Many of the interviewees said that their initial reaction to diagnosis was to stop having sex. This was largely determined by fear of transmitting the virus and fear of rejection. One woman said:
“After diagnosis I was actually scared shitless to have sex with anyone. I thought: 'No. That's it, I'm never having sex with anybody ever again’.”
For some people, these inhibitions persisted:
“I think it’s all mental really … I don’t put myself out there… There has been rejection and all those things before and that feeds back into not seeking any sort of sexual activity with anyone.”
On the other hand, some men described an increase in sexual activity after receiving their diagnosis. They spoke of having condomless sex with other HIV-positive partners as a liberating experience, free of the fear of contracting HIV.
“There was this exploration … It was a bit more exciting and I was being a bit more extreme and doing things that I didn't do before.”
A partner’s accepting response to HIV was important for many people who made a healthy adjustment. Some interviewees – often those in long-term relationships – reported no change to their sex lives after diagnosis:
“It was good, we were just married, so we were having sex quite often. Just normal sex.”
However, a partner who was willing to have sex without fully acknowledging the HIV and who glossed over fears of transmission did not necessarily facilitate positive adjustment. The partner needed to acknowledge HIV as part of the individual while not showing undue fear.
Accurate knowledge of transmission risks (especially U=U) helped many interviewees adjust to living with HIV:
“It does wonders for your mental health and knowing that you can’t transmit the virus.”
But factual information was not always enough to shake off deeply rooted fears:
“I still worry [about HIV transmission]. I’ve gone to workshops … and I’ve read about it a lot … even if I’m doing it the absolute safest way to have sex, I still worry…”
Peer and community support could be helpful for adjustment:
“I got to meet other positive guys, especially the older ones and just sort of learnt from their experience… it helped with that self-acceptance.”
Next week, we will be hosting an aidsmapLIVE event on HIV, sex and relationships. See the sidebar to find out how you can join the conversation on Wednesday 12 February at 6pm (UK time).