Sexual (Dis)satisfaction and Its Contributors Among People Living with HIV Infection in Sweden

Abstract

Earlier research reports lower sexual satisfaction among people living with HIV (PLHIV) compared to HIV-negative persons. A number of psychosocial factors directly associated with sexual dissatisfaction have been identified. Little is known about sexual satisfaction and their contributors among PLHIV in Sweden. The aim of this study was to examine direct and indirect effects of variables within sociodemographic, clinical HIV-related, psychological, and sexual domains on sexual (dis)satisfaction among PLHIV in Sweden. Data for this study were derived from a nationally representative, anonymous survey among PLHIV conducted in 2014 (n = 1096). Statistical analysis included four steps: descriptive analyses, identification of variables associated with sexual (dis)satisfaction, identification of variables associated with those contributors of sexual (dis)satisfaction, and a path model integrating all these analyses. A total of 49% of participants reported being sexually dissatisfied, and no significant differences were observed when non-heterosexual men, heterosexual men, and women were compared. Among women, a negative change in sex life after HIV diagnosis and distress with orgasmic difficulties was directly associated with sexual dissatisfaction. For men, hopelessness, high HIV stigma, sexual inactivity in the last 6 months, and a negative change in sex life after HIV diagnosis were directly associated with sexual dissatisfaction. Path analyses showed in both men and women significant indirect associations between not being involved in an intimate relationship, lower self-reported CD4 cell counts, and perceiving obligation to disclose HIV status to sexual partners as a barrier to look for a long-term partner and sexual dissatisfaction. Our results show that despite good treatment outcomes, the HIV diagnosis has a negative bearing on sexual satisfaction. The need for gender-tailored interventions and clinical implications of these findings are discussed.

Sexuality and childbearing as it is experienced by women living with HIV in Sweden: a lifeworld phenomenological study

“…Our study shows that many of the women experienced negative changes in their sexual lives when being diagnosed with HIV, a finding in line with another recent Swedish study examining HIV-positive people’s sexual satisfaction. (Schönnesson et al, 2018). The women in our study also experienced a change of their sexual identities in, for example, being a mother or a partner.…”

Beyond viral suppression: the quality of life of people living with HIV in Sweden

“…Data were collected through a nation-wide survey, "Living with HIV in Sweden", designed to explore selfreported QoL and its correlates through an anonymous, self-reported questionnaire (Schönnesson et al, 2018). Data were collected at 15 clinics and two needleexchange centres across the country, together covering 75% of all known patients living with HIV at the time of data collection.…”

“…The questionnaire was available in 10 languages in order to include migrants, and was developed and piloted in collaboration with the three largest non-governmental HIV organisations in Sweden: HIV-Sweden, National HIV Association Noah's Ark and Stockholm's Drug Users Union. The data collection procedures are described in further detail elsewhere (Schönnesson et al, 2018).…”

Aspects that influence the self-care of patients living with human immunodeficiency virus

“…After the logistic regression, the present study revealed that PLWHA who present a change in sexual life after HIV diagnosis has a greater chance of making changes in their lifestyle. However, a study shows that HIV diagnosis leads PLWHA to have sexual dissatisfaction 19 . The persistence of HIV-related stigma and discrimination may be a barrier to the sexual life of PLWHA, which has a greater effect on the desire and frequency of sexual activity than on the discontinuation thereof, a fact influenced by HIV/AIDS stigma, and moral and religious values 20 .…”