Disciplining Bodies, Desires and Subjectivities: Sexuality and HIV-Positive Women

Abstract

Very little is known about the sexuality of women who are living with HIV, outside the context of risk prevention and education. Available research in the first-world context shows that, although most women continue to be sexually active following diagnosis, decreased sexual functioning is very common and more prevalent than among HIV-positive men. The present multi-site Canadian study is concerned with the ways in which women’s sexuality is transformed by the experience of living with HIV. Semi-structured interviews with 20 women were analysed using thematic decomposition, an analytic technique that combines discursive approaches with thematic analysis. The women in this study construct HIV as inhibiting in relation to sexuality. A predominant discourse of disciplining bodies, desires and subjectivities emerges, which centers on the restrictions imposed by an HIV-positive diagnosis. The following discursive constructions, in particular, emerge from the women’s accounts: diminished spontaneity, foreclosed (provisional) sexual freedom, foreclosed power, foreclosed flirtation, inciting violence, (un)natural sex, responsibility imperatives, muted/mutated sexuality, and diminished intimacy. The women’s predominant positioning within AIDS discourses as conduits of transmission, the relative neglect of women’s psychological and sexual health concerns in both research and public health agendas, and women’s relatively anomalous standing in AIDS communities imposes limits on bodies, lives, and subjectivities. These are reflected in these women’s accounts, wherein a focus on protecting others frequently impedes access to fulfilling (and safe) sexual and emotional relationships.

“It’s Just Supposed to Happen”: The Myth of Sexual Spontaneity and the Sexually Marginalized

“…If sexual spontaneity is reduced it can cyclically reduce the incidence of sexual initiation, activity and interest [7]. The Gurevich study [10] pointed out that a lack of sexual spontaneity can be due to a reduced level of sexual self esteem and attractiveness because HIV infected people do not feel like desirable sexual partners. The study made it clear that the loss of sexual freedom and ''natural sex'' was a cause for a reduction in sexual spontaneity which was perceived to be a considerable drawback of being HIV positive.…”

“…Since Western societies became aware of the HIV/AIDS epidemic in the 1980s, a major focus of sexual psychology and sexual health studies have shown that losing sexual spontaneity is an effect of having a sexually transmittable disease or being worried about acquiring one [7,10,45,46]. Indeed, it was found that women with HIV experienced diminished spontaneity as a result of being concerned about passing the disease to potential partners [7].…”

“…For these individuals, communication between partners may be necessary before, during and after sexual activities. While some of these individuals will realize that communication can actually increase satisfaction within sexual relationships [29], others who hold onto the myth of spontaneous sex will experience problems with sexual self-esteem and well-being [10].…”

“…As such, here, we explore research that uses the medical model of human sexuality to investigate how the myth of sexual spontaneity would affect traditional explanations of sexual functioning. The influence of the medical model on the script of sexual spontaneity is demonstrated in research literature that deals with HIV/ AIDS and sexually transmitted infections (STI's) [10], female sexual dysfunction [42], erectile dysfunction [43] and mobility impairments 1 [44].…”

“…The assumption that good sex is spontaneous is also indicated in research literature which focuses on illness and impairment, contraceptive use and sexual dysfunction [5][6][7]. In this literature, sexual spontaneity seems linked to sexual satisfaction as both terms are often presented together which may lead the reader to assume a causal relationship between the two [8][9][10].…”