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J Sex Res. 2018 Nov-Dec;55(9):1134-1154. doi: 10.1080/00224499.2018.1440370. Epub 2018 Apr 6.

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types.

Author information

a Faculty of Health Sciences , Simon Fraser University.
b Epidemiology and Population Health , British Columbia Centre for Excellence in HIV/AIDS.
c School of Social Work , McMaster University.
d Department of Obstetrics and Gynecology and Department of Medicine, Faculty of Medicine , University of British Columbia.
e ViVA , Positive Living Society of British Columbia.
f Department of Obstetrics and Gynecology, Faculty of Medicine , University of British Columbia.
g Amsterdam Institute for Global Health and Development, Department of Global Health , University of Amsterdam.
h Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine , McGill University.
i Division of Infectious Diseases, Faculty of Medicine , University of British Columbia.
j Oak Tree Clinic , British Columbia Women's Hospital and Health Centre.
k Chronic Viral Illness Service , McGill University Health Centre.
l Department of Family Medicine , McGill University.
m Department of Public Health and Policy , University of Liverpool.
o Department of Medicine , University of Toronto.
n Women's College Research Institute , Women's College Hospital.


In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women's own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women's rights, which are critical to overall well-being.

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