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HIV and Erectile Dysfunction: What Men Need to Know

Men living with HIV can still enjoy happy and healthy sex lives. 

June 27 is National HIV Testing Day, making it the perfect time to learn about HIV and sexual health. In 2018, there were more than 36 million adults living with HIV worldwide. Men living with HIV are at a greater risk for erectile dysfunction (ED).

This article explores the relationship between HIV, sexual health, and erectile dysfunction. Read ahead to learn more about maintaining a happy and healthy sex life with HIV.

What is HIV?

The human immunodeficiency virus (HIV) is a virus that damages the immune system, making it more difficult for the body to fight off infection. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS). People living with HIV/AIDS (PWLHA) are vulnerable to other infections and illnesses (e.g. certain cancers).

There is no cure for HIV, meaning that once someone has the virus, they have it for the rest of their life. However, modern treatment methods enable PWLHA to live longer and healthier lives. Early treatment is critical to living a healthier life and preventing transmission to partners.

HIV is spread through contact with certain bodily fluids. It cannot be spread through casual contact, such as handshaking or hugging. HIV is most commonly spread through sexual activity and needle or syringe use.

Bodily fluids that can transmit HIV include:

  • Blood
  • Seminal fluid
  • Vaginal fluid
  • Rectal fluid

The only way for someone to know if they have HIV is to get tested. For more information on HIV and STI testing, visit the Center for Disease Control and Prevention’s “GetTested” website.

How Does HIV Affect Health and Sexual Health?

Research demonstrates a strong link between HIV and sexual dysfunction in men. For example, an estimated 46% of men living with HIV also experience erectile dysfunction (ED). The direct cause of ED in men living with HIV is unclear.

Researchers believe multiple factors are at-play when it comes to the relationship between HIV and ED. Advanced HIV infections pose a greater risk for sexual concerns and reduced engagement in sexual activity with partners. In one study, men aged 40-59 were the most likely of those living with HIV to report erectile dysfunction.

Potential causes of ED in men living with HIV include:

  • Other chronic conditions. Comorbidities, such as heart disease, diabetes, or cancer can negatively impact sexual health and sexual function.
  • Psychological stress and fear. The fear of transmitting HIV to a partner and the stress of living with HIV can cause psychologically induced ED.
  • Mental health disorders. Depression, anxiety, and mood disorders contribute to ED. Men living with HIV and ED may also report living with depression or anxiety.
  • Certain medications. Medications for chronic conditions and HIV treatment itself may contribute to problems with sexual function. Doctors may recommend different medications for men currently managing chronic conditions.

HIV Prevention Strategies

HIVModern medicine and public health practice have revolutionized HIV prevention. Those currently living without HIV can prevent acquiring the virus and those living with HIV can prevent transmitting the virus to sexual partners in a variety of ways. These practices include taking sexual precautions, not sharing needles, and taking medication to reduce risk of transmission.

Those not currently living with the virus can prevent HIV by:

  • Abstinence. Refraining from anal, oral, or vaginal sex reduces your risk of coming into contact with bodily fluids that carry HIV.
  • Monogamy or limiting sex partners. By limiting your number of sexual partners, you reduce your risk of being exposed to HIV. It is important for both partners to know their STI and HIV status.
  • Not sharing needles. Never share needles or syringes with others, as this is a common mode of HIV transmission.
  • Using barrier methods. Using barrier methods correctly and consistently reduces your risk of HIV. Barrier methods include external condoms, internal condoms, and dental dams.
  • Using pre-exposure prophylaxis (PrEP).
    PrEP is a daily pill designed to prevent HIV transmission. Only those who are not currently living with HIV can take PrEP. This medication requires a prescription.

Those living with HIV can prevent transmitting the virus to a partner by:

  • Taking HIV medication. Antiretroviral treatment (ART) suppresses a person’s viral load, sometimes making it undetectable. The lower one’s viral load, the lower the risk of transmitting the virus to a partner.
  • Using barrier methods. Continue using barrier methods correctly every time you have sex with a partner.

What Can Men with HIV Do to Take Control of their Health?

Men living with HIV have the opportunity to take control of their health and live happier and healthier sex lives. Taking care of physical health, managing other chronic conditions, and using effective treatment methods all benefit men living with HIV. Men with HIV should speak with their doctor if they wish to pursue treatment for ED.

Men with HIV can improve their health and erectile function by:

  • Engaging in regular exercise. People living with HIV can engage in the same types of exercise as people who do not have HIV. Keeping physically healthy is important to overall health and erectile health.
  • Eating healthier. Proper nutrition and a balanced diet are great for the heart and the immune system. Improved health leads to improved sexual function.
  • Maintaining a healthy weight. Excess weight gain is associated with ED.
  • Speaking with a therapist. Counseling and sex therapy can help to work through stress and anxiety related to HIV and ED.
  • Staying in treatment. Antiretroviral treatment is essential to staying healthy, reducing risk for advancing to the next phase of HIV, and preventing HIV transmission. Keeping up with treatment can ease the stress of living with HIV and can improve ED symptoms related to stress and anxiety.
  • Considering ED medications. Safe and effective ED medications can treat ED and alleviate stress surrounding sexual performance. Prescription lifestyle medications, like Viagra, are generally safe to use with other medications.

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