Senior Research Associate, Department of Epidemiology and Global Health, Umeå University, SE-901 87 Umeå, Sweden.
Professor, Department of Epidemiology and Global Health, Umeå University, SE-901 87 Umeå, Sweden.
Sex Reprod Health Matters. 2023 Dec;31(1):2245197. doi: 10.1080/26410397.2023.2245197.
Around 40% of people living with human immunodeficiency virus (HIV) in Sweden are women. However, little is known about their experiences, particularly those related to sexual and reproductive health and rights (SRHR). This study aims to explore perceptions and experiences of SRHR among women living with HIV (LWH). Twelve interviews were conducted with women LWH from September to October 2019 and analysed using thematic analysis. The central theme describing participants' experiences of social relationships, intimate encounters and reproductive life, "Discrimination is harder to live with than the disease itself", is based on three themes that contain subthemes. Theme 1 describes how participants reconsider and reorient their sexual and reproductive life after diagnosis. Theme 2 highlights how (mis)perceptions of HIV affect sexual and reproductive life and lead to abusive treatment and internalisation. Theme 3 describes a paradoxical shift of responsibilities where participants experience being compelled to take greater responsibility in some situations and stripped of the right to decide in others. This study suggests that despite notable progress in HIV treatment, stigma and discrimination stemming from outdated beliefs and (mis)conceptions, ambiguous policies and guidelines, and unequal access to information affect SRHR experiences of women LWH more than the virus itself. The results emphasise the need to: update knowledge within healthcare settings and among the public; clarify ambiguous legislations and guidelines; ensure equal access to information to enable all women LWH to take informed decisions, make fully informed choices and realise their SRHR; and consider the diversity of women LWH and enable shared decision-making.
在瑞典，约有 40%的艾滋病毒（HIV）感染者为女性。然而，人们对她们的经历知之甚少，特别是与性健康和生殖健康及权利（SRHR）相关的经历。本研究旨在探讨 HIV 阳性女性（LWH）对 SRHR 的认知和体验。2019 年 9 月至 10 月，对 12 名 LWH 女性进行了访谈，并采用主题分析进行了分析。描述参与者对社会关系、亲密关系和生殖生活的体验的核心主题是“歧视比疾病本身更难忍受”，它基于包含子主题的三个主题。主题 1 描述了参与者在诊断后如何重新考虑和重新定位他们的性和生殖生活。主题 2 强调了对 HIV 的（错误）看法如何影响性和生殖生活，并导致虐待性待遇和内化。主题 3 描述了一个责任的悖论性转变，参与者在某些情况下被迫承担更大的责任，而在其他情况下却被剥夺了决定的权利。本研究表明，尽管在 HIV 治疗方面取得了显著进展，但源于过时的信念和（错误）观念、模糊的政策和准则以及不平等获取信息的耻辱和歧视，对 LWH 女性的 SRHR 体验的影响比病毒本身更大。研究结果强调需要：更新医疗保健环境和公众中的知识；澄清模糊的立法和准则；确保平等获取信息，使所有 LWH 女性能够做出知情决策、做出充分知情的选择并实现其 SRHR；并考虑到 LWH 女性的多样性，并能够进行共同决策。
