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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
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