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HIV & sex in relationships

Having safe sex in relationships can be complicated by the play of strong emotions. Feelings like trust and closeness can make it difficult to have safe sex' 'Because you trust somebody you don't think to use condoms.' The views expressed here are of gay and Black African communities that we interviewed in 2005. Several people we talked to believed they became infected with HIV because they trusted their partners and were unaware their partners were infected with HIV or having unsafe sex outside the relationship. Also having safe sex is not always straightforward. For instance, a partner who wants safe sex may have trouble convincing the other.

 

He believed that a partner was responsible for his HIV infection. (Read by an actor.)

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Age at interview: 40
Sex: Male
Age at diagnosis: 30
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She stayed on with me, she stayed with me for about six years all over, living with me… And then she was accusing my other girlfriend to be responsible also. She was saying, no she is the one responsible. 

So later we discovered that she was actually the one that was responsible. And how I came to know that, after she has left me, when my family came to join me, she's a friend to… she is the friend to the wife of my friend. So she revealed to the friend of my friend, to his or her own girlfriend, her own girlfriend as well. 

So anyway she revealed to her that she was in that situation, that she had the HIV… But she didn't tell them that she gave it to me because all along she has been denying that she's was responsible for this. So that was what happened… I feel very, very sad, in fact, I just… I don't think I can ever forgive that girl. I cannot. If I didn't know the person that caused this to me, that's a different thing. 

But I, when I know the person that caused it, I mean if I knew it's not just easy to forget about it, but, well, that is life. She has left my place, I'm on my own, I have my family, I am living well, living happily with my family. 

 

He mistakenly believed himself to be HIV negative and so it upset him when his partner insisted...

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Age at interview: 31
Sex: Male
Age at diagnosis: 29
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I have done a very stupid thing because, when I had sex, I really do like to do sex without the condom and he said no. Because his last boyfriend for ten years their relationship, have died of HIV. 

And he said, 'No, I don't want to.' I said, 'But why, because you are positive?' He said, 'No, I'm not positive. But I have been with someone that is positive for five, for six years. And I said to myself, never do sex without condom, and I don't want this to happen again.'

Then he asked me, it's very funny because he asked, 'What happened if you are, if you discovered that I was positive?'… So we didn't have sex without a condom, I stayed very upset about that. Then I go back to London I said, 'I will do some tests, to prove for you that I don't have nothing, and I want to have sex without condom.' And he said, he said, 'Whatever you do, I will not do sex without condom.' I said, 'OK, but I will do this test anyway.'

After two weeks I went to take the result… And I never remember, I never forget .. they said, 'Unfortunately, you are positive.' This, this was the kind of thing that the, the world is stopped. And I said… this guy that I wish I don't speak English, not learning or don't understand English, because I said, 'Excuse me, are you sure that this is my test?' I they said, 'Would you like see?' I said, 'Yeah, I would like to see.'

There… the world is stopping there. I didn't, you know, I didn't remember nothing. Everything that I knew about HIV it's disappeared. I just it is stopped. The whole world stopped. I just remember that I just was start to cry, cry, cry…

 

Says that sex between people is complex and it can be difficult to get men to use condoms. (Read...

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Age at interview: 33
Sex: Female
Age at diagnosis: 27
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When I was with a person I thought had lots of girls, I would want to use condoms. But then again it was difficult because back there, and even here with black men I would say, when… they're not very keen on condoms at all and it's very difficult. They sort of talk you out of it, they're not like… they don't really, it's not like they force you to do it, but they sometimes talk you out of it. 

And you then feel… as a woman, it's very easy to start feeling that… cos you're with a man, you want to please him or satisfy him, so you just want to do what he really wants you know. So yeah, that I found difficult. And also the fact that I could… I mean they… My experience a few times I would say is when a black man doesn't want to use condoms and the woman will say… 

If I'm saying I want to use condoms, they can easily get, you know, spoil the mood and just turn off you know sort of… it's difficult. Their mood could change as in… you know, and then maybe they'll start complaining that you know, 'I'm OK, I'm fine so why are you using condoms…?' Cos again, they're also ignorant about the risk as well, yeah. 

Lack of sex in a relationship did not necessarily mean the end of relationships, especially for gay men we talked to. Sex had stopped in some long-term gay relationships for a various reasons including relationships naturally becoming more like close friendships, fear of transmitting HIV, low libido caused by treatments, illness (which was not sexy said one man) and for psychological reasons. Nevertheless, men in such relationships described 'very close and strong bonds' with partners and said they could find sex outside the main relationship if they wanted to. 

 

At the time of his diagnosis, despite a strong bond there was too much else to think about to...

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Age at interview: 39
Sex: Male
Age at diagnosis: 34
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Well at the time (of HIV diagnosis) it (sex) was obviously, it was kind of out of, out of the question really. And we had anyway more or less given up sex at the time. But I mean since then, since then pretty much we, we, we, we have given up sex, com, completely. I think mostly because of the risk involved. Which in a way it was quite' it's quite ironic because we, we were in a way, our relationship, our relationship was maturing in something more honest, closer. And perhaps was getting to a stage where we probably would have been able to have a' a bit of a revival in this respect. But it's' it's' certainly in the first few months after my diagnosis there was too much going on to kind of think about that. Too much going' too much going on' Too much ri' too much risk to think about, too many things to adjust to' in our own, in our relationship, to kind of' add this additional layer of, of complication in a way. 

I still do have a sex life. It is' I suppose what you would describe as, sort of one night stands or anonymous encounters.

Negotiating safe sex

The people we talked to were very concerned about protecting their HIV negative partners from HIV. Nevertheless, people disagreed about whether or not condom use was easy to maintain in such relationships: 'I don't believe it's difficult to practise safe sex,' said one man. 'I can't say it (condoms) was particularly easy, but it's just something you just have to adapt to… something you had to face and overcome,' said another man. One man claimed, 'There's no man who would not like having sex without a condom.' It was easier for people who had always used condoms for sex to use condoms in relationships - a younger gay man said his generation took condom use for granted. One woman said that whether or not a man uses a condom feels 'just the same to me.'

 
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Found it easy to introduce condoms into his sex life with his wife.

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Age at interview: 47
Sex: Male
Age at diagnosis: 41
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From the very beginning she decided straight away to stay with me. But you know it's really' it's complicated area of human relationship. But now, I can say just now, but... understandable. It's funny if we have no problems [laughter]. After I got HIV. We have sex life. And, we just use condoms like that. It's no problems at all. Yesterday I spoke to my wife, 'Listen darling maybe'' You know my daughter. My [daughter's name]. My eldest daughter just a couple of day ago said, 'You know daddy I just found out that positive people can have kids.' So just today in the morning'. Of course I was joking. But I said to my wife, 'Do you know about that? Maybe we can, you know, one more.' [Laughter] She just was laughing. She said, 'I'm too old. Too old for that.'

For HIV positive people in relationships with HIV negative partners, considerations of HIV could present problems. Thinking about HIV could detract from enjoying sex and relationships: 'If he'd become positive I think it would have been devastating…,' said one man.

 

He can't cope with the idea that his partner might be upset by his HIV. (Read by an actor.)

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Age at interview: 38
Sex: Male
Age at diagnosis: 35
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I have found and I still find the most difficult thing… The mo- thing that I, I really find most difficult to deal with is not how I feel, it's how the other person would feel. So I'm having a long term relationship at the moment for… oh, it's been in fact 2 or 3 years. And that's very strong. 

But the, the thing I find the worst is the… kind of the sadness when they think about it. Or when I think about it. There's that kind of… Even though my doctor has told me that… He says, 'You're not going to die of this anymore. You know, you're going to die of a heart attack or be run over in the street.' It's that kind of… It's that… It is a, it is a rather… When I think about it, I find it, I find it rather sad. 

And I've found that issue I do dodge a little. The sadness of the HIV… I don't actually like seeing things on TV about HIV when I'm with my partner. It just makes me feel like oh my God, how can I… why did I… how did I become HIV? And how does it affect, you know, the person that I'm with? It's upsetting them. Because, you know, they're upset that I've got it.

 

While they always had safe sex, using condoms felt like missing out on a reward.

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Age at interview: 38
Sex: Male
Age at diagnosis: 24
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I think it, it (using condoms) felt like it was an inhibition, there was an inhibition there because of that. But I mean there was sort of you know' I mean it was actually at the time as well when it was first being discussed that in' it was almost like a reward, that if you're both HIV negative and you're in a monogamous relationship your reward is that you can have unprotected sex. There you go, haven't you been good. And we couldn't have that reward. And I can remember he had a sort of HIV scare that he had sort of bad gums and his dentist said to him, 'Oh you ought to go and get tested for HIV'. And thinking on that level it would have made it easier if he'd been, if the' had been positive. I mean I'm very glad that it wasn't, you know don't get' don't get me wrong.

Yeah, there would have been no transmission worries and things like that. 

 

He feels his partner is worried about becoming infected with HIV and he finds it hard to enjoy...

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Age at interview: 34
Sex: Male
Age at diagnosis: 33
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Sometimes I am not interested in sex cos… I sometimes feel weaker, yeah. Sometimes I just feel, I don't know… maybe I'm just wasting her time because I just don't feel like enjoying it like the other days, the early days when I got involved, or the days when I was married. 

It's now very different. It's just something that I will… just trying to make myself… try to enjoy or to… to just fulfil the desire, but that sex is no longer enjoyable. 

Cos once, one, the person I am sleeping with, she always try to look whether the condom is, the condoms are OK. You see, so something like… if she cannot just tell you that she does not trust you, but you can see from the reaction. So obviously my reaction also, I have a feeling that no, no, I could have this thing more enjoyable, but I can't, just because of the status I have. 

But anyway… I always have different feelings. Anyway, as long as I am still alive, as long as I am having my treatment, I can live longer.

While some negative partners said they did not have a problem with a HIV positive partner, in practice, there could still be problems in the relationship e.g. fear of contracting HIV in sex. Some people were concerned that their HIV negative partners were not careful enough to avoid HIV: 'I thought more about HIV than he did. He wasn't as careful I think as he should have been,' said one man. A few people even talked about arguing to maintain safe sex with HIV negative partners who wanted to have unsafe sex for a range of reasons, such as wanting to feel close to their partner.

 
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Although his HIV negative partners said they had no problems with HIV, HIV did create problems.

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Age at interview: 37
Sex: Male
Age at diagnosis: 24
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And they all had issues around it and you know they all said no, no it is fine it is not a problem you're HIV positive. And over a period of time with one of them it was the urge to then have unsafe sex' He would push towards that' Until it would freak him out completely. And the other ones, with the other one it was a case of them just drawing away from having safe anal sex, and then suddenly thinking I don't know if I am comfortable with oral sex now, over a period. And is like why what is different now? I am healthy things are great. And with the other one the fact that it was new to him, and it was just like, 'Oh no, hold on, I have just done this twice', so I ended that one quite quickly. And so for that that one, the HIV was just an added thing. I mean the fact that he knew' because he'd only just come out, and he just knew nothing about HIV, and so I was educating him as well, and I thought do I really need to be doing this at this point in my life? And so we broke up.

 

It was difficult to convince his HIV negative partner that he should use condoms for anal sex.

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Age at interview: 35
Sex: Male
Age at diagnosis: 31
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But I was always' I always thought that it's my responsibility to protect him. And the more I tried to like use safe sex, the more we used to fight and row. Because he didn't' just didn't want to do it. He'd say he couldn't get aroused using condoms. You know. But I used to insist. I just had to insist, you know. I mean we did oral and stuff unprotected and that. But, you know, when you tell someone till you're blue in the face that they shouldn't be doing it, and they just go ahead and do it anyway, where do you go from there? You know. But it did, did cause a lot of' initially a lot of problems. Because I just didn't want that on my conscience. I was dealing with my own shit in my own head, you know. I didn't want his' And he was enough' He was high maintenance enough anyway [laughs]. You know. Without adding to it. 

Positive-positive relationships

With the difficulties in HIV positive-negative relationships, positive-positive relationships could be easier. Even though at the time of writing there were few recorded cases of re-infection with drug-resistant HIV globally, many positive people used condoms with positive partners because they were cautious. Some were also concerned about sexually transmitted infections (STIs) such as syphilis and hepatitis C which were much more likely than HIV re-infection and used condoms so as not to pick up another sexually transmitted infection. Some said they were prepared to take the risk of not using condoms with other HIV positive partners for the additional pleasure or feeling of not using condoms.

A number of people (the black African individuals in particular) believed it was important to find partners who were also HIV positive because of the fear of infecting other people during sex, and the potential for prosecution in the UK for transmitting HIV to someone who was not infected.

Last reviewed May 2017.

Last updated May 2017.

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