Abstract:
Objectives: To characterise the experiences of
heterosexual men and women living with HIV
postdiagnosis and explain these experiences in relation
to their identity and sexuality.
Design: Qualitative study using in-depth interviews
and a theoretically informed biographic disruption
theory.
Setting: Interviews were conducted in two Nairobi
slums (Kenya).
Participants: 41 HIV-infected heterosexual men and
women aged 18 years or older.
Results: People living with HIV have divergent
experiences surrounding HIV diagnosis. Postdiagnosis,
there are multiple phases of identity transition,
including status (non-)disclosure, and attempts at
identity repair and normalcy. For some people, this
process involves a transition to a new self-identity,
incorporating both HIV and antiretroviral treatment
(ART) into their lives. For others, it involves a partial
transition, with some aspects of their prediagnosis
identity persisting, and for others it involves a rejection
of HIV identity. Those people who were able to
incorporate HIV/AIDS in their identity, without it being
disruptive to their biography, were pursuing safer
sexual and reproductive lives. By contrast, those people
with a more continuous biography continued to reflect
their prediagnosis identity and sexual behaviour.
Conclusions: People living with HIV/AIDS (PLWHA)
had to rework their sense of identity following
diagnosis in the context of living in a slum setting.
Men and women living with HIV in slums are poorly
supported by health systems and services as they
attempt to cope with a diagnosis of HIV. Given the
availability of ART, health services and professionals
need to support the rights of PLWHA to be sexually
active if they want to and achieve their fertility goals,
while minimising HIV transmission risk.
