Sexuality and HIV are intricately linked. About half of all people with HIV experience sexual problems that often negatively affect their quality of life. Sexual health includes the physical, psychological and social aspects of sexuality. Due to an HIV infection, these different aspects can be disturbed individually or together. The nurse consultant at the Jan van Goyen Medical Center therefore pays a lot of attention to your sexual health during the first few consultations (and, if necessary, also during later consultations).
Physical aspects of HIV and sexuality
- Testosterone deficiency
Due to the HIV infection or the medication, the free (active) testosterone level is too low in approximately 20% of the HIV-infected patients. This can manifest itself in general complaints (fatigue, listlessness) as well as in sexual complaints (erectile dysfunction, less sex drive). In the case of these kinds of complaints, a testosterone test is always performed in the Jan van Goyen Medical Center; if the result is low, we propose a trial treatment with testosterone supplementation. This can be done by means of a gel (androgel) which is applied daily to the skin or by subcutaneous injections (Sustanon) administered once every three or four weeks.
- Other sexually transmitted diseases (STDs) besides HIV
About 15 % cases of gonorrhea, syphilis and chlamydia in men who have sex with men (MSM) are identified in men who are known to be HIV positive. These STDs influence sexual functioning and the chance of HIV transmission from patient to their sexual partner (which is easier in the case of an additional STD). The practitioners and nurses in the MC Jan van Goyen therefore have regular contact with the STD outpatient clinic of the GGD. The nurses can arrange for you to have a private appointment at the GGD on a regular basis so that a regular STD check is carried out.
Psychological and social aspects of HIV and sexuality
HIV often interferes with the sexual life of HIV-infected people and their partners. For example, it happens that people with HIV or their partners give up sex because of fear of infecting the other person with HIV. The psychological burden of being ill can lead to sexual dysfunctions, especially in the case of depression. Feelings of shame, anger or guilt can also stand in the way of healthy sexuality. Finally, drug and alcohol use can affect sexual health.
