Research finds the sexuality and sexual rights of women living with HIV are overlooked

By Ian Bryce

A new paper from health sciences PhD candidate Allison Carter analyzing research on women living with HIV finds women’s sexual wellbeing and rights—including pleasure, satisfaction, and freedom from discrimination and violence—are overlooked.

Carter and her team, which includes women living with HIV and care providers, reviewed 32 studies involving 11,552 women living with HIV globally. The studies, ranging from 1997 to 2017 (when HIV became a treatable, chronic condition), provide insight into the effect of social and cultural factors on sexuality for women after an HIV diagnosis.

The study found that many women with HIV experience HIV-related stigma, violence, poverty, and depression that negatively affect sexual health and wellbeing, including women’s interest and enjoyment of sex.

Carter says these findings indicate that women’s anxieties and challenges around sex and HIV are rooted in societal oppression. Yet these multiple traumas and their impact on women’s sexuality frequently go unseen and unsupported, as most research and policy agendas remain primarily concerned with preventing HIV to others.

Research has well established that successful HIV treatment along with an undetectable viral load keeps people with HIV alive and healthy. Recent scientific findings further confirm that these factors effectively eliminate the sexual transmission of HIV.

“As more women engage in care and experience the many health benefits associated with HIV treatment, there is an opportunity to also support women to have happy and fulfilling sexual lives,” says Carter, who is based at the BC Centre for Excellence in HIV/AIDS. “Sexual health is not just about HIV prevention.”

“Women living with HIV are sexual beings with their own needs, desires and concerns,” added HIV activist and study co-author Jessica Whitbread. “A safe and satisfying sexual life—however women themselves want to define ‘satisfying’—is a human right.”

“This important study highlights the need to completely reframe our approach to sexual health and pay greater attention to positive and rewarding experiences such as satisfaction and pleasure, and the social environments necessary to support this,” says SFU associate professor Angela Kaida, senior author and Canada Research Chair in Global Perspectives on HIV and Sexual and Reproductive Health at SFU.

The team says that decriminalizing HIV non-disclosure is needed to de-stigmatize and normalize sexualities and relationships with HIV. They also say that the culture of discrimination and violence must change dramatically to support women’s sexual wellbeing.

The paper, published in Sex Roles: A Journal of Research, is available online here.