QuestionMark? #98

July 21, 2016by Mark Rutherford

QuestionMark? #98


Dear Mark,


I’ve been HIV positive for over ten years and have never taken meds. My doctors have monitored me and told me my blood counts were good enough and I didn’t need meds. I always felt lucky because I remember all the trouble my friends had years ago when they started their meds. I feel very lucky that I have not had to start any of these medications. But now my doctors say it is time for me to begin therapy. I know it is the right thing to do but I’m scared. Do you have any words of wisdom?


Sincerely, Michael


Dear Michael,


Take a deep breath and go ahead and do it. Things are different now than they were ten years ago. There are new drugs with fewer side effects.   Chronic manageability is truly feasible in this day and age.   There is the very real probability that you will live a long and happy life. If you can keep your numbers down by taking appropriate drugs, you may even die of something else….like old age.


I understand why you feel scared. You remember how it was. You remember your friends and the terrible time they had. I clearly remember my friends that are gone. I remember sitting in the hospital room with them not knowing what to say. I remember holding the trash can while they threw up in it. I told them it was going to be okay. But I wasn’t sure that it would be.


However, that was the old landscape of HIV. Today is a different time. There are different options both in antiretroviral therapy and in your own personal future. There is a great book called Fit for Life by…. This is not to say that HIV is a walk in the park. It isn’t. It is still a very serious disease that can be deadly. It is just another one of the great unknowns in our life. The famous poet, Rilke, says to embrace the questions, “do not seek the answers, which cannot be given you, because you wouldn’t be able to live them…and the point is to live everything”. I say follow his advice.



Dear Mark,

My lover and I have been together for 14 years. She is a good person and I really do love her. We have 9 animals together and have owned our own home for over 9 years. She has a decent job and we get along okay financially. Here’s the twist….we have only had sex 5 times…count them…five times since we have been together. That’s 5 times having sex in 14 years. I used to say it didn’t matter. Our connection was emotional not physical. That had worked but, for some reason, in my early forties, I am experiencing a re-awakening. I am wanting to have sex and this is causing a HUGE problem between us. She is telling me that she is just not a sexual person and that if I have to have sex that maybe we weren’t meant to be together. I think I want to be with her for the rest of my life. The thought of leaving devastates me but I also want to get my needs met.


Signed, Sexless in Fort Lauderdale


Dear Sexless,


Both of you need to get to a good couples therapist and talk this out. Try to find a therapist who is skilled in Imago Relationship therapy. This form of couple’s therapy teaches a dialogue that enables the couple to talk about the feelings that are happening rather than the event itself. Process verses content.


If your relationship has lasted this long, there are some very good components. Essentially, there is enough good about your connection with each other to make you feel okay in fighting for the two of you to stay together. In therapy, find out why she doesn’t want to have sex. Is it low sex drive? (even if it’s low it can’t be THAT low) There is usually contributing factors that impede a couple’s ability to be sexually intimate.


There may be underlying issues that just haven’t come up or she hasn’t been able to talk with you about them. Now is the time to find out. Don’t rule out medical issues. I would recommend a complete physical and see if there are any issues there. In discussion, you will be able to find some common ground that works for the two of you. Sex doesn’t have to be everyday but if at least one partner is wanting to have it, it should be more than 5 times in 14 years.