Casual sex and HIV

The meaning of sex and HIV

Sex is a very human activity, or as one man said, “a vital part of human relations.” But with HIV, as another man said, the “awful sting in the tail” is that sex can result in getting a serious condition. People enjoyed casual sex i.e. sex that was not part of a relationship for a whole range of reasons including the human contact, the pleasure, the adventure, the feeling of closeness, and even the sweatiness of it all. The men in particular talked about liking casual sex, but so did some women. Casual sex meant all kinds of different things to different people, such as letting go of everyday concerns, blowing off steam, getting close to someone and feeling alive.

What people feel sex means to them can sometimes make it harder to use condoms in anal and vaginal sex. For instance, some people talked about wanting to feel uninhibited and connected to others during sex, and how condoms could be thought of as getting in the way of these feelings.

Like sex, HIV itself can also mean different things to different people. Some people were very clear that they were potentially at risk of HIV, while others believed that HIV only happened to other people. One woman, before she had HIV, felt like she could not be touched by the virus. She became infected because she did not use condoms all the time. Some people can feel fatalistic about the virus: “you are either going to get it, or you’re not”, and this thinking could encourage unsafe sex. The reality though is that HIV-negative people who practice safe sex do avoid getting HIV through sex.

One of his partners did not want to use condoms for anal sex because he thought he either already…

Age at interview 52

Gender Male

Age at diagnosis 42

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Very many people talked about the need for people to be responsible and to ensure safe sex. The people we spoke to were very concerned about not passing HIV on to anyone. Many people echoed the words of a man who said: “I’d be horrified at the idea of passing HIV onto anybody.” Some people went the extra mile to prevent transmission. One used condoms for oral sex. Some were also concerned about sexually transmitted infections (STIs) such as syphilis and hepatitis C and used condoms with HIV-positive partners so as not to pick up another sexually transmitted infection.

Believes that anal sex without condoms between HIV positive men can have serious health…

Age at interview 39

Gender Male

Age at diagnosis 20

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People disagreed about whether using condoms in sex was easy or not (see ‘Sex in relationships‘ for more detail). While some did not like using condoms, others had no problems. One man said, “With us men we’ve got a problem saying ‘oh, it is like I am eating this sweet [wrapped] in a newspaper.'” Another man said, “If you automatically assume you are going to have safe sex, then you just do it.”

Sex and emotional problems

Sex could also be used as a way of dealing with your emotional troubles. For instance, one man suspected that a HIV-negative partner of his wanted to have unsafe sex with him because he had such a low opinion of himself. Some people we talked to said that when they were feeling low, unsafe sex could be tempting: “You kind of flirt with the idea of saying ‘what’s the point in having protected sex?'” But as I started to be become well again, it seemed like a very stupid thing to be doing. I thought ‘that’s not for me.'” Having an emotional problem can also make it difficult to think about condoms. Before he became infected, one man said that while he wanted to use condoms with a partner, he was depressed and had a “void of thinking,” and so he had not even thought to introduce condoms.

He thinks he became infected with HIV at a time when he was having emotional problems. (Read by…

Age at interview 30

Gender Male

Age at diagnosis 27

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Some people said that when they first got diagnosed it was natural to be angry and think something like, “Since you don’t know who gave it [HIV] to you, you want to spread it. It’s kind of a ‘payback’ thing.” But people found ways to deal with such difficult feelings: “But I said to myself, ‘it’s my carelessness, so why should I want to put somebody else through what I am going through?'”*

The temptation of unsafe sex

Sometimes people felt they were taken by surprise by their own behaviour and the strength of their emotions during sex, and the way they weren’t really thinking clearly during sex. One man described the time he became infected as, “A strangely out of character episode of unprotected sex.” Another man said that when he got infected “we’d want to use them [condoms] but then we’d start to get hot and heavy, and didn’t stop to think and put them on, much to my regret.” And using alcohol or drugs can sometimes mean that “you drop the barriers a bit,” and you are less careful to have safe sex. One man said, “If you want to take drugs to have fun, then it should be to a level that you still know what you are doing.” Another man said, “Be careful if you drink, and be prepared, everybody’s susceptible to overwhelming temptation.”

So the message is that it is best to consider the temptation to have unsafe sex as very human, and something you can prepare for, rather than something that might happen only to other people.

Casual sex can be tricky. People often do not discuss their HIV status before sex. And yet, during sex we may convince ourselves of all kinds of things, like our partner is too healthy to be infected. We might even convince ourselves our partner is HIV-positive like we are. The people we spoke to said your mind can play tricks on you during sex, and is “very capable of blotting out things it wants to forget” or not know about.

People also explained that sometimes their partners could be persuasive about not wanting to use condoms. For instance, some women in particular said it was sometimes hard to stand up to men and insist on condoms since it can lead to conflict: “You can go out and insist on somebody using condoms, and if they refuse, you have to throw them out [of the house].” Another said that some people who are HIV-positive say “OK you are positive, I am positive, why do we have to use a condom? They don’t care.” But men are not always the problem. It was also sometimes hard for men to convince women to use condoms.

She says that men who want unprotected vaginal sex have various ways of getting what they want…

Age at interview 33

Gender Female

Age at diagnosis 27

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A partner removed a condom during sex and she believes it is difficult for women to insist on…

Age at interview 37

Gender Female

Age at diagnosis 26

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Says that young people in particular find it hard to get what they want from sex.

Age at interview 26

Gender Male

Age at diagnosis 17

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Basic tips for safe sex with HIV

  • If you are HIV-positive and you are not sure of your sexual partner’s HIV status, assume they are HIV-negative
  • If you are HIV-negative and you are not sure of your sexual partner’s HIV status, assume they are HIV-positive
  • If you are negative, assume everyone you have sex with is positive
  • Sex is not meant to be logical, anticipate that you might be tempted to have unsafe sex. When are you more likely to feel this way, and what can you do about it?
  • Try making a decision to be safe before you have sex, particularly if you are feeling down or using drugs or alcohol.
  • Make sure there are lots of condoms nearby so you aren’t “scrambling around” for them
  • Carry condoms in your handbag or wallet
  • If you are HIV-positive and are looking for other positive partners for sex without condoms e.g. on the Internet, you can get advice about the risk of picking up new infections from your HIV doctor
  • HIV charities often offer counselling or courses on how to enjoy sex more and be safe.
*In the UK people have been convicted of grievous bodily harm (GBH) because they infected their sexual partners with HIV through unprotected sex without disclosing first that they were HIV-positive.

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