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  • Nozibele Qamngana

HIV and Sex. It doesn’t need to be boring.

When my and I did our #MayabaLoveJourney, we briefly started talking about sex. I remember Skhu saying that one of the things we fear when it comes to HIV is that we won’t enjoy our sex life anymore. It’s going be boring. It’s going to be restrictive. We started talking a little bit about it, but we didn’t go into details. I thought it deserved a separate video to dive more into the topic. Before we carry on, allow me to say this. Being HIV does not limit you in having sex. We have tons of sex, in different styles, in different places and in different times. I strongly believe that fear stems from lack of knowledge. And I am here to share from my own experience, with the hope that this will help you.


The first thing I’m going to say concerning this topic is that I understand that this can be very sensitive. Sex on its own can be a very sensitive topic. And then adding the “complexity” of being HIV positive or being in a mixed status relationship can be a little daunting. I get it. But, like in any other relationship, the key in what I’m about to share boils down to communication. You are going to have to talk. Open up to your partner about your fears. Talk to them about what you would like. Be on the same page. Make each other comfortable. I guarantee you that everything else will follow.

Skhu and I are in a mixed status couple. I’m HIV positive. He’s HIV negative. When I met him, I was not on treatment. I delayed starting treatment for about a year. I was not mentally ready. To make sure I didn’t infect him, we used condoms for the first two years of our relationship. That is the one option you have.


Using condoms has always been an interesting topic. “Yho, but am I going to use condoms for the rest of my life?”

“I don’t like the feel of a condom when I’m having sex. It’s sometimes tight”. I’ve heard this several times.

“The thought of stopping in the middle of a make out session, to search for a condom, then put it on. By the time I’m done, she’s no longer interested”


I remember hearing some of this from my ex-boyfriend. I’ve shared this story before. The doctor had advised us to make sure we practice sex safe by using a condom every time. All of a sudden, he didn’t feel comfortable in using a condom anymore. He kept on saying it was too tight on his penis. This puzzled me because I know his penis didn’t grow overnight. But I went along with it because I wanted to keep him happy. I’ve spoken to several guys about this. And from what I gathered, the issue of condoms is more of a physiological than physical. “We want skin to skin”, the often said. But when I probed further, I realized…and, to some extent, they agreed that there was no difference when they were having sex with a condom and when they were not. It’s all in the power of the mind.


But let me possibly suggest ways on how to spice things up when using a condom:

- Lubricants: applying a lubricant on the outside of the condom and on our partner helps to reduce friction during sex

- Female condoms: at times, men feel the pressure of buying condoms and being the only one’s using a condom. Change it up a bit and maybe try female condoms.

- Be spontaneous! We get used to routine. Start small. Change where you put your condoms. Just before your partner comes in the bedroom, quickly take a few condoms and put them inside the pillowcase. Anywhere your partner didn’t expect. This brings some excitement.


I started my ARVs in 2017. It took me six months for my viral load to be undetectable. I will share my journey with ARVs with a different post. What is very important to note is that ARVs help in minimizing the strength of the virus in your body. Having an undetectable viral load doesn’t mean you’re cured. It only means that the virus is not as aggressive. And chances of passing the virus to another person, through sex are very low. During this time, Skhu started with Pre-Exposure Prophylaxis (PreP). PreP is an HIV preventative pill. It helps people who are at high risk of contracting HIV from being infected. Like ARVs, it’s taken every day. It’s not easily accessible on public clinic. You generally need a prescription from the doctor to get it over the counter. Please don’t confused PreP with PEP. Post-Exposure Prophylaxis (PEP) is given to someone that has already had contact with someone that is infected. It is generally given in public clinics to people that have been raped. They need to take the PEP pill daily for about 28 days to protect them getting HIV.


Taking PreP may mean a lifetime commitment. That is why it’s very important to have an honest and open conversation with your partner about starting PreP. To be effective, it needs to be taken consistently.

With an undetectable viral load and PreP, chances of contracting HIV are very low. With this, the couple can have sex without a condom.

Others may ask, “what about anal or oral sex?”


Let me start with anal sex. Personally, I’ve never tried anal sex. I’m not sure I ever will. My butt hole is too small for anal sex. Jokes! But medical practitioners advise that anal sex increases your risk of HIV. The lining of the anus is thin and tears easily, which makes it more vulnerable to infection. If you are a receptive partner, is it advisable that you continue using a condom, use PreP and use lubricants.


Oral sex on the other hand – now that I have done. It is claimed that the risk of contracting HIV is very low with oral sex, given the measures we have discussed above have been put in place. Your chances increase if the other partner has bleeding gums or bad sores. You are more at risk of contracting STDs. Other practical measures can include using a condom as a barrier during oral sex. For example, if you are pleasuring your partner’s private parts, you cover the area with a condom first. Another suggestion is avoid letting your partner ejaculate in your mouth.


I’ve just realized that I have been focusing on serodiscordant couples. What about when both partners are HIV positive? It has been advised that it’s still important to use protection during sex – because you might have different strains of HIV. This can cause problems if one strain of HIV is resistant to certain antiretroviral drugs, making it harder for you to find treatment that works. Knowing about reinfection is important. If either partner has drug resistance or a different type of resistance this can be transmitted. How often reinfection occurs is not known. The risk is probably at least as low as catching HIV the first time. This will be higher if viral load is detectable and dramatically less for someone on effective treatment. The implications for your health if reinfection occurs will depend on how serious the resistance is. This means knowing about both your and your partners treatment history. If neither of you have resistance, or if you both have the same resistance, then reinfection is not a problem. But if one of you has drug resistance, and a detectable viral load, then reinfection would stop these drugs from working.


After reading this, I’m hoping you have been able to see why you sex life doesn’t need to be boring at all. Sex-away my friends. In the bedroom, on top of the kitchen counter, in the shower, on the couch…sex-away!

I hope this has been very helplful.

Nozi


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