Sexual satisfaction among people living with HIV in the era of biomedical prevention: enduring impacts of HIV-related stigma?

Thomas Norman; Adam Bourne; Jack Thepsourinthone; Dean Murphy; John Rule; G. J. Melendez-Torres; Jennifer Power

doi:10.1071/SH24103

RESEARCH ARTICLE (Open Access)

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Sexual satisfaction among people living with HIV in the era of biomedical prevention: enduring impacts of HIV-related stigma?

Thomas Norman

^A ^* , Adam Bourne ^A ^B , Jack Thepsourinthone ^A , Dean Murphy ^A , John Rule ^C , G. J. Melendez-Torres ^D and Jennifer Power

^A

+ Author Affiliations

- Author Affiliations

^A Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic, Australia.

^B Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.

^C National Association of People with HIV Australia (NAPWHA), Sydney, NSW, Australia.

^D Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.

^* Correspondence to: T.Norman@latrobe.edu.au

Handling Editor: Benjamin Bavinton

Sexual Health 21, SH24103 https://doi.org/10.1071/SH24103

Submitted: 14 May 2024 Accepted: 26 November 2024 Published: 17 December 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

People living with HIV (PLHIV) have historically faced a range of challenges negotiating satisfying sex lives in the context of virus transmission risks and HIV-related stigma. We examine the experience of sexual satisfaction among PLHIV in an era of pre-exposure prophylaxis (PrEP) and undetectable=untransmissible (U=U)/treatment as prevention.

Methods

Data are derived from HIV Futures 9, a cross-sectional survey of PLHIV in Australia conducted between December 2018 and May 2019. Logistic regression was used to identify factors associated with sexual satisfaction, including awareness of/engagement with U=U and PrEP as well as experiences that denote HIV-related stigma.

Results

Over half (56.5%) of the total sample (n = 715) reported they were not satisfied with their sex lives. Those who avoided sex because of their HIV status (44.4%) were more likely to report sexual dissatisfaction, as were those who were aged 50 years or over and those with worse self-reported health. Participants who expressed a concern about their drug use were more likely to report sexual dissatisfaction when compared with those who expressed no such concern.

Conclusions

Concerns about HIV continue to be present in the lives of PLHIV and can interrupt or undermine intimate and sexual relationships. Although biomedical prevention technologies such as PrEP and antiretroviral therapy may alleviate anxiety relating to onward transmission of HIV, these findings indicate that concerns about HIV status, which may be related to experiences of stigma, are still adversely associated with enjoyment of sex for those living with HIV.

Keywords: antiretrovirals, HIV/AIDS, people living with HIV, relationships, sexual experience, sexual satisfaction, stigma.

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