HIV and 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.)

Age at interview 40

Gender Male

Age at diagnosis 30

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

Age at interview 31

Gender Male

Age at diagnosis 29

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

Age at interview 33

Gender Female

Age at diagnosis 27

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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  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…

Age at interview 39

Gender Male

Age at diagnosis 34

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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.”

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

Age at interview 47

Gender Male

Age at diagnosis 41

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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.)

Age at interview 38

Gender Male

Age at diagnosis 35

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

Age at interview 38

Gender Male

Age at diagnosis 24

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

Age at interview 34

Gender Male

Age at diagnosis 33

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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.

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

Age at interview 37

Gender Male

Age at diagnosis 24

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

Age at interview 35

Gender Male

Age at diagnosis 31

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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.

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