TY - JOUR
T1 - Prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada
AU - Carter, Allison
AU - Gormley, Becky
AU - Muchenje, Marvelous
AU - Zhu, Denise
AU - Patterson, Sophie
AU - Kestler, Mary
AU - Hankins, Catherine
AU - Logie, Carmen H.
AU - Brotto, Lori A.
AU - Tharao, Wangari
AU - Lee, Melanie
AU - Li, Jenny
AU - Ding, Erin
AU - de Pokomandy, Alexandra
AU - Loutfy, Mona
AU - Kaida, Angela
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: CHIWOS has been awarded funding from the Canadian Institutes of Health Research (MOP-111041), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund. Some authors are receiving salary support: S.P. from a Clinical Lectureship in Public Health awarded by the National Institute of Health Research (NIHR), A.d.P. from the Fonds de Recherche Santé Québec (FRSQ), and A.K. through a Tier 2 Canada Research Chair in Global Perspectives on HIV and Sexual and Reproductive Health.
Funding Information:
The authors thank all the women living with HIV who participated in CHIWOS for giving their time and voices to this study, and the Peer Research Associates for the enthusiasm, passion, and dedication they bring to their work with CHIWOS. The authors also thank the entire national team of co-investigators and collaborators. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: CHIWOS has been awarded funding from the Canadian Institutes of Health Research (MOP-111041), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund. Some authors are receiving salary support: S.P. from a Clinical Lectureship in Public Health awarded by the National Institute of Health Research (NIHR), A.d.P. from the Fonds de Recherche Sant? Qu?bec (FRSQ), and A.K. through a Tier 2 Canada Research Chair in Global Perspectives on HIV and Sexual and Reproductive Health.
Publisher Copyright:
© The Author(s) 2022.
PY - 2022/1/28
Y1 - 2022/1/28
N2 - Objectives: We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. Methods: We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV diagnosis and associated distress (none, mild, moderate, severe). Five areas of concern were assessed, including difficulties related to sexual self-esteem, sexual function, relationships, and emotional and behavioral aspects of sex. Logistic regression analyses identified correlates of reporting any sexual concerns and severe distress about these concerns. Results: Of 906 participants (median age 48, Q1–Q3 = 41–55), 596 (65.8%) reported sexual concerns post-HIV diagnosis. We found a high prevalence of concerns related to relationships (43.3%), sexual self-esteem (49.4%), and emotional aspects of sex (45.4%), relative to sexual functioning (38.4%) and behavioral aspects (33.7%). Of those with sexual concerns, 36.7% reported severe distress. Reports of severe distress were the highest for relationship difficulties (32.5%), relative to other areas of concern (21.4%–22.8%). In adjusted analyses, women reporting sexual dissatisfaction and high HIV-related stigma had significantly higher odds of reporting sexual concerns. Conversely, those reporting higher resilience, better mental health, African, Caribbean, and Black identity, and sex as somewhat unimportant, not at all important, or neutral to their lives had lower adjusted odds. Factors associated with severe distress about sexual concerns included older age, body dissatisfaction, sexual dissatisfaction, and high HIV-related stigma, while better mental health and getting support from someone living with HIV were protective. While 84.4% of women had discussed with a provider how viral load impacts transmission risk, only 40.6% had conversations about sexual wellbeing. Conclusion: More attention to women’s sexual wellbeing within social and relational contexts is critical to ensure the sexual rights of women living with HIV are upheld.
AB - Objectives: We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. Methods: We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV diagnosis and associated distress (none, mild, moderate, severe). Five areas of concern were assessed, including difficulties related to sexual self-esteem, sexual function, relationships, and emotional and behavioral aspects of sex. Logistic regression analyses identified correlates of reporting any sexual concerns and severe distress about these concerns. Results: Of 906 participants (median age 48, Q1–Q3 = 41–55), 596 (65.8%) reported sexual concerns post-HIV diagnosis. We found a high prevalence of concerns related to relationships (43.3%), sexual self-esteem (49.4%), and emotional aspects of sex (45.4%), relative to sexual functioning (38.4%) and behavioral aspects (33.7%). Of those with sexual concerns, 36.7% reported severe distress. Reports of severe distress were the highest for relationship difficulties (32.5%), relative to other areas of concern (21.4%–22.8%). In adjusted analyses, women reporting sexual dissatisfaction and high HIV-related stigma had significantly higher odds of reporting sexual concerns. Conversely, those reporting higher resilience, better mental health, African, Caribbean, and Black identity, and sex as somewhat unimportant, not at all important, or neutral to their lives had lower adjusted odds. Factors associated with severe distress about sexual concerns included older age, body dissatisfaction, sexual dissatisfaction, and high HIV-related stigma, while better mental health and getting support from someone living with HIV were protective. While 84.4% of women had discussed with a provider how viral load impacts transmission risk, only 40.6% had conversations about sexual wellbeing. Conclusion: More attention to women’s sexual wellbeing within social and relational contexts is critical to ensure the sexual rights of women living with HIV are upheld.
KW - HIV
KW - mental health
KW - sexual wellbeing
KW - social determinants
KW - women
UR - https://www.scopus.com/pages/publications/85123905050
U2 - 10.1177/17455065221074877
DO - 10.1177/17455065221074877
M3 - Article
C2 - 35088623
SN - 1745-5057
VL - 18
JO - Women's health (London, England)
JF - Women's health (London, England)
ER -
SDG 3 Good Health and Well-being
SDG 5 Gender Equality