Experiences Of HIV-positive Women Research Articles

Use of Critical Ethnography to Study the PMTCT Program

Background: Despite the efforts at establishing Prevention of Mother to Child Transmission (PMTCT) programs in Rwanda, there are still children who are becoming infected through mother-to-child transmission of HIV. The purpose of our research study was to explore the experiences of HIV positive women using PMTCT program to prevent HIV transmission in Rwanda. Methodology: In this study, a qualitative approach using a critical ethnographic design was used to answer to our research question and with the aim to discover the meaning, process, and context of the studied phenomenon. In this paper, we discussed ethnography, critical ethnography, and its related philosophical assumptions as well as illustrating the rational for the use of critical ethnography to study the PMTCT program. Critical ethnography ultimately will contribute to raising awareness on how we can prevent new infections among children born from HIV positive mothers who are using the PMTCT program. The findings suggested a wide range of challenging factors that are shaped by social, political, cultural, economic, ethnic, and gender values, and that directly and indirectly affect the uptake of the PMTCT program. While using the critical realist ontology, we discovered multiple truths about the challenging factors for HIV+ mothers experience to uptake the PMTCT program. We triangulated their experiences with the findings gathered from healthcare providers, PMTCT leaders and policymakers, field observation, and document analysis. No previous studies on this phenomenon used a critical lens to explore the reality behind a wide range of experiences of mothers using the PMTCT program to prevent HIV transmission in Rwanda. Conclusion: The critical nature of this inquiry contributed to the depth and breadth of knowledge related to the delivery of the PMTCT program to prevent MTCT of HIV.

A model for enhancing prevention of mother to child HIV transmission in a low resource setting

BackgroundThe prevention of mother-to-child transmission (PMTCT) programmes plays a significant role in the reduction of human immunodeficiency virus (HIV) infections in the under-five age group and maternal mortalities. A phenomenological study on the experiences of HIV-positive women who utilised the PMTCT services identified challenges affecting the use of those services. An enabling environment is required for the effectiveness of the PMTCT programme. PurposeThe purpose of this paper is to develop and describe a model for enhancing prevention of mother-to-child HIV transmission in a low-resource setting. MethodThe model was developed in three sequential phases: empirical foundation, development of the model and description of the model. The model was developed using Walker and Avant’s steps of theory development. Chinn and Kramer’s criteria were used to evaluate the model and the modified version of the Delphi technique was utilised for peer review and further refinement of the model. This emanated from findings of a doctoral thesis on the experiences of HIV-positive PMTCT clients at a central hospital in Zimbabwe. The procedure involved the use of systems theory, central concept identification, a literature review, the definition of key terms and the identification of the elements of the model, after which the model was developed, described, and evaluated. ResultsThe elements of the model encompass the context, input, process and outcome. ConclusionThe model will act as a reference framework for midwives and programme planners with a view of enhancing utilisation and the quality of PMTCT services.

The reproductive health and sexual behavior of HIV-infected women: the review

The increased access to effective anti-retroviral treatment (ART) has made HIV comparable to chronic disease in terms of life expectancy. The advances in scientific knowledge and, in particular, in management of HIV-infected pregnant woman have reduced the risk of mother-to-child transmission of HIV. The analysis of current research demonstrates that HIV has been a problem in terms of sexuality and reproduction. The needs related to sexuality and reproduction are crucial ones to overall health and well-being of HIV-infected population. The future research is to focus not only on how sexual relations and relationships of HIV-positive women are manifested, but also on how health care system is to provide adequate support to women in relation with sexuality and reproduction. The purpose of study was to apply analysis of current research on sexuality, sexual and contraceptive behavior and implementation of reproductive function in HIV-infected women and the conditions affecting this realization. The review of national and international scientific publications concerning such areas as gynecology, reproductive health, sexuality and reproductive behavior of HIV-positive women from indexed on-line journals and relevant websites using such search engines as PubMed and Google in 1997-2019. The sample included 34 peer-reviewed qualitative studies, which covered 9523 HIV-positive surveyed women. The technique of interpretative meta-synthesis was applied to generalize and evaluate how experiences of HIV-positive women in sexuality and reproduction behavior have been described in qualitative studies. The effective anti-retroviral treatment has made HIV comparable to chronic disease in terms of life expectancy. The analysis of current research on this topic established that HIV was a problem in terms of sexuality and reproduction. The conditions that make the burden of HIV more severe are: HIV is an obstacle for starting and continuing relationship, providing sense of fear and loss. At the same time motherhood, spiritual beliefs, and supportive relationships made the burden of HIV easier. The HIV-positive test in women makes their sexual and reproductive health more complicated because of HIV status. Therefore, women face such unique challenges as problems in partnerships, sexual satisfaction and childbearing. The study results are important for developing optimal medical care to alleviate the burden of HIV infection. In addition to medical care, health care workers should consider social and psychological needs to support HIV-positive patients in improving their health and their sexual and reproductive health as well.

Ageing and HIV, the experience of HIV-positive women in French-speaking Switzerland

Thanks toa burdensome lifelong treatment, it is now possible to lead an almost 'normal' life while being HIV-positive. The status of people living with the human immunodeficiency virus (HIV) is rarely questioned. The image of the 'dying contagious patient' has been replaced by that of the 'classic chronically ill patient'. However, their HIV-positive status still leads to discrimination. A sociological study based on the accounts of 30 HIV-positive women in French-speaking Switzerland reveals how they feel faced with the prospect ofageing with HIV.

AIDS, Stigma, Marriage, and Economic Empowerment: Exploring Intersections of Women's Marginalization in West Nile Uganda

Deep-seated stigma continues to plague efforts to prevent and treat HIV/AIDS in much of Sub-Saharan Africa. While access to antiretroviral treatment has expanded, the spread of HIV continues to rise in the West Nile Region of Uganda. Economic empowerment programs are often heralded as a key means to address gender inequality and poverty and mollify the impacts of AIDS-related stigma. In order to assess how economic empowerment programs impact HIV-positive women's experiences with stigma, we conducted a series of focus groups with HIV-positive women involved with economic empowerment programs and interviews and focus groups with key family members of women with AIDS in West Nile Uganda. Employing an intersectional approach, we found that HIV/AIDS interrelated with particular marriage and descent practices in ways that further marginalized women. We also discovered that economic empowerment programs actively countered women's vulnerability by directly addressing the mutual influences of axes of inequality w...

Sexuality and Reproduction in HIV-Positive Women: A Meta-Synthesis.

The increased access to effective antiretroviral treatment (ART) has made HIV comparable to a chronic disease in terms of life expectancy. Needs related to sexuality and reproduction are central to overall health and well-being. An interpretative meta-synthesis was performed to synthesize and assess how HIV-positive women's experiences of sexuality and reproduction have been described in qualitative studies. A total of 18 peer-reviewed qualitative studies were included, which comprised a total of 588 HIV-positive interviewed women. The studies originated from resource-rich countries outside the Asian and African continents. The analysis, resulting in a lines-of-argument synthesis, shows that HIV infection was a burden in relation to sexuality and reproduction. The weight of the burden could be heavier or lighter. Conditions making the HIV burden heavier were: HIV as a barrier, feelings of fear and loss, whereas motherhood, spiritual beliefs, and supportive relationships made the HIV burden lighter. The findings are important in developing optimal health care by addressing conditions making the burden of HIV infection lighter to bear. In future research there is a need to focus not only on examining how HIV-positive women's sexual and relationships manifest themselves, but also on how health care professionals should provide adequate support to the women in relation to sexuality and reproduction.

Contending with Psychological Distress in Contexts with Limited Mental Health Resources: HIV-Positive Kenyan Women's Experiences

This study describes the psychosocial distress experiences of HIV-positive women in Kenya. In-depth narrative interviews were conducted three times over six months between 2009 and 2010 with 54 HIV-positive women living in Kenya to explore how the women perceived psychological distress and the steps they took to find support to cope with their HIV-positive diagnosis. Thematic analysis revealed that the women described psychological distress as: physical and emotional shock, worry, and hopelessness and suicidality. The women reported receiving support to cope through spiritual connections, family and friends, others coping with HIV/AIDS, and health care agencies. This study heightens awareness of the critical value of understanding culturally relevant mental health evaluations in a limited mental health access context.

Contraception Use among Iranian Women With HIV: A Qualitative Study.

Background:The application of family planning methods to people with HIV not only prevents unwanted pregnancy, but also leads to a reduction in the possibility of transmission of the virus from the patient to the sexual partner and the fetus. In order to prevent the spread of HIV and enhance reproductive rights, it is necessary to inform women with HIV of the contraception methods.Objective:The aim of this study was to explore experiences of HIV positive women about contraception use.Method:This qualitative study was conducted on 18 women with HIV who were at reproductive age and had referred the Center for clients with Risky Behavior in Imam Khomeini Hospital. Data were analyzed using the conventional content analysis method in MAXQDA 10.Results:The following two themes were derived from descriptions of the use of contraception methods by women with HIV: 1) Contraception is the forgotten component of reproductive health services; 2) inconsistent condom use. Each theme also contained three sub-themes.Conclusion:Results of investigations showed that Risky Behavior consultation Centers mostly stress the use of condom for husband/sexual partners without HIV. In addition, since health care practitioners play an important role in provision of reproductive health services, their lack of knowledge and cooperation considerably contribute to the spread of the disease and violation of patient rights.

“Bearing my fruit into the grave”: experiences of anticipatory grieving and bereavement among Zimbabwean HIV positive women with loss of their only child

This study aimed to explore the bereavement experiences of HIV positive women who had lost their only child. Participants were 10 women living with HIV (age range = 24–35 years) and with loss of their only child. Data on experiences of anticipatory grief and bereavement among HIV positive women were collected over a period of six months. The data were analysed thematically. Findings suggest the women to have traumatic memories of their deceased children and also from the marital disharmony which followed the loss. The participants reported to have questioned their womanhood since they did not have any surviving child and dreaded the fact that they would die childless. Women also reported a sense of persona worthlessness following the death of the child and lived in fear and uncertainty of the future concerning their own mortality.

Reflections on informed choice in resource-poor settings: The case of infant feeding counselling in PMTCT programmes in Tanzania

A growing emphasis on patient involvement in health care has brought ‘informed choice’ to the core of the debate on provider–patient interaction in global health-care programmes. How the principles of patient involvement and informed choice are implemented and experienced in diverging health systems and cultural contexts are issues of increasing interest. Infant feeding and infant feeding counselling of HIV-positive women have posed particular challenges related to choice. Based on ethnographic research conducted from 5 November 2008 to 5 August 2009 within prevention of mother-to-child transmission of HIV (PMTCT) programmes in two hospitals in rural and semi-urban Tanzania, this study explores nurse counsellors' and HIV-positive women's experiences of infant feeding counselling and patient choice. One of the hospitals (hospital A) promoted exclusive breastfeeding as the only infant feeding option, while the other hospital (hospital B) aimed to follow the Tanzanian PMTCT infant feeding guidelines of 2007 promoting patient choice in infant feeding methods. Women in hospital A expressed trust in the advice given and confidence in their own ability to practice exclusive breastfeeding, while women in hospital B expressed great uncertainty and confusion about how best to feed their infants. This paper reflects on the feasibility of a counselling procedure that promotes choice of infant feeding methods in PMTCT programmes in severely resource-poor settings where HIV-positive women have limited access to resources and to up-to-date knowledge on HIV and infant feeding outside the counselling room. We suggest that a universalistic procedure presenting the same unambiguous message on infant feeding to all women enrolled in the PMTCT programme in this and similar settings is likely to produce more confidence, less confusion and, hence, better results in terms of HIV-free survival of the baby.

‘Every pregnant woman needs a midwife’—The experiences of HIV affected women in maternity care

Title‘Every pregnant woman needs a midwife’—the experiences of HIV affected women in Northern Ireland. Objectiveto explore HIV positive women's experiences of pregnancy and maternity care, with a focus on their interactions with midwives. Designa prospective qualitative study. Settingregional HIV unit in Northern Ireland. Participants22 interviews were conducted with 10 women at different stages of their reproductive trajectories. Findingsthe pervasive presence of HIV related stigma threatened the women's experience of pregnancy and care. The key staff attributes that facilitated a positive experience were knowledge and experience, empathy and understanding of their unique needs and continuity of care. Key conclusionspregnancy in the context of HIV, whilst offering a much needed sense of normality, also increases woman's sense of anxiety and vulnerability and therefore the need for supportive interventions that affirm normality is intensified. A maternity team approach, with a focus on providing ‘balanced care’ could meet all of the woman and child's medical needs, whilst also emphasising the normalcy of pregnancy.

The Experiences of HIV-Positive Women Living in an African Village

Kenya has approximately 1.4 million adults infected with HIV/AIDS, with a national prevalence rate of approximately 7.4%. The majority of the Kenyan people have not participated in a Voluntary Counseling and Testing (VCT) program and do not know their HIV status. This increases the likelihood of infecting others and spreading the disease. The Living in fear, making the decision to be tested, the journey toward acceptance, changing behavior, planning for the future, and encouraging others to be tested. VCT programs are crucial in attaining goals related to the prevention and management of AIDS. By exploring these women's experiences and perceptions, issues concerning AIDS and the acceptance and use of VCT may be better understood.

Understanding the Lived Experience of HIV Positive Women in Kenya: A Global Perspective

Kenya has approximately 1.4 million adults infected with HIV/AIDS, with a national prevalence rate of approximately 7.4%. The majority of the Kenyan people have not participated in a voluntary counseling and testing program and do not know their HIV status. This increases the likelihood of infecting others and spreading the disease. The purpose of this phenomenologic study was to explore HIV positive women's experiences and perceptions about voluntary counseling and testing programs.

“She made up a choice for me”: 22 HIV-positive women's experiences of involuntary sterilization in two South African provinces

Since 1998 South African law has provided that adults should have access to sterilization but only with their informed consent. However, the right to sterilization and other sexual and reproductive rights have not been fully realized as women struggle to access limited services, and there are allegations of discrimination and sterilization abuses. This qualitative study explores the experiences of 22 HIV-positive women in two provinces who reported being sterilized between 1996 and 2010 without their informed consent (n=18) or without their knowledge (n=4). Key issues reported by participants included failure to respect their autonomy, lack of information given about what sterilization entailed, and subtle or overt pressure to sign the consent form. Although the legal framework was intended to ensure informed decision-making regarding sterilization, these protections appear to have failed the HIV-positive women in this study. The findings suggest that some health professionals may consider a signature on a consent form as sufficient regardless of how it was obtained. Furthermore the women's perceptions that they were singled out as needing to be sterilized simply because they were HIV-positive warrants further investigation. More research is required on the nature of the problem and on other stakeholders' perceptions.

'The divorce program': gendered experiences of HIV positive mothers enrolled in PMTCT programs - the case of rural Malawi

BackgroundFor HIV infected mothers in developing countries, choosing to enroll in a prevention of mother to child transmission (PMTCT) of HIV program is supposed to represent the first step towards protecting their child from possible transmission of HIV from mother to child. Counseling and testing enable HIV infected mothers to learn about their status and to obtain the benefits of a PMTCT package. The study on which this article is based explored experiences of HIV positive women and their partners linked to Prevention of Mother to Child Transmission of HIV (PMTCT) programs in Chiradzulu district, Southern Malawi.MethodsA qualitative study using in-depth interviews (IDIs), focus group discussion (FGDs) and case studies was carried at two PMTCT sites. IDIs and FGDs were recorded and transcribed. The case studies involved a deeper inquiry into the past, present and situational factors of selected participants.ResultsIn a context of customary matrilineal kinship, matrilocal residence patterns and complete male absence from the PMTCT program, the demand by the PMTCT program for partner disclosure played up fears of rejection among men given accusations of infidelity by the wives' relatives. This situation led many men to abandon their families. Mothers enrolled in PMTCT programs hence faced not only the fear of transmitting the virus to their infants, but also the loss of income and support associated with a departed husband and the social disgrace of a ruined family. Community members referred to the PMTCT program as 'the divorce program'ConclusionsPMTCT programs may vary in effectiveness in different contexts unless they fundamentally respond to socio-cultural factors as lived out in communities they intend to serve. The PMTCT program in rural southern Malawi is a case in point.

HIV-positive women's experiences of a PMTCT programme in rural Malawi

Objectiveto explore women's experiences of a prevention of mother-to-child transmission (PMTCT) programme in rural Malawi. Design, setting and participantsan exploratory, qualitative study using in-depth interviews with 24 purposively selected women infected with human immunodeficiency virus (HIV). The women were in three groups of eight: (1) those who delivered at the hospital and took nevirapine (NVP) before birth and whose babies received NVP within 72 hours of birth; (2) those who birthed at home and took NVP before birth but their babies never received NVP; and (3) those who birthed at home and did not take NVP and whose babies did not receive NVP. Data were analysed using content analysis. Findingsfour themes emerged: (1) ‘a wish to confirm and protect’ refers to women's decisions to take the HIV test, (2) ‘a revelation for action’ is an illustration of how the testing may be part of an empowering process, (3) ‘a dilemma between silence and openness’ points to the dilemma that women are facing in their decision to share or not to share their HIV status with spouse, family, friends and community, and (4) ‘a desire challenged by circumstances, chance and tradition’ refers to the circumstances and actions which prevent these women from actually delivering at the hospital to protect their babies from HIV infection. Conclusionsthe PMTCT programme influences women's lives profoundly, and the importance of quality counselling and strengthening male involvement is stressed as the programme is implemented by an increasing number of service providers.

Sexual and Reproductive Health Services and HIV Testing: Perspectives and Experiences of Women and Men Living with HIV and AIDS

All over the world HIV has been stigmatised, making it difficult for people living with HIV to access testing, treatment, care and counselling or even to act on a diagnosis or get advice and treatment, for fear of being judged. Prejudice in society has also often been reflected and reproduced by health care providers. A human rights approach, which positively incorporates sexual and reproductive rights, rather than a restricted medical view, is therefore essential for the achievement of true partnerships between health care providers and service users. This paper is about the experiences of HIV positive women and men in sexual and reproductive health services and HIV testing. It provides guidance not only on how things could and should be done but also on how they should not be done. It outlines the sexual and reproductive rights positive people consider crucial and gives examples of how these are being violated. It presents perceptions and implications of HIV testing and how health services can support people after a positive diagnosis. It analyses the importance of confidentiality, continuity of care, knowledge and information, and the role of support groups and home-based care. It calls on sexual and reproductive health services to address issues of stigma and discrimination when offering and carrying out HIV testing and counselling, and in providing treatment, care and support.RésuméPartout dans le monde, les personnes vivant avec le VIH souffrent de stigmatisation, ce qui entrave leur accès au dépistage, au traitement et aux soins, les empêche d'agir après le diagnostic et d'obtenir des conseils ou un traitement, par crainte d'être jugées. Le personnel sanitaire a souvent reproduit les préjugés de la société. Une approche des droits de l'homme, qui inclut positivement les droits génésiques, de préférence à une perspective médicale restreinte, est donc essentielle pour établir de véritables partenariats entre le personnel sanitaire et les patients. Cet article porte sur les expériences d'hommes et de femmes séropositifs dans les services de santé génésique et de dépistage du VIH. Il conseille non seulement sur la manière dont les choses peuvent et doivent être faites, mais aussi sur la manière dont il ne faut pas les faire. Il répertorie les droits génésiques jugés fondamentaux par les personnes séropositives et donne des exemples de violations. Il présente des conceptions et des conséquences du dépistage du VIH et montre comment les services de santé peuvent soutenir les patients après un diagnostic positif. Il analyse l'importance de la confidentialité, de la continuité des soins, de la connaissance et de l'information, et du rôle des groupes de soutien et des soins à domicile. Il demande aux services de santé génésique d'aborder les questions de stigmatisation et de discrimination quand ils proposent et assurent des programmes de conseil et dépistage du VIH, et dispensent un traitement, des soins et un soutien.ResumenPor todo el mundo el VIH ha sido estigmatizado, lo cual dificulta que las personas que viven con VIH tengan acceso a pruebas, tratamiento, atención y consejería, o incluso que tomen medidas respecto al diagnóstico u obtengan consejos y tratamiento, por temor a ser juzgados. El prejuicio de la sociedad con frecuencia también ha sido reflejado y reproducido por los prestadores de servicios de salud. Por tanto, un enfoque de derechos humanos, que incorpore de manera positiva los derechos sexuales y reproductivos, en vez de una visión médica restringida, es esencial para lograr verdaderas alianzas entre los prestadores de servicios de salud y los usuarios. Este artículo trata sobre las experiencias de mujeres y hombres VIH-positivos con servicios de salud sexual y reproductiva y pruebas de VIH. Proporciona orientación no sólo respecto a cómo pueden y deben hacerse las cosas, sino también respecto a cómo no deben hacerse. Esboza los derechos sexuales y reproductivos que las personas seropositivas consideran cruciales y da ejemplos de cómo estos están siendo violados. Expone percepciones e implicaciones de las pruebas de VIH y cómo los servicios de salud pueden apoyar a las personas después de un diagnóstico positivo. Analiza la importancia de la confidencialidad, continuidad de la atención, conocimiento e información, y la función de los grupos de apoyo y la atención en el hogar. Hace un llamado a los servicios de salud sexual y reproductiva para que traten los problemas de estigma y discriminación al ofrecer y realizar pruebas y consejería de VIH, y al brindar tratamiento, atención y apoyo.

Sex, Life and the Female Condom: Some Views of HIV Positive Women

This article offers some insights into the experiences of HIV positive women with the female condom, drawing on my own personal experience and responses of 18 members of the International Community of Women Living with HIV/AIDS to an e-mail survey conducted in 2005. Major barriers reported to female condom use were cost and sporadic or very limited access. All respondents talked about needing to negotiate the use of female condoms with their male sex partners. Most felt more in control and more confident during sex when using the female condom than with the male condom or unprotected sex. Concerns about female condoms appear to be common, especially among women who have never used one; those who had used the female condom for long periods of time said good things about it. Women reclaiming our bodies is a central part of the joy and the challenge of promoting the female condom. For HIV positive women and girls, using a condom is more than protection against pregnancy, but a matter of life and death greater than the risks pregnancy can bring. Female condoms could make a critically important contribution to protecting HIV positive women’s sexuality and continued sexual activity, as a fundamental part of our sexual and reproductive rights, if only they were more widely available and affordable.RésuméCet article réfléchit à l’utilisation du préservatif féminin par des femmes séropositives, sur la base de mon expérience personnelle et des réponses de 18 membres de la Communauté internationale des femmes vivant avec le VIH/SIDA à une enquête par courriel de 2005. Le coût des préservatifs féminins et leur approvisionnement sporadique ou très limité étaient les principaux obstacles à leur utilisation. Toutes les personnes interrogées ont indiqué qu’elles devaient négocier l’utilisation de préservatifs féminins avec leurs partenaires. La plupart estimaient qu’elles se prenaient mieux en charge et étaient plus assurées pendant les rapports sexuels avec le préservatif féminin qu’avec le préservatif masculin ou sans protection. Les inquiétudes sur le préservatif féminin étaient communes, particulièrement chez les femmes qui ne l’avaient jamais utilisé ; celles qui l’avaient utilisé pendant longtemps l’appréciaient. Redonner aux femmes la maîtrise de leur corps est au centre des satisfactions et des difficultés que procure la promotion du préservatif féminin. Pour les femmes séropositives, utiliser un préservatif est davantage qu’une protection contre la grossesse, c’est une question de vie ou de mort, bien plus grave que les risques d’une maternité. S’ils étaient plus disponibles et d’un coût abordable, les préservatifs féminins pourraient faire une contribution essentielle à la protection de la sexualité des femmes séropositives et les aider à poursuivre une activité sexuelle, élément fondamental de nos droits génésiques.ResumenEn este artículo se exponen algunas observaciones sobre las experiencias de las mujeres VIH-positivas con el condón femenino, con base en mi propia experiencia y en las respuestas de 18 integrantes de la Comunidad Internacional de Mujeres que Viven con VIH/SIDA a una encuesta por correo electrónico realizada en 2005. Los obstáculos principales al uso del condón femenino fueron el costo y el acceso esporádico o muy limitado. Todas las encuestadas hablaron sobre la necesidad de negociar el uso del condón femenino con sus parejas sexuales. La mayoría se sintió más en control y con más confianza durante las relaciones sexuales cuando usaba el condón femenino que con el condón masculino o sin protección. Las inquietudes respecto al condón femenino parecen ser comunes, especialmente entre las mujeres que nunca lo han usado; aquéllas que lo habían usado durante un largo plazo dijeron cosas buenas al respecto. Una parte central de la alegría y el reto de promover el condón femenino es motivar a las mujeres a que reclamen su cuerpo. Para las mujeres y niñas VIH-positivas, usar un condón es más que una simple protección contra el embarazo, es una cuestión de vida o muerte mayor que los riesgos que conlleva el embarazo. Si el condón femenino estuviera disponible más ampliamente y a precios más asequibles, éste podría influir en gran medida en la protección de la sexualidad y la actividad sexual de las mujeres VIH-positivas, como un elemento fundamental de nuestros derechos sexuales.

Advocacy training by the International Community of women living with HIV/AIDS

The International Community of Women Living with HIV/AIDS joined forces with the POLICY project with the aim of developing an advocacy agenda on sexual and reproductive health rights, and access to care, treatment, and support for women living with HIV/AIDS in South Africa and Swaziland. The process began with an assessment of the concerns and experiences of HIV-positive women, and the policy and institutional environment. A workshop was subsequently held in Durban, involving 45 HIV-positive women from Swaziland and South Africa, to discuss the assessment and identify priority issues for advocacy. The same group of women met two months later and produced a plan which directly addresses the reality of HIV-positive women's lives.

Keeping safe, keeping connected: A qualitative study of HIV-positive women's experiences of partner relationships

This article reports the findings of a study specifically oriented to the exploration of HIV-positive women's experiences of partner-relationships. Transcripts of individual interviews with six women were analysed using Interpretative Phenomenological Analysis (IPA). The article focuses on an emergent, central organizing theme of ‘psychological protection’, which is defined as a perceived need to protect oneself from the psychological threats associated with an HIV-positive identity. Conflicts between protecting the self and protecting others, and between psychological protection and physical protection in partner-relationships, are highlighted. The potential for a partner-relationship to be psychologically protective against feelings of ‘otherness’ is indicated. The study suggests an underlying tension, for these women, between psychological safety and a need for connection with others. Issues of relevance to those working with HIV-positive women are discussed.