You can avoid contracting a sexually transmitted infection (STI) like HIV without letting your fears affect your daily life.

There’s a thin line between taking proper precautions to avoid contracting HIV and having an irrational fear of HIV that actively interferes with your quality of life, love, and love-making.

On one side of the line is a responsible sex-haver, and on the other side of the line is a person with HIV phobia.

HIV phobia can be a painful type of anxiety for both the person with the phobia and their loved ones, but help is available, and there are solutions.

“HIV phobia is an intense fear of getting HIV,” says Dr. Emily Rymland, DNP, FNP-C, clinical development manager at Nurx.

Specifically, it’s an extreme and irrational fear of contracting the virus, even if you are very low risk.

“It’s a fear that can interfere with a person’s ability to engage in and fully enjoy sex,” she explains.

Although it’s wise for people to take measures to prevent contracting HIV — as you should aim to prevent contracting any virus or developing any chronic condition to the extent that you can — nobody should fear it, says Dr. Rymland.

Phobias are a specific type of anxiety. So, HIV phobia can lead to symptoms of anxiety and even cause panic attacks.

Anxiety and panic attacks can lead to a variety of physical symptoms, such as:

HIV phobia can lead to aversion, or an avoidance of spaces, places, and activities that someone has deemed “higher risk,” even if those activities or places aren’t actually higher risk.

It can also lead to excessive consumption of news, information, and media about HIV.

Some people with HIV phobia get tested for the virus an “excessive” amount or more than is recommended for their individual risk category. In many cases, they aren’t particularly soothed by their results.

Your testing frequency and emotions around testing and results could highlight another symptom.

Yes. Nosophobia is the extreme (and irrational) fear of developing an ailment that either is or is perceived as life threatening. Common culprits include cancer, kidney disease, and HIV.

HIV phobia simply refers to the fear, specifically, of HIV.

Also known as health anxiety disorder or illness anxiety disorder, hypochondria is a generalized fear about (losing) one’s health.

People with hypochondria often find themselves preoccupied with anxiety that they are sick. But unlike those with HIV phobia, people with hypochondria usually aren’t preoccupied with one specific sickness or disease. Instead, individuals with hypochondria are usually preoccupied with most or all of them.

In summary, hypochondria is a fear of general illness, while HIV phobia is a fear of a specific illness.

According to Dr. Rymland, many people with HIV phobia are those who were alive in the 80s and early 90s when HIV *was* a death sentence. After all, it wasn’t until 1995 that the Food and Drug Administration (FDA) approved antiretrovirals to help control the virus.

“It’s understandable that people who were alive [at that time] might have a lingering fear of it,” she says. “But now that HIV is a manageable condition, HIV phobia is unwarranted.”

Regardless of age, many other people who have HIV phobia are those who were raised in homophobic households. Specifically, homophobic households that have used fear-mongering around HIV stage 3 to police their family members’ sexuality and sexual activity.

Of course, homophobic caregivers aren’t the only things that can perpetuate these false messages. Schools, religious institutions, “sex ed” classes, and the media can also contribute to this.

“When somebody has an intense fear of getting HIV, it’s usually related to shame,” says Dr. Rymland. “Shame of being sexually active, shame of being queer, or some other type of shame.”

Phobias aren’t necessarily rational. That means that sometimes, there isn’t a specific cause that you can point to as to why someone has a certain phobia.

To determine if you have HIV phobia, you’ll need to spend some time reflecting on your relationship with blood, body fluids, safer sex barriers, and sex in general.

Think back to the last time you had, or almost had, partnered sex:

  • Were you thinking about the pleasure you were having, or were you preoccupied with potential risks?
  • Did your anxieties around the fear you were having physically or emotionally affect the experience for you?
  • How did you feel afterward?
  • Did you take any actions after you had sex to mitigate any potential risks of contraction?

You can also think about your STI testing protocols and routines:

  • How often do you get tested?
  • Is it more than the recommended amount?
  • How much more?

Healthcare professionals generally recommend getting tested for STIs at least once annually.

“Annual testing is the rule of thumb, but many people should get tested more often, as often as every 3 months,” says Dr. Rymland. “If you have a new partner, multiple partners, or aren’t sure of a partner’s HIV status, get tested.”

Now think about your reaction to seeing other people’s bodily fluids:

  • When you see a spot of blood on the pool deck, how do you react?
  • If you notice urine on the toilet seat in the bathroom, what do you do?
  • When you see excrement in the subway, what is your first thought?

You might also find it helpful to consider how you feel about being in spaces where bodily fluids are common. For example:

  • public bathrooms
  • locker rooms
  • pools
  • gyms
  • urgent care centers

Diagnosing HIV phobia can’t be done with a simple blood test in the way that diagnosing HIV is.

The only way a phobia of any kind can be diagnosed is by working with a mental health professional.

The professional will talk with you and observe you to better understand your symptoms and how the phobia is influencing your life.

They will likely diagnose HIV phobia if the phobia is negatively affecting your quality of life.

Phobias don’t always require a specific treatment plan. However, because HIV phobia can interfere with a person’s ability to exist in public spaces, have pleasurable sex, and enter and enjoy romantic and sexual relationships, it usually requires treatment.

HIV phobia is usually treated with some form of therapy.

One example is exposure therapy. That doesn’t mean forcing you into unsafe situations where contracting HIV is a real risk, but instead, through measures such as:

  • spending time with people who live with HIV
  • having an imaginal experience where you think about being intimate with someone
  • spending time in places you deem “higher risk”

Sometimes, cognitive behavioral therapy (CBT) can be helpful.

Usually, CBT involves teaching you to recognize when your fears or thoughts veer toward the irrational and bring them back to the land of the realistic.

Reducing your risk of contracting HIV through safer sex practices and addressing the underlying phobia may help you find relief.

This path forward often includes the following.

1. Take PrEP

An oral prescription medication that’s taken daily, “PrEP is incredibly effective at preventing HIV transmission if you’re exposed to the virus,” explains Dr. Rymland.

“Now that we have PrEP, there is truly no reason to fear HIV,” she says. “Most insurance plans are required to cover PrEP and the required HIV testing, and the budget announced by the Biden administration allocated nearly $10 billion to make PrEP accessible to all who need it.”

If you don’t have a primary care doctor or access to an in-person clinic, you might look into telehealth services like Nurx.

2. Use barriers

Regardless of whether you’re taking PrEP, you may want to consider using condoms and other barriers.

“Condoms offer an additional layer of protection against HIV, and protect against other STIs as well,” says Dr. Rymland.

This applies to both internal and external condoms.

3. Communicate openly with your partner(s)

“One of the most important things you can do to both overcome fear and protect yourself is to communicate openly with your partners,” says Dr. Rymland. “Discussing your status and asking your partner’s status is key.”

Knowing a partner’s status can empower you to make the best choices for your individual situation.

Remember: If a potential partner is HIV positive and on treatment, the virus could be undetectable. If it is undetectable, it can’t be transmitted to you. This is called U = U (Undetectable = Untransmittable).

4. Begin to address your phobia

If you’re someone whose phobia is rooted in internalized homophobia or shame about the kind of sex you’ve had, want to have, or are having, surrounding yourself with educators, influencers, elders, and other individuals you admire can be helpful.

This can (and should!) be done both online and offline.

It’s natural to want to avoid contracting a sexually transmitted infection (STI) you do not currently have. But avoiding spaces, people, or all or certain sex acts to avoid contracting an STI like HIV isn’t ideal.

If your quality of life is affected by this fear, consider working with an LGBTQIA+ affirming healthcare professional. Help is available — you don’t have to live with this kind of fear.

Gabrielle Kassel is a New York-based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.