Renegotiating the sexual self after an HIV-diagnosis: listening to white, European women

Gerada, Martina (2013) Renegotiating the sexual self after an HIV-diagnosis: listening to white, European women. Doctoral thesis, London Metropolitan University.


Research in the fields of HIV and female sexuality share a contentious past which centred on prevention and often vilified or victimised women. Psychological research, including that in Counselling Psychology (CoP), has proven more sensitive to women’s needs, yet continues to portray the sexual lives of HIV-positive women in a negative light. Despite adopting a philosophy of holism and valuing the creation of social environments that sustain mental well-being, CoP literature is relatively silent on the role of sexuality in women’s adaptation to HIV. This qualitative study explores how white, European women with HIV, who have historically been underrepresented in HIV literature, renegotiate their sexual subjectivity, a concept that has been implicated in women’s healthy psychological development (Tolman, 2002). Data was analysed using The Listening Guide (Gilligan, 1982; Beauboeuf, 2007), a feminist research tool that focuses on voice to investigate social discourses and individual meaning-making in narrative data. Results present six co-occurring voices which describe participants’ relationship to Self, HIV and Other. They speak of the continued, significant psychological impact of an HIV-diagnosis, despite advances in medication, which precipitates multiple psychosocial crises related to identity, intimacy and meaning in life. The voice of distress confirms previous research on HIV-trauma and also highlights women’s early vulnerability to infection.

The voices of resistance, sexual knowing, empowerment, and the generative voice, demonstrate how sexuality is not always a stumbling block to adaptation but can also enable personal growth and psychological healing. The dignified voice speaks of participants’ acceptance of the challenges borne of HIV and their ability to preserve the dignity of their lives’ circumstances. Clinical implications are discussed in light of counselling psychology’s multidisciplinary approach, spanning areas of HIV prevention, social change and individual and group therapy with women living with HIV.

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