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Casual sex & 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 in 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...

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

Age at interview: 52
Sex: Male
Age at diagnosis: 42
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I have had sexual experiences where people have, knowing what I've got and didn't want to use any protection… There was one guy in particular who, who I went back to his place I think. I'd already told him that I was HIV positive and he shrugged his shoulders [sniffs]. 

And you know, the proceedings start and he said, 'Let's not worry about the protection.' And I said, 'Well, you know, you're putting yourself at risk.' So he shrugged his shoulders and said, 'Well, who the hell knows whether I've got it or not.' He said, 'I know I'm going to get it.' 

That's going back to what I originally said, you know, you, because of what happened to me you psyched yourself up in the realisation that because you're in that category you're going to get it anyway, you know. So it's inevitable yeah, and then, and then when you do get it, it's not so much of a shock. And I think there's a lot of gay men out there like that, and I think he was just one of those people.

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...

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

Age at interview: 39
Sex: Male
Age at diagnosis: 20
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I practise safer sex. Very occasionally I will get shagged without a condom. And that is how I contracted hepatitis C.

Very' I' Very occasionally I would get shagged without a condom. With other people who were positive, who were roughly the same stage of disease progression as I am at, and have roughly the same drug experience. Because you can't say it doesn't matter, if you're having sex with another positive person. It potentially does matter. And it potentially does matter a great deal. It is apparently possible, and there are now documented cases, of people being reinfected with the virus. So potentially you could be reinfected with another HIV virus which is resistant to drugs, before you've had any drugs. And you may well be unfortunate enough to pick up a resistant virus anyway, nowadays. I think a good percentage of the new infections are with virus which is already resistant to, to one or more drugs. So you could pick up another virus which is resistant to drugs. You could pick up something else that you can't get rid of, potentially, like hepatitis C. And I've tried. The drug therapy doesn't work with everyone.

You can pick up other sexually transmitted diseases. Which, a, can be more difficult to treat if you're positive, and b, can increase the risk of you passing on your HIV to someone else, potentially, via oral sex. Or, or something like' So there are reasons not to have unsafe, unsafe sex with other positive people. So don't go into it from the attitude of it doesn't matter. Because it does. But I still choose to.

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...

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

Age at interview: 30
Sex: Male
Age at diagnosis: 27
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I mean when you think retrospectively, well I thought I was a balanced gay guy. But there I was being fucked without a condom in a sauna by somebody I'd just met. And, well, it's hardly balanced… You know, it's hardly the sort of thing that I would… if you'd asked me, I would have, have… have said that I did. And yet there I was doing it. 

So there was something going wrong in life in general. And that was to do with, I think all these sort of different things that I've been able to… sort out, to some extent. Or acknowledge, simply acknowledge… The mind boggles as to what was going through my mind at that particular instance… 

Heaven knows what was going through my mind at that particular point. That I assume I acquired HIV. But I mean in general terms, just not looking after myself. Working too hard. You know, I think having become a little bit of an automaton.

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. ...

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

Age at interview: 33
Sex: Female
Age at diagnosis: 27
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But from my friends are going with black men, it's an issue, it's a big problem for them. There's a few of them that will insist, and then you get the ones that it's difficult for them. They insist but the man will just maybe take it off or something you know. 

Yeah, it's a problem and I think with black men, African men, they need to understand that… they still don't believe… again they think it won't happen to them or something. And they look at women and think oh she's healthy you know. A few African women I know that have been in clubs or wherever and they've told men when they've met them you know… I'm positive, they say no, no you're lying because you don't want me… that's why you're saying that, yeah. They just won't believe, yeah. 

I don't know if it's ignorance or they're just, more of denial I think, yeah. They'd rather take the risk… 

What would happen I would say with a white man is they would stop the relationship because they want… I can remember speaking to someone on the phone and he was just saying in terms of sex, he likes having unprotected sex and I said, “Oh no, that's not going to happen, that's totally impossible.” And… there was him, and he said, he was meant to contact me again and he didn't. Which I felt must be because of that.

And then there was the sort of person that said oh no, no, no… We actually went into an argument and he said no, he doesn't get much pleasure with condoms and he doesn't want condoms. And I went on to explain to him that then you're putting yourself at risk, and you will pick up something eventually you know, if you've not already picked it up you know. Yeah, so they won't sort of stay in a relationship if… that's my own experience.

 

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

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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
Sex: Female
Age at diagnosis: 26
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The condoms, you have to be open, honestly. A condom you can't hide. It is' I walk with it in my handbag. That's something I don't mind, I walk with it everywhere I go, because you never know when temptation can take' But there is one thing that happened actually. There's a man where we put a condom on, but in the middle of it, he removed it, and threw it away. I didn't know it, I didn't know it. But I did not dare say the condom was out. He said he doesn't like it with condoms. Now I don't know should' can I tell this man or should I keep quiet? I decided no, I leave it, because it will turn into something else. I tried. I did try. It was his choice. And I brought the condom. I gave it to him, I put it on myself, but in the middle he decided to remove it, so I can't do anything else' The problem is we women in this system, you don't want to add more violence on what you have. You might bring a different one, a stronger one, who will destroy you more, you see? We know what we are' so I don't want to add more violence' More different ones on what I have.

 

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

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

Age at interview: 26
Sex: Male
Age at diagnosis: 17
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This is a young people's disease, that's why I'm so passionate about it. Globally you know under 25s represent over 50% of all infections. So it really is young people who are the most at risk group and they will get the brunt of the force and the... Because they don't know how to negotiate. Or you're still figuring out your boundaries and you know, what you want in life. And attraction to someone can be an extremely powerful force and being able to say no, or this is what I'm comfortable with or, you know asking the right questions about when they've been tested, not everybody's able to do that.

Basic tips for safe sex with HIV

  • If you are HIV positive and you are not sure of your sexual partners HIV status, assume they are HIV negative
  • If you are HIV negative and you are not sure of your sexual partners 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 'scrabbling 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.

Last reviewed May 2017.

Last updated January 2013.

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