Q and A


I have lost my sex drive – what is the cause of this?


I’ve been HIV positive now since early 2007, I’m male, 28 and not yet on medication.

For the last few months I have completely lost my sex drive and become very depressed.

I feel I have the signs of low testosterone levels. My sex drive has completely diminished, resulting in erectile dysfunction. I’m very depressed despite being on an SSRI (serotonin-specific reuptake inhibitor), which I have been on for years and I just cannot seem to snap out of it. I’ve tried DHEA (Dehydroepiandrosterone) supplements but no change, cialis but no change, and changed my SSRI also without effect.

Is it highly unlikely to be hypogonadism at 28? Is it common with HIV infection? I want to ask my GP but I’m worried incase I seem like a hypochondriac.

Many thanks


Thank you for your question.

Please don’t be worried, sexual dysfunction is more common than you think.

Low testosterone levels, erectile dysfunction and lack of sex drive can all be due to a mixture of things including HIV infection, psychological factors, depression, smoking, alcohol consumption, age and certain SSRI drugs can also decrease libido. Sexual dysfunction is also more common in HIV positive people not on HIV treatment.

HIV positive men and women have lower testosterone levels than HIV negative people so this could be the HIV, even though you are young. If you feel you have the signs of low testosterone then ask your HIV doctor for a referral to a sexual health specialist so they can test your testosterone levels.

It would be good to know how your life has changed since you have become HIV positive? It is easy to become more isolated and become less social. Do you have a partner or friends who know your status? Are you accessing enough support? All of these factors, however unrelated they feel, will have a psychological impact on your sex drive and erectile dysfunction.

Talk to your HIV doctor about support to come to terms with how your HIV diagnosis may be related to sexual desire.


  1. Roy Trevelion

    Hi Gordon,

    It’s likely that sexual problems affect a lot of HIV positive people.

    However, there can be many causes for low sex drive and sexual dysfunction. This can include low testosterone levels and psychological issues.

    But please talk to your doctor. Referral to a sexual health clinic or counselling support is often a good idea. Many clinics have psychologists who are trained and experienced in sexual dysfunction.

    Please see this guide to sexual health and quality of life. There’s also a list of treatments included in the guide.

  2. gordon

    my wife also complain about my sex drive is low.what else must l take to boost

  3. Lisa Thorley

    Hi Missye,

    Its very common that a persons sex drive changes as they get older. However a lack of sex drive can be due to a lot of things, as the above post explains.

  4. Missye

    My husband has full blown AIDS and is on medication for it but he feels that his sex drive has diminished drastically from the disease itself, the medication or both. I always feel like I just don’t make him happy anymore but I know that he loves me and wants no one else but me. I see the want and desire he had for me at times then other times it’s like we’ve been married for 50 years and we’re in our 80’s. We are clueless really and could use and advice given. We just want our crazy, fun sex life back.

  5. Roy Trevelion

    Hi Thabo,

    Although most research into loss if interest in sex that’s associated with HIV has been carried out in men, when women have been included in these studies, a similar level of concern has been reported.

    There’s much more info about HIV and sexual health in this guide to HIV and your quality of life.

    But, it’s great that your wife is on ARVs. Because if viral load is undetectable, HIV cannot be transmitted. Even if you don’t use condoms. So if you’re HIV negative you are at zero risk. Please see undetectable = undetectable here. This U=U campaign is really taking off because the message is clear that there is zero risk if you’re undetectable to partners who are HIV negative.

    It’s a good idea if you can talk to your doctor about this too. Would you both find it okay to do that. Getting counselling can often help with sexual problems like these.

  6. Thabo

    My wife is on ARVs and at one stage she was told that they will make her sexually active but all said was negative. I support her with all I can but still she is not there for me sexually.We used condoms for her satisfaction and guaranteed protection, however she still refuses.What am I supposed to do as I don’t want to see myself going outside for sex because that might affect her negatively?

  7. Lisa Thorley

    Hi Confort,

    Please see the above post.

  8. confort

    I have a problem since ,I started taking Odimune pills for HIV my sex drive is diminishing. My penis size has also decreased. Is this the results of taking the pills ?

  9. Simon Collins

    Hi, ARVs are not likely to be causing this. Please talk to your doctor though who can give advice on other aspects of sexual health.

  10. Miss ms

    Are the arvs causing me to be wet during sex; im a lady 28 on hiv treatment, every time my boyfriend complains about me being wet; saying im not hot meaning he don’t feel it. What can b a problem. Thanks


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