Developing a Model of Sexual Satisfaction in Younger Women Living with HIV (YWLWH) in Serodifferent Relationships

Cecilia MacDougald

Research output: ThesisDoctoral Thesis


HIV is a virus that, without medication, can be sexually transmitted. This can make sexual relationships harder for women living with HIV (WLWH), particularly those in serodifferent relationships (relationships with people who don’t have HIV). Sexual difficulties among WLWH are common. However, medical advances are making it possible for WLWH to live longer, healthier lives and engage in sexual relationships without fear of transmission (Rodger et al., 2016; 2019). While sexual satisfaction (SS) among older women living with HIV has been explored (e.g., Taylor et al., 2017), younger WLWH’s (YWLWH) experiences of sexual satisfaction after HIV diagnosis have not. Seven YWLWH (aged 22-49) were recruited through two UK HIV advocacy forums and social media. Participants took part in semi-structured interviews about their sexual experiences in past/current serodifferent relationships. Grounded Theory analysis identified eight theoretical codes: (1) Beliefs about future sexual relationships after HIV diagnosis (2) Sexual behaviour after HIV diagnosis, (3) Feeling sexually satisfied due to individual factors, (4) Feeling sexually satisfied due to relational factors, (5) Feeling sexually satisfied due to HIV-related factors, (6) Other emotional/cognitive factors linked to SS, (7) Experiences of status sharing with HIV-negative partners and (8) Feeling supported living with HIV. A theoretical model indicating the relationship between codes highlighted how fears of HIV transmission, rejection from sexual partner, and internalised HIV-stigma influences sexual behaviour and beliefs about sex after HIV diagnosis. However, SS is facilitated by factors that assist YWLWH to overcome such fears, including professional and peer support, partner acceptance, knowledge of transmission risk, and positive re-interpretations of HIV. SS is then maintained through dyadic relational factors (e.g., communication) and individual factors (e.g., sexual pleasure). Increased access to peer support and information sharing regarding negligible transmission risk with undetectable viral loads may improve WLWH’s sexual wellbeing. Findings also suggested HIV services could focus more on asking about WLWH’s sexual wellbeing.
Original languageEnglish
  • Evangeli, Michael, Supervisor
Publication statusUnpublished - 2021

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