Q&A: HIV Positive & Having Trouble Achieving Orgasm

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QUESTION: I am a 30 year old gay male. I was diagnosed with HIV and am on medication for it. I also have been taking medication for depression. Lately, I have noticed that I have more trouble achieving orgasm. I also lost my job and am still struggling to come to terms with having HIV. I'm not sure this is related. Any thoughts would be much appreciated.

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gentleman in scarf resembling red AIDS ribbon

Photo: Lefteris Koulonis (Flickr)

Counseling services are often available through HIV service providers or through free or sliding scale clinics in the community.

I’m sorry to hear about the difficulties you’ve been facing including learning that you are HIV positive, losing your job, and dealing with stress and depression.

However, I am happy to hear that your sex life with your partner continues to be pleasurable even with your orgasmic difficulties, and also that you are resourceful enough to seek out information about your concerns.

Talk To Your Healthcare Provider

A number of factors can influence men’s orgasm and ejaculation, including certain prescription and over the counter medications.

Some research suggests that Viagra can help to improve sexual problems caused by antidepressants and that is one option you can talk with your healthcare provider about.

Another option is to ask your healthcare provider about switching to a different antidepressant that is less likely to include difficulty with orgasm or ejaculation as a side effect.

Coping With Stress

However, orgasm can also be challenged by depression, stress and anxiety, so you might find that you are able to tackle this issue without any changes to your medications whatsoever.

There has been a limited amount of research suggesting that regular yoga practice can enhance men’s sexual function and can also help many men and women cope with stress, depression and challenges associated with chronic illness, including HIV and AIDS.

Yoga has even been found to help lower blood pressure. If you are open to trying yoga and seeing how it feels for you, it may be a “can’t hurt, might help” strategy for several aspects of your life including depression, stress and your orgasmic function.

Counseling May Help

Counseling may also be helpful. If you receive insurance benefits through your partner, which I know is often a challenge for same-sex couples, then perhaps you will have access to counseling services.

Counseling services are also often available through HIV service providers or through free or sliding scale clinics in the community. Because talk therapy has been shown to help with depression and stress, counseling may also help in these areas as well as, ultimately, with your sexual life.

Focus On Your Sex Life

There are also, of course, ways to adjust your sex life.

Some men find it easier to ejaculate or experience orgasm when they stimulate their penis, scrotum, anal opening or rectum with a vibrator – particularly a more intense one such as the Accuvibe or Hitachi Magic Wand (which, while often sold as a back massager, is also available through many adult bookstores and web sites and is frequently used as a vibrator).

Relaxing and breathing during sex may help you to focus on your physical sensations and sexual pleasure so that you can enhance your chances of orgasm. I hope these suggestions are helpful.

Next Question:The Differences Between HPV & HIV

I recently came up HPV positive. Does that means I’m going to be HIV positive?

Read Dr. Debby Herbenick’s response.

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Dr. Debby Herbenick (M.P.H., Ph.D.)

is a sexual health educator at The Kinsey Institute, Associate Director of the Center for Sexual Health Promotion at Indiana University and author of several books including Sex Made Easy and Because It Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction.
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