduce the buzzkill of anxiety and allow each of you to enjoy being fully in the moment with each other and to experience the sensations of your foreplay and mounting desire. You’ll be amazed at what can happen if you remove those barriers.

Take it slow and take the pressure out of it. Intimacy and judgments about performance don’t coexist. Best wishes!

Dr. Brian


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