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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


     

EXCERCISE OF SEXUALITY AND PLEASURE OF PEOPLE LIVING WITH HIV/AIDS

By sexologist Victor Velasco Morales

http://www.aids-sida.org/_sexualityandpleasure.html

INTRODUCTION

Feeling each others hands, giving love and pleasure. With that touch, they could sense all the feeling that during the time they lived together they were able to share.  Afterwards, those hands dared to enter under the sheets and they found the loved body.  The body that the disease broke the protection walls of and opened it to the eternity.  The contact with that skin that for others meant a piece of the presence of the death, for the lover was a contact with the life that their union had made blossom.

Looking then, under the sheets, for that hair that so much pleasure had given.  Touching genltly that so well known point that turned on their mutual passion and seeing in the eyes that glow of complicity discovered on the day they knew that a love like theirs was possible... Increasing then the touch, that became a gentle massage, relaxing and full of passion at the same time.  Looking in the loved eyes, the glow that announced the climax, that now, despite the disease, kept being mutual and then they let themselves go.  After that, they put on those lips, a kiss; one of them went out to the aisle, while the nurse came in to make the lover take the medication.

There, in the darkness of the aisle the other one kept going with the loving fever, remembering that night in which, at last they had accepted the reality:  The feared virus had come to their existance and threatened to end with their common project.  However, they decided that it wouldn't be like that, that they wouldn't let it become an executioner, but they would welcome it and turn it into their mutual teacher, to be able to get the sense of life and be able to fully enjoy each moment of the same.  Remembering that now at this time, after crying for so long and mourning, they felt strong again.

In those moments, remembering how in spite of the female doctor, along with the information that they lived with the HIV, gave them the indication that they should abstain from sex, they didn’t listen and, after crying together, they held each other tightly and joined their lips.  They seem to feel again how the tongue sunk deep into the other’s lips, turning into a snake of pleasure and vitality.  Then, they went through their bodies already covered with sweat, gathering the acid flavor that the excitement put on their skins, they went like that, turning themselves until each one of the mouths got to the center of pleasure of the other’s body and there, each one went through each curl found, making come out sounds of pleasure.  With special care, each one of them put to the other lover the latex to protect themselves from the temptation of flooding their mouths with those honeys of pleasure and their tongues, licked gently each other’s organs, making each other feel getting almost to the point of orgasm.

Afterwards, they seemed to remember they had hands to bring pleasure to their lover and then, they made use of them, going through each inch of the body that, vibrant, responded to the touch.  The tongues went back into action, now to murmur faltering phrases that grew the excitement and made them come into a simlutaneous orgasm in which they emptied all their tenderness.  At the end, they both smiled and told each other with a smile of complicity “just to think that when they told us that we had the AIDS virus we believed this was over to us”.

This last scene, with a thousand of possible variants it's a fortunate reality to some people who have received an adequate information about the HIV/AIDS.  However, for many more, in special for heterosexual women living with the HIV/AIDS, living with the virus has turned into a reinforcement of the loneliness and lack of pleasure to which they have been condemned for so long in their subordinated position in the society.  It is possible and necessary for people living with HIV/AIDS to exercise their right to a pleasing sexuality.  To help them find ways to it, it’s the objective of this article.

BASIC DEFINITIONS

Talking about a definition of sexuality it’s difficult, because this is a cultural construction nutured by elements that, for didactic matters, we can divide as biological, psychological, social and even spiritual.

The biological anatomic-physiological elements, are mainly related with the capacity of reproduction inherent to the existance of the sexes and with the capacity of experimenting pleasant sensations linked to the sexual arousement and the orgasm, and are the ones most frequently identified with the concept of sexual acts, and even with the one of sexuality, though in reality, they’re only part of it.

Psychological elements are refferred as to the human capacity of experimenting and sharing feelins, while socials are related with the appreciation the sexual acts receive as good or bad in each society and with the power relations that are established between individuals because of their ascription within a defined group in principle because its sexual characters.

I consider that spirituality has to do with the sense in which, in relation with the search for trascendence and personal values, each sexual act acquires, for example, the decision of having sexual activity or not, despite having the desire to do so, looking for a bigger affective comprimise or a bigger emotional well-being.

All these components of sexuality are always manifested in a dynamic and inter-related way.  However, for the purposes of this article, I will assume that the excercise of sexuality it’s all the group of activities (and the sense they have) that allow a person to look for the sexual arousement and/or the orgasm, and during that search, to share several emotions and feelings with oneself and with other people, framing all that by social regulations, explicit and implicit.

SEXUALITY AND HIV/AIDS.

AIDS, as any fact of life, can be taken as a paralyzing tragedy in front of which there is nothing to do, or well, it can be turned into an opportunity to find a new sense in our lives.  To achieve the second, we have to transform the vision we have of AIDS as an absolute death sentence and turn it into a starting point to make physical, mental and spiritual changes that allow us to increase the quality of life of the people involved.

For most of the people in our societly, there is a great relationship between the excercise of sexuality and HIV/AIDS.  This situation is partially true, for about 80% of the AIDS cases in our country have been originated in a sexual transmission of the HIV and because that keeps being the one that originates most of the new cases of HIV transmission produced each day.  Even more, the identification AIDS = Sexuality, it has been given around: AIDS = Non-Reproductive and Pleasing Sexuality, which in our society (for considering that sexuality is something bad and can only be justified for the reproductive purpose) turns the people living with AIDS into a “guilty victim” to which you can take rights away from -among these the human right to excercise his or her sexuality with responsibility and pleasure-.

In this manner, the sexuality of a person living with HIV, has been framed by the fact that there is a progressive deterioration of the health in general which limits this excercise, because of the fact that measures have to be taken to avoid new contagions, because in each act of love and/or passion, the virus can be transmitted if adequate protective measures are not taken, and above all, because of the “civil death” that many people living with HIV suffer and that, mistakenly, make theirs.

     

If we assume that sexuality it’s an element that accompanies the human being during all his existance and we wish to excercise it as an opportunity of pleasure and well-being, it is necessary to assume that Our Body and Our Sexual Wishes are Worthy Motifs and Joy, and not a manifestation of a sin or a punishment.  And that, having the virus forces to take in mind the need of avoiding new infections and reinfections by the HIV.  But it doesn’t force you per se to the sexual abstinence nor the Cancellation of The Search for Sexual Pleasure and, Much Less of the Possibility of Feeling and Sharing Affection.

When a person finds out he or she is living with AIDS, several feelings can appear in him or her related with the mourning implied with knowing oneself with a disease that’s been classified as progressive and mortal.  These feelings include anxiety, depression, uncertainty, agression, victimizing and fear to death.  All these feelings have an effect in our sexuality and transform it.

Among the transformations that the sexuality from a person that knows him or herself living with AIDS suffers, are the experience of situations in which the sexual desire vanishes, in other ocassions the desire remains, but because of the fear of infecting other people or to reinfect ourselves, we can decide no to excercise our desire, which leads us to abstain from excercising our sexual desire.

In other ocassions, the feeling of anger, if there isn’t an adequate psychological support, can be transformed into a wish for “getting even” through infecting other people.  In this case, the desire can or cannot grow.  Because the sexual activity grows, along with the number of sexual partners in occasional relationships, obviously, it does not only increment the activity, but also the risks of transmitting the virus and of reinfecting or getting infected by other diseases, which accelerates the development of the disease towards AIDS.

Another situation that can show up is the one of losing one’s partner, whether we have found out we’re infected in the moment our partner got sick or died, or because when we know ourselves living with the HIV, our partner leaves us.  This affects our self-steem and in fear of establishing new relationships, that can lead us to unintentional emotional isolation and sexual abstinence.  Inside this isolation, we can consider the virtual kidnapping that some HIV+ people get to suffer, by their families, which isolates them from friends and possible partners.

A person with HIV/AIDS, that has been infected by sexual means, can face the need of revealing not only his or her disease, that’s very stigmatized, but also reveal aspects of his or her sexuality that are not socially accepted, such as homo or bisexuality, or even, finding him or herself involved in risk practices that are considered denigrating, such as having several sexual partners or excercising the sexual work.  Even if the person hasn’t been infected by sexual means, he or she can feel obligated to justify his or her sexual activity, that starting from that moment, will be considered “under suspicion” and will limit his or her range of possible partners.

Women, generally find out that their sexual desire can hardly be expressed in an open manner.  If they know themselves living with HIV and assume the need of asking their partners to use the condom, they find resistance to such practices and, if they express the situation of being positive to the HIV, then they find themselves rejected by the possible partners and lose opportunities of excercising their sexuality, finding themselves with problems of self-image which have a negative repercussion on them, affecting their sexual desire, self-steem and self-image.

An additional factor with a repercussion about sexuality of people living with HIV, who have not been widely evaluated, is the effect on people living with HIV/AIDS by the drugs they receive, however we do forsee that among the side effects that these drugs can be the diminishing of the sexual desire, of the erectile capacity and of the ejaculatory control as well as of the quality of the vaginal lubrication.  The lack of investigation and reports in this field, are due to the fact that many doctors keep sharing the prejudice that sexuality is not something vital and that it’s not something to be worried about in a person “destined to die”, or worse yet, that he or she owes his or her disease to an “out of control sexuality”.

After the first period of mourning, we get to a point in which we decide to “make peace with life” and rebuild our existence over new bases.  We start like this to assume HIV/AIDS as another element of our everyday life and we adjust to that parting from our more general attitude towards life.  We can, like we’ve said, live it as a tragedy, with guilt and then, resignate to die in the middle of the lamentations and pitty, or well, we can assume our situation with an attitude of respect, self-acceptance and dignity, “Making changes in Our Life that allow us to raise our Self-Esteem and Claim and Exert our Right to Love and Pleasure”.

Though is not possible to absolutely separate affection from erotism in our life, we can, for didactic purposes, treat them separately, insisting that the first step to be able to build creative and loving relationships is doing it parting from the acceptance of oneself as people with all the possibilities and difficulties that each human being posseses.  Being positive to the HIV is within these difficulties as another fact of life, that doesn’t make us better nor worse, different at the most, because we have a clearer conciousness of the ending of our existance and, because of that, we are concious of the need of fully living each moment we have.

We can take this conciousness, as a gift for our existance and, from that vision of life, we can assume compromises with ourselves to be more honest and respectful in our relationships.  No one is obligated to love someone else, but every human being is obligated to relate  him or helsef “lovingly” with the people who surround him or her; because of this, even when we don’t love someone, we are obligated to not to cheat, to not demand from each person for more than he or she can give us and to not to promise anything we can’t give.  Meaning, we have to relate with each person being aware that each human being is valuable.

In this sense, we have to part from the fact that the Respect for each way of being of each human being and of their own affective and erotic needs, the Empathy, meaning, the ability of understanding his or her own motivations, without judging them and, the Unconditional Acceptance are the base for constructing a relationship with any other human being.  The only requirement is that before to any other human being, we should apply these conditions to our own life.

If we do it like this, we will be respecting the fact that our sexuality is unique and that keeps existing and, out of respect, we will not demand ourselves to act differently from what our feelings and needs demand.  Likewise, out of respect to ourselves, we will not demand ourselves to carry the guilt from someone resulting infected by us, from there that we will relate ourselves honestly with whomever accepts us knowing that being positive to the HIV doesn’t define us, but our human ability to love does.

The ethic matter comes about if it’s mandatory to tell all the people whom with we relate that we are positive.  From the fact that it is not something shameful, the answer would be ‘yes’.  However, given the fact that there is a prejudice against people living with HIV/AIDS and that, at the beginning no relationship assures its permanence, the indispensable demand, more than manifesting the positivity, would be the one of Doing only Sexual Activities that don’t Mean Risk of infection to Our Partner, Nor of reinfection For who knows him or herself Positive.

Regarding the excercise of our capacity to define physical pleasure, it’s very important to understand that the HIV is a virus that is hardly transmitted, this is because due to its biology can’t be transmitted by air, nor for casual contacts.  The virus requires to be transmitted from a person to another through corporal fluids or organic tissues.

     

To understand how the infection by HIV can happen by sexual means, it’s important to know that the transmission of the virus requires: 1) A quantity of virus enough to be able to go from a body to another. 2) That the virus is protected from the environment inside a live cell, which is its vehicle to get through.  3) The path in which cells containing the virus go by, being semen, vaginal fluids or blood these possible paths.  And 4) Ways of entrance or exit through wounds or mucous, which though they don’t have wounds, are permeable to the virus and are located in the penis’ urethra, in the vagina, in the anus or in the inside of the mouth.

If any of these elements is missing, the infection by sexual means can’t be produced, and neither can occur if the ways of entrance are being blocked by some kind of wall covering them of if the paths are being cut or the vehicles being stopped.  So, to avoid the infection we can use several strategies:

1.  Sexual abstinence, meaning not having any kind of sexual contact with any other person, not even with one-self.  This strategy can be useful for some people who consider that sexuality is something thay can’t do anymore because of living with the AIDS virus.  It has the advantage of being something that doesn’t imply any additional costs and that is effective to stop the sexual transmission of the HIV.  The disadvantages of this option are the emotional costs and in terms of relationship that implies and, above all, ITS HIGH RATE OF FAILURES, because many people who choose for abstinence, in alcohol conditions or of an intensive affective encounter, forgets his or her purposal and agrees to perform unprotected sexual practices.

Because of this, even when at first instance you have chosen for abstinence, everybody has to know the protected sex and safe sex procedures.

2. Self-erotism, in other words, caresses we give to ourselves and that can be accompanied by visual, verbal of fantasy stimulations to produce arousement or orgasm.  We can, in these cases, use several sexual toys that go from dildos to inflatable dolls.  Obviously, to enjoy these options, it’s very important to recuperate the ludic sense that our sexuality possesses.

3. The called Safe Sex which consists in all those techniques to share tactile, visual, auditory, olfactory stimulations with one or several sexual partners with whom the penetration of the penis into another body is avoided, and by this the interchange of corporal fluids is avoided between a body and another. 

This includes strokes of every kind, except for those in which the fingers or the penis are put into corporal cavities such as the anus, the vagina or the mouth.

4. The named protected sex, which consists on those practices in which there’s penetration of the penis into the body of another person, avoiding -through the use of  barriers, such as the condom, plastic wrapper or latex squares- that the corporal fluids get to some wound or mucous membrane.

It is parting from this knowledge that it has been possible to raise the following four principles of a Protected Erotic Life, defined by me as: “The group of attitudes, knowledge and practices that allow us the excercise of our sexual desire and the obtaining of pleasure, reducing to the maximum possible the risk of acquiring sexually transmitted diseases, as well as to avoid non-desired or non-planned pregnancies.”

The elements of Protected Erotic Life are the following:

a) Considering that in every sexual relation we get involved People with equal human dignity and responsibility.  This means that we are mutually responsible for protecting ourselves from infections and/or re-infections, as well of deciding when, how, why and what we decide to have sexual relations for.  While we are mutually responsible, each one of us is Responsible of Its Own Protection.

b) Learning to de-genitalize the exercise of our sexuality, in other words, taking again what we’ve said about, in search for sexual pleasure we can utilize all our body, our imagination and we can incorporate toys, sounds, flavors and the rest of the elements that make that our pleasure is not only focused on the penetration of the penis into the vagina, the anus or the mouth, but that we consider possibilities of having orgasms by stimulation with dildos, for kissing the body of our partner or thanks to a mutual masturbation.

c) To perform sex with penetration, we can learn to utilize instruments and techniques that reduce the risk and increase the pleasure.  Among these instruments is the condom.  It is important to insist that the condom is an instrument and not a lucky charm that changes the sexual or moral characteristics of its users.  Meaning, a person who uses a condom doesn’t become promiscuous by using it, nor becomes homosexual.  Let’s remember that the user of the condom must always practice before doing it with his or her partner, to be able to master the technique of its correct use.

When we have reconciliated with life and we start again a sexual active life, we can find that the condom can be very useful, but it makes us face some demands about learning how to use it, recognizing the most effective type of lubricant and learning how to negotiate it, all of which are not obstacles that you can’t pass, even when they’re real and we have to acknlowledge them to be able to overcome them.

There is a Female Condome already, which has potentially as many or more advantages than the masculine one and can save women fron the problem of negotiating the use of the same if their partners don’t wish to do so.

d) Let’s practice a Universal Mutual Protection, which means that we should avoid the possibility of re-infections and of spreading the infection.  So, because we can’t be informing all if we are positive or not, nor we can put everybody to a test, the best thing is that we use the protection practices with everybody equally, specially in our sexual life or when contact with blood is implied, like in surgeries or beauty treatments