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Love with HIV: a latent class analysis of intimate relationships among women living with HIV enrolled in Canada's largest multisite community-based research study...."Nearly half of Canadian WLWH were not in relationships"
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Reported by Jules Levin
Durban 2016 July 18-22
from Jules: Take a look at Table 2 where you will see depression & stigma are preset in around 50% of all women; viral load undetectable in about 80%. How many people tell me - oh HIV is under control today, its not a problem, tell this to HIV men & women who are unable to form relationships & suffer with the stigma & depression associated with having HIV !
47% no relationship
9% relationship without love
short-term casual 16%
long-term unhappy 7%
long term happy 22%
Presenter
Allison Carter
Authors
A. Carter1,2, S. Greene3, C. Hankins4, L.A. Brotto5, D. Money5,6, M. Kestler7, S. Patterson1,2, N. O'Brien8, K. Salters1,2, E. Ding1, K. Webster2, V. Nicholson2, M. Sanchez9, M. Desbiens10, D. Dubuc8, S.Y. Lin1,2, R.S. Hogg1,2, A. de Pokomandy8, M.R. Loutfy10, A. Kaida2, CHIWOS Research Team
Institutions
1British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 2Simon Fraser University, Burnaby, Canada, 3McMaster University, Hamilton, Canada, 4University of Amsterdam, Amsterdam, Netherlands, 5University of British Columbia, Department of Obstetrics and Gynecology, Faculty of Medicine, Canada, 6BC Women's Hospital and Health Centre, Women's Health Research Institute, Vancouver, Canada, 7University of British Columbia, Division of AIDS, Department of Medicine, Vancouver, Canada, 8McGill University Health Centre, Montreal, Canada, 9ViVA, Positive Living Society of BC, Vancouver, Canada, 10Women's College Research Institute, Toronto, Canada
Background: Quantitative studies traditionally reduce relationships to single-item variables and investigate sexual risk-taking. To broaden understanding of relationships and sexuality, we characterized types of intimate relationships among women living with HIV (WLWH) using multiple measures and examined differences in affection and associated psychosocial characteristics.
Methods: Using a critical feminist approach, we analyzed questionnaire data for 1,335 WLWH
(≥16 years) in the multi-site, community-based Canadian HIV Women''s Sexual and Reproductive Health Cohort Study. We conducted latent class analysis, incorporating eight indicators: marital status, duration, sex with regular partner in past 6-months, physical intimacy, emotional closeness, relationship power, exclusivity, and couple HIV-serostatus. We assessed construct validity by examining prevalence of affection (''Someone to love and make you feel wanted''), and identified covariates using multinomial logistic regression.
Results:
We delineated 5 latent classes:
no relationship (47%), relationship without sex (9%), and three types of sexual relationships-short-term/casual (16%), long-term/unhappy (7%), and long-term/happy (22%).
Women in the latter two classes had high probabilities of reporting an exclusive married/common-law/living-apart relationship of ≥3-years duration relative to women in short-term/casual relationships, yet they diverged on contentment with physical intimacy (44%-unhappy vs. 97%-happy), emotional closeness (24% vs. 86%), power (43% vs. 82%), and couple HIV-serodiscordance (59% vs. 71%).
Affection was most prevalent in long-term/happy relationships (64%) and relationships without sex (48%), compared to long-term/unhappy (39%), short-term/casual (37%), and no relationship (23%)(p< 0.0001).
Relative to no relationship: women >50-years were less likely to be in any relationship; women reporting sex work [AOR:3.03(95%CI:1.64,5.61)] and violence [6.64(3.33,13.26)] were more likely to be in short-term/casual relationships; women without depression [2.90(2.04,4.12)] were more likely to be in long-term/happy relationships. No differences by gender, sexual orientation, or ethnicity were observed.
Conclusions: Nearly half of Canadian WLWH were not in relationships. Women''s relationships were heterogeneous, though HIV-serodiscordance was common and one-fifth reported long-term/happy and loving sexually active relationships. Sex, however, did not equate with affection, and relationships without sex had higher levels of love than some sexual relationships. A nuanced focus on promoting healthy relationships may offer a more comprehensive approach to supporting women''s sexual well-being, particularly among older WLWH and those with experiences of sex work, violence, and depression.
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