Archives of Sexual Behavior

, Volume 48, Issue 4, pp 1015–1040 | Cite as

Love with HIV: A Latent Class Analysis of Sexual and Intimate Relationship Experiences Among Women Living with HIV in Canada

  • Allison Carter
  • Saara Greene
  • Deborah Money
  • Margarite Sanchez
  • Kath Webster
  • Valerie Nicholson
  • Lori A. Brotto
  • Catherine Hankins
  • Mary Kestler
  • Neora Pick
  • Kate Salters
  • Karène Proulx-Boucher
  • Nadia O’Brien
  • Sophie Patterson
  • Alexandra de Pokomandy
  • Mona Loutfy
  • Angela KaidaEmail author
  • the CHIWOS Research Team
Original Paper


Love remains hidden in HIV research in favor of a focus on risk. Among 1424 women living with HIV in Canada, we explored (1) whether eight facets of sex and intimacy (marital status, sexual activity, physical intimacy, emotional closeness, power equity, sexual exclusivity, relationship duration, and couple HIV serostatus) may coalesce into distinct relationship types, and (2) how these relationship types may be linked to love as well as various social, psychological, and structural factors. Five latent classes were identified: no relationship (46.5%), relationships without sex (8.6%), and three types of sexual relationships—short term (15.4%), long term/unhappy (6.4%), and long term/happy (23.2%, characterized by equitable power, high levels of physical and emotional closeness, and mainly HIV-negative partners). While women in long-term/happy relationships were most likely to report feeling love for and wanted by someone “all of the time,” love was not exclusive to sexual or romantic partners and a sizeable proportion of women reported affection across latent classes. Factors independently associated with latent class membership included age, children living at home, sexism/genderism, income, sex work, violence, trauma, depression, HIV treatment, awareness of treatment’s prevention benefits, and HIV-related stigma. Findings reveal the diversity of women’s experiences with respect to love, sex, and relationships and draw attention to the sociostructural factors shaping intimate partnering in the context of HIV. A nuanced focus on promoting healthy relationships and supportive social environments may offer a more comprehensive approach to supporting women’s overall sexual health and well-being than programs focused solely on sexual risk reduction.


Love Sex Relationships Power Feminism Women HIV 



The Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) is funded by the Canadian Institutes of Health Research (CIHR, MOP111041); the CIHR Canadian HIV Trials Network (CTN 262); the Ontario HIV Treatment Network; and the Academic Health Science Centres Alternative Funding Plans Innovation Fund. AC and KS received support through a Doctoral Research Award from the CIHR HIV/AIDS Research Initiative and the Canadian Association for HIV Research. NO and AdP received support from Fonds de Recherche du Quebéc—Santé. AK received salary support through a Tier 2 Canada Research Chair in Global Perspectives on HIV and Sexual and Reproductive Health. The CHIWOS Research Team would like to especially thank all of the women living with HIV who participate in this research. We also thank the entire national team of Co-Investigators, Collaborators, and Peer Research Associates. We would like to acknowledge the national Steering Committee, the three provincial Community Advisory Boards, the national CHIWOS Aboriginal Advisory Board, and our partnering organizations for supporting the study, especially those who provide interview space and support to our Peer Research Associates. We also thank Dr. Robert S. Hogg for his involvement as Doctoral Supervisor. Listed here are all the CHIWOS Research Team members and affiliated institutions: Rahma Abdul-Noor (Women’s College Research Institute), Aranka Anema (Harvard Medical School), Jonathan Angel (Ottawa Hospital Research Institute), Dada Mamvula Bakombo (McGill University Health Centre), Fatimatou Barry (Women’s College Research Institute), Greta Bauer (University of Western Ontario), Kerrigan Beaver (Women’s College Research Institute), Marc Boucher (CHU Ste-Justine), Isabelle Boucoiran (CHU Ste-Justine), Jason Brophy (Children’s Hospital of Eastern Ontario), Lori Brotto (University of British Columbia), Ann Burchell (St, Michael’s Hospital), Claudette Cardinal (Simon Fraser University), Allison Carter (Kirby Institute), Lynne Cioppa (Women’s College Research Institute), Tracey Conway (Women’s College Research Institute), José Côté (Centre Hospitalier de l’Université de Montréal), Jasmine Cotnam (Canadian Aboriginal AIDS Network), Cori d’Ambrumenil (AIDS Vancouver Island), Janice Dayle, (McGill University Health Centre), Erin Ding (British Columbia Centre for Excellence in HIV/AIDS), Danièle Dubuc, (McGill University Health Centre), Janice Duddy (Pacific AIDS Network), Mylène Fernet (Université du Québec à Montréal), Annette Fraleigh (Women’s College Research Institute), Peggy Frank (Simon Fraser University), Brenda Gagnier (Women’s College Research Institute), Marilou Gagnon (University of Victoria), Jacqueline Gahagan (Dalhousie University), Claudine Gasingirwa (Women’s College Research Institute), Nada Gataric (British Columbia Centre for Excellence in HIV/AIDS), Rebecca Gormley (British Columbia Centre for Excellence in HIV/AIDS), Saara Greene (McMaster University), Danielle Groleau (McGill University), Charlotte Guerlotté (COCQ-SIDA), Trevor Hart (Ryerson University), Catherine Hankins (McGill University), Roula Hawa (Women’s College Research Institute), Emily Heer (Alberta Health Services), Robert S. Hogg (British Columbia Centre for Excellence in HIV/AIDS and Simon Fraser University), Terry Howard (Glasshouse Consultants), Shazia Islam (Women’s College Research Institute), Joseph Jean-Gilles (GAP-VIES), Hermione Jefferis (AIDS Vancouver Island), Evin Jones (Pacific AIDS Network), Charu Kaushic (McMaster University), Mina Kazemi (Women’s College Research Institute), Mary Kestler (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Maxime Kiboyogo (McGill University Health Centre), Marina Klein (McGill University Health Centre), Nadine Kronfli (McGill University Health Center), Gladys Kwaramba (Women’s College Research Institute), Gary Lacasse (Canadian AIDS Society), Ashley Lacombe-Duncan (University of Michigan), Melanie Lee (Simon Fraser University), Rebecca Lee (CIHR Canadian HIV Trials Network), Jenny Li (British Columbia Centre for Excellence in HIV/AIDS), Viviane Lima (British Columbia Centre for Excellence in HIV/AIDS), Elisa Lloyd-Smith (Vancouver General Hospital), Carmen Logie (University of Toronto), Evelyn Maan (Oak Tree Clinic), Valérie Martel-Lafrenière (Centre Hospitalier de l’Université de Montréal), Carrie Martin (Canadian Aboriginal AIDS Network), Renee Masching (Canadian Aboriginal AIDS Network), Lyne Massie (Université du Québec à Montréal), Melissa Medjuck (formerly of the Positive Women’s Network), Brigitte Ménard, (McGill University Health Centre), Cari L. Miller (formerly of Simon Fraser University), Judy Mitchell (Positive Living North), Gerardo Mondragon (British Columbia Centre for Excellence), Deborah Money (Women’s Health Research Institute and Faculty of Medicine at UBC), Ken Monteith (COCQ-SIDA), Marvelous Muchenje (Women’s Health in Women’s Hands CHC), Florida Mukandamutsa (CASM), Mary Ndung’u (African Partnership Against AIDS), Valerie Nicholson (Simon Fraser University), Kelly O’Brien (University of Toronto), Nadia O’Brien (McGill University Health Centre and McGill University), Gina Ogilvie (University of British Columbia, Women’s Health Research Institute), Susanna Ogunnaike-Cooke (Public Health Agency of Canada), Joanne Otis (Université du Québec à Montréal), Rebeccah Parry (Simon Fraser University), Sophie Patterson (Simon Fraser University), Angela Paul (Positive Living North), Doris Peltier (Canadian Aboriginal AIDS Network), Neora Pick (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Alie Pierre (McGill University Health Centre), Jeff Powis (Michael Garron Hospital), Karène Proulx-Boucher (McGill University Health Centre), Corinna Quan (Windsor Regional Hospital), Jesleen Rana (Women’s Health in Women’s Hands CHC), Eric Roth (University of Victoria), Danielle Rouleau (Centre Hospitalier de l’Université de Montréal), Geneviève Rouleau (Centre Hospitalier de l’Université de Montréal), Sergio Rueda (Centre for Addiction and Metal Health), Kate Salters (Simon Fraser University, British Columbia Centre for Excellence in HIV/AIDS), Margarite Sanchez (ViVA, Southern Gulf Islands AIDS Society, Simon Fraser University), Roger Sandre (Haven Clinic), Jacquie Sas (CIHR Canadian HIV Trials Network), Édénia Savoie (McGill University Health Centre), Paul Sereda (British Columbia Centre for Excellence in HIV/AIDS), Stephanie Smith (Women’s College Research Institute), Marcie Summers (formerly of the Positive Women’s Network), Wangari Tharao (Women’s Health in Women’s Hands CHC), Christina Tom (Simon Fraser University), Cécile Tremblay (Centre Hospitalier de l’Université de Montréal), Jason Trigg (British Columbia Centre for Excellence in HIV/AIDS), Sylvie Trottier (Centre Hospitalier Universitaire de Québec), Angela Underhill (Women’s College Research Institute), Anne Wagner (Ryerson University), Sharon Walmsley (University Health Network), Clara Wang (British Columbia Centre for Excellence), Kath Webster (Simon Fraser University), Wendy Wobeser (Queen’s University), Denise Wozniak (Positive Living Society of British Columbia), Mark Yudin (St. Michael’s Hospital), Wendy Zhang (British Columbia Centre for Excellence in HIV/AIDS), Julia Zhu (British Columbia Centre for Excellence in HIV/AIDS). All other CHIWOS Research Team Members who wish to remain anonymous.


  1. Abelsohn, K., Benoit, A. C., Conway, T., Cioppa, L., Smith, S., Kwaramba, G., … CHIWOS Research Team. (2014). “Hear(ing) new voices”: Peer reflections from community based survey development with women living with HIV. Progress in Community Health Partnerships: Research Education and Action, 9(4), 561–569. Scholar
  2. AIDES. (2016). #Révélation. Retrieved February 20, 2019 from
  3. Akaike, H. (1974). A new look at the statistical model identification. IEEE Transactions on Automatic Control, 19(6), 716–723.CrossRefGoogle Scholar
  4. Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52(3), 317–332.CrossRefGoogle Scholar
  5. Bair-Merritt, M. H., Lewis-O’Connor, A., Goel, S., Amato, P., Ismailji, T., Jelley, M., … Cronholm, P. (2014). Primary care-based interventions for intimate partner violence: A systematic review. American Journal of Preventive Medicine, 46(2), 188–194. Scholar
  6. Balaile, G., Laisser, R., Ransjo-Arvidson, A. B., & Hojer, B. (2007). Poverty and devastation of intimate relations: Tanzanian women’s experience of living with HIV/AIDS. Journal of the Association of Nurses in AIDS Care, 18(5), 6–16. Scholar
  7. Bay-Cheng, L. Y., & Goodkind, S. A. (2016). Sex and the single (neoliberal) girl: Perspectives on being single among socioeconomically diverse young women. Sex Roles, 74(5–6), 181–194.CrossRefGoogle Scholar
  8. Becker D. (2014). The dating game: Accepting the past and living in the present. Positive Living Newsletter: Girl Talk, 6–7.
  9. Beckerman, N. L., & Auerbach, C. (2002). Couples of mixed HIV status: Psychosocial issues affecting intimacy. Journal of Couple & Relationship Therapy, 1(4), 73–85. Scholar
  10. Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: Psychometric assessment of the HIV Stigma scale. Research in Nursing & Health, 24(6), 518–529. Scholar
  11. Bhana, D. (2013). Introducing love: Gender, sexuality and power. Agenda, 27(2), 3–11. Scholar
  12. Bowleg, L. (2008). When Black + lesbian + woman ≠ Black lesbian woman: The methodological challenges of qualitative and quantitative intersectionality research. Sex Roles, 59(5–6), 312–325. Scholar
  13. Bowleg, L., Lucas, K. J., & Tschann, J. M. (2004). “The ball was always in his court”: An exploratory analysis of relationship scripts, sexual scripts, and condom use among African American women. Psychology of Women Quarterly, 28(1), 70–82. Scholar
  14. Bozdogan, H. (1987). Model selection and Akaike’s information criterion (AIC): The general theory and its analytical extensions. Psychometrika, 52(3), 345–370.CrossRefGoogle Scholar
  15. Brizay, U., Golob, L., Globerman, J., Gogolishvili, D., Bird, M., Rios-Ellis, B., … Heidari, S. (2015). Community-academic partnerships in HIV-related research: A systematic literature review of theory and practice. Journal of the International AIDS Society, 18(1), 19354. Scholar
  16. Bunnell, R. E., Nassozi, J., Marum, E., Mubangizi, J., Malamba, S., Dillon, B., … Mermin, J. H. (2005). Living with discordance: Knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. AIDS Care, 17(8), 999–1012. Scholar
  17. Caballero, M. (2016). Pleasure is a human right. HIV Equal. Retrieved February 20, 2019 from
  18. Canadian HIV/AIDS Legal Network. (2014). The criminalization of HIV non-disclosure in Canada and internationally. Retrieved February 20, 2019 from
  19. Cardinal, C., Lee, M., Nicholson, V., Webster, K., Carter, A., & Kaida, A. (2014). Women! It’s our time to talk about sexuality. In Positive Gathering Conference 2014, Vancouver, BC.Google Scholar
  20. Carter, A., de Pokomandy, A., Loutfy, M., Ding, E., Sereda, P., Webster, K., … Kaida, A. (2017a). Validating a self-report measure of HIV viral suppression: An analysis of linked questionnaire and clinical data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study. BMC Research Notes, 10(1), 138–145. Scholar
  21. Carter, A., Greene, S., Money, D., Sanchez, M., Webster, K., Nicholson, V., … Kaida, A. (2017b). The problematization of sexuality among women living with HIV and a new feminist approach for understanding and enhancing women’s sexual lives. Sex Roles, 77(11–12), 779–800. Scholar
  22. Carter, A., Greene, S., Money, D., Sanchez, M., Webster, K., Nicholson, V., … Kaida, A. (2018a). Supporting the sexual rights of women living with HIV: A critical analysis of sexual satisfaction and pleasure across five relationship types. Journal of Sex Research, 55(9), 1134–1154. Scholar
  23. Carter, A., Greene, S., Nicholson, V., O’Brien, N., Dahlby, J., de Pokomandy, A., … CHIWOS Research Team. (2015). ‘It’s a very isolating world’: The journey to HIV care for women living with HIV in British Columbia, Canada. Gender, Place & Culture, 23(7), 941–954. Scholar
  24. Carter, A., Loutfy, M., de Pokomandy, A., Colley, G., Zhang, W., Sereda, P., … On behalf of the CHIWOS Research Team. (2018b). Health-related quality-of-life and receipt of women-centred HIV care among women living with HIV in Canada. Women and Health, 58, 498–518. Scholar
  25. Carter, A., Roth, E. A., Ding, E., Milloy, M.-J., Kestler, M., Jabbari, S., … Kaida, A. (2017c). Substance use, violence, and antiretroviral adherence: A latent class analysis of women living with HIV in Canada. AIDS and Behavior, 22(3), 971–985. Scholar
  26. Closson, E. F., Mimiaga, M. J., Sherman, S. G., Tangmunkongvorakul, A., Friedman, R. K., Limbada, M., … HPTN063 Study Team. (2015). Intimacy versus isolation: A qualitative study of sexual practices among sexually active HIV-infected patients in HIV care in Brazil, Thailand, and Zambia. PLoS ONE, 10(3), 16. Scholar
  27. Clum, G., Chung, S.-E., Ellen, J. M., & The Adolescent Medicine Trials Network for HIV/AIDS Interventions. (2009). Mediators of HIV-related stigma and risk behavior in HIV infected young women. AIDS Care, 21(11), 1455–1462. Scholar
  28. Cooper, D., Moore, E., & Mantell, J. E. (2013). Renegotiating intimate relationships with men: How HIV shapes attitudes and experiences of marriage for South African women living with HIV: ‘Now in my life, everything I do, looking at my health’. Acta Juridica, 2013, 218–238.PubMedGoogle Scholar
  29. Cranson, D. A., & Caron, S. L. (1998). An investigation of the effects of HIV on the sex lives of infected individuals. AIDS Education and Prevention, 10(6), 506–522.PubMedGoogle Scholar
  30. Day, M. V., Kay, A. C., Holmes, J. G., & Napier, J. L. (2011). System justification and the defense of committed relationship ideology. Journal of Personality and Social Psychology, 101(2), 291–306. Scholar
  31. Dempster, A., Laird, N., & Rubin, D. (1977). Maximum likelihood estimation from incomplete data. Journal of the Royal Statistical Society: Series B (Methodological), 39(1), 1–38.Google Scholar
  32. DePaulo, B. M., & Morris, W. L. (2005). Singles in society and in science. Psychological Inquiry, 16(2–3), 57–83.CrossRefGoogle Scholar
  33. Devries, K. M., & Free, C. J. (2011). Boyfriends and booty calls: Sexual partnership patterns among Canadian Aboriginal young people. Canadian Journal of Public Health, 102(1), 13–17. Scholar
  34. Doyal, L., & Anderson, J. (2005). ‘My fear is to fall in love again…’: How HIV-positive African women survive in London. Social Science and Medicine, 60(8), 1729–1738. Scholar
  35. Espinosa-Hernández, G., & Vasilenko, S. A. (2015). Patterns of relationship and sexual behaviors in Mexican adolescents and associations with well-being: A latent class approach. Journal of Adolescence, 44, 280–290. Scholar
  36. Fahs, B. (2014). ‘Freedom to’ and ‘freedom from’: A new vision for sex-positive politics. Sexualities, 17(3), 267–290. Scholar
  37. Fair, C., & Albright, J. (2012). “Don’t tell him you have HIV unless he’s ‘the one’”: Romantic relationships among adolescents and young adults with perinatal HIV infection. AIDS Patient Care and STDs, 26(12), 746–754. Scholar
  38. Farvid, P., & Braun, V. (2016). Unpacking the “pleasures” and “pains” of heterosexual casual sex: Beyond singular understandings. Journal of Sex Research, 54(1), 73–90. Scholar
  39. Faulkner, S. L. (2003). Good girl or flirt girl: Latinas’ definitions of sex and sexual relationships. Hispanic Journal of Behavioral Sciences, 25(2), 174–200. Scholar
  40. Fernet, M., Otis, J., Massie, L., St-Pierre-Gagné, S., Nengeh Mensah, M., de Pokomandy, A., … Hot, A. (2017). PLURIELLES: Evaluation of a Quebec-based program aimed at improving HIV-positive women’s sexual health beyond HIV. Paper presented at the Canadian Association of HIV Research Conference, Montreal, Canada.Google Scholar
  41. Floyd, K. (2002). Human affection exchange: V. Attributes of the highly affectionate. Communication Quarterly, 50(2), 135–152. Scholar
  42. Fratti, K. (2017). I am HIV positive. This is what it’s like to date. Redbook Magazine. Retrieved February 20, 2019 from
  43. García-Moreno, C., Hegarty, K., d’Oliveira, A. F. L., Koziol-McLain, J., Colombini, M., & Feder, G. (2015). The health-systems response to violence against women. The Lancet, 385(9977), 1567–1579. Scholar
  44. Gjesfjeld, C. D., Greeno, C. G., & Kim, K. H. (2007). A confirmatory factor analysis of an abbreviated social support instrument: The MOSS-SSS. Research on Social Work Practice, 18(3), 231–237. Scholar
  45. Greenhalgh, C., Evangeli, M., Frize, G., Foster, C., & Fidler, S. (2016). Intimate relationships in young adults with perinatally acquired HIV: A qualitative study of strategies used to manage HIV disclosure. AIDS Care, 28(3), 283–288. Scholar
  46. Grodensky, C. A., Golin, C. E., Jones, C., Mamo, M., Dennis, A. C., Abernethy, M. G., & Patterson, K. B. (2015). “I should know better”: The roles of relationships, spirituality, disclosure, stigma, and shame for older women living with HIV seeking support in the South. Journal of the Association of Nurses in AIDS Care, 26(1), 12–23. Scholar
  47. Gulledge, A. K., Gulledge, M. H., & Stahmannn, R. F. (2003). Romantic physical affection types and relationship satisfaction. American Journal of Family Therapy, 31(4), 233–242. Scholar
  48. Gurevich, M., Mathieson, C. M., Bower, J., & Dhayanandhan, B. (2007). Disciplining bodies, desires and subjectivities: Sexuality and HIV-positive women. Feminism & Psychology, 17(1), 9–38. Scholar
  49. Hankins, C., Gendron, S., Tran, T., Lamping, D., & Lapointe, N. (1997). Sexuality in Montreal women living with HIV. AIDS Care, 9(3), 261–272. Scholar
  50. Harnois, C. E. (2013). Feminist measures in survey research. Thousand Oaks, CA: Sage Publications.CrossRefGoogle Scholar
  51. Hayfield, N., & Clarke, V. (2012). “I’d be just as happy with a cup of tea”: Women’s accounts of sex and affection in long-term heterosexual relationships. Women’s Studies International Forum, 35(2), 67–74. Scholar
  52. Haysom, L. (2013). Love: Gender, sexuality and power. Agenda, 27(2), 1–2. Scholar
  53. Holland, J., Ramazanoglu, C., Scott, S., Sharpe, S., & Thomson, R. (1992a). Risk, power and the possibility of pleasure: Young women and safer sex. AIDS Care, 4(3), 273–283. Scholar
  54. Holland, J., Ramazonoglu, C., Sharpe, S., & Thomson, R. (1992b). Pleasure, pressure and power: Some contradictions of gendered sexuality. Sociological Review, 40(4), 645–674. Scholar
  55. Hughes, S. D., & Truong, H.-H. M. (2017). Sero-discovering versus sero-cognisant: Initial challenges and needs of HIV-serodiscordant couples in Porto Alegre, Brazil. Culture, Health & Sexuality, 19(8), 888–902. Scholar
  56. International Community of Women Living with HIV/AIDS. (2015). Criminalization of women living with HIV: Non-disclosure, exposure and transmission. Retrieved February 20, 2019 from
  57. International Community of Women Living with HIV/AIDS. (2017). Love positive women. Retrieved February 20, 2019 from
  58. Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19(1), 173–202. Scholar
  59. Jakubiak, B. K., & Feeney, B. C. (2016). Affectionate touch to promote relational, psychological, and physical well-being in adulthood: A theoretical model and review of the research. Personality and Social Psychology Review, 21(3), 228–252. Scholar
  60. Jarman, M., Walsh, S., & De Lacey, G. (2005). Keeping safe, keeping connected: A qualitative study of HIV-positive women’s experiences of partner relationships. Psychology & Health, 20(4), 533–551. Scholar
  61. Kaida, A., Carter, A., Lemay, J., O’Brien, N., Greene, S., Nicholson, V., … CHIWOS Research Team. (2014). Hiring, training, and supporting peer researchers: Operationalizing community-based research principles within epidemiological studies by, with, and for women living with HIV (Abstract O106). Paper presented at the Canadian Conference on HIV/AIDS Research, St. John’s, Newfoundland. Retrieved February 20, 2019 from
  62. Kaida, A., Nicholson, V., Patterson, S., Carter, A., Ding, E., Sereda, P., … CHIWOS Research Team. (2017). The influence of the criminalization of HIV non-disclosure on intentional sexual inactivity among women living with HIV in Canada. Paper presented at the Canadian Conference on HIV/AIDS Research, Montreal, QC.Google Scholar
  63. Kaida, A., Carter, A., de Pokomandy, A., Patterson, S., Proulx-Boucher, K., Nohpal, A., … on behalf of the CHIWOS Research Team. (2015). Sexual inactivity and sexual satisfaction among women living with HIV in Canada in the context of growing social, legal and public health surveillance. Journal of the International AIDS Society, 18(5), 20284–20294. Scholar
  64. Keegan, A., Lambert, S., & Petrak, J. (2005). Sex and relationships for HIV-positive women since HAART: A qualitative study. AIDS Patient Care & STDs, 19(10), 645–654. Scholar
  65. Kim, E. (2010). The melodrama of virginity and sex drive: The gendered discourse of “the sexual oppression of disabled people” and its “solutions”. Sexuality Research and Social Policy, 7(4), 334–347. Scholar
  66. Lang, A. J., & Stein, M. B. (2005). An abbreviated PTSD checklist for use as a screening instrument in primary care. Behaviour Research and Therapy, 43(5), 585–594. Scholar
  67. Lang, A. J., Wilkins, K., Roy-Byrne, P. P., Golinelli, D., Chavira, D., Sherbourne, C., … Stein, M. B. (2012). Abbreviated PTSD Checklist (PCL) as a guide to clinical response. General Hospital Psychiatry, 34(4), 332–338. Scholar
  68. Lanza, S., Bray, B., & Collins, L. (2013). An introduction to latent class and latent transition analysis. In I. B. Weiner, J. A. Schinka, & W. F. Velicer (Eds.), Handbook of psychology (Vol. 2, pp. 691–716). Hoboken, NJ: Wiley.Google Scholar
  69. Lanza, S. T., & Collins, L. M. (2008). A new SAS procedure for latent transition analysis: Transitions in dating and sexual risk behavior. Developmental Psychology, 44(2), 446.CrossRefGoogle Scholar
  70. Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling, 14(4), 671–694.CrossRefGoogle Scholar
  71. Lanza, S. T., Dziak, J. J., Huang, L., Xu, S., & Collins, L. M. (2015). PROC LCA and PROC LTA user’s guide (Version 1.3.2). University Park: The Methodology Center, Pennsylvania State University.Google Scholar
  72. Lawless, S., Crawford, J., Kippax, S., & Spongberg, M. (1996a). ‘If it’s not on…’: Heterosexuality for HIV-positive women. Venereology, 9(1), 15–23.Google Scholar
  73. Lawless, S., Kippax, S., & Crawford, J. (1996b). Dirty, diseased and undeserving: The positioning of HIV positive women. Social Science and Medicine, 43(9), 1371–1377. Scholar
  74. Life and Love with HIV. (2017). Retrieved from
  75. Longfield, K. (2004). Rich fools, spare tyres and boyfriends: Partner categories, relationship dynamics and Ivorian women’s risk for STIs and HIV. Culture, Health & Sexuality, 6(6), 483–500. Scholar
  76. Loutfy, M., Greene, S., Kennedy, V. L., Lewis, J., Thomas-Pavanel, J., Conway, T., … on Behalf of the CHIWOS Research Team. (2016). Establishing the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS): Operationalizing community-based research in a large national quantitative study. BMC Medical Research Methodology, 16(1), 101–110. Scholar
  77. Manlove, J., Welti, K., Wildsmith, E., & Barry, M. (2014). Relationship types and contraceptive use within young adult dating relationships. Perspectives on Sexual & Reproductive Health, 46(1), 41–50. Scholar
  78. Maticka-Tyndale, E., Adam, B. D., & Cohen, J. (2002). Sexual desire and practice among people living with HIV and using combination anti-retroviral therapies. Canadian Journal of Human Sexuality, 11(1), 33–40.Google Scholar
  79. Mazanderani, F. (2012). An ethics of intimacy: Online dating, viral-sociality and living with HIV. BioSocieties, 7(4), 393–409. Scholar
  80. McClelland, A., & Whitbread, J. (2016). PosterVirus: Claiming sexual autonomy for people with HIV through collective action. In C. Kelly & M. Orsini (Eds.), Mobilizing metaphor: Art, culture, and disability activism in Canada (pp. 76–97). Vancouver, BC: UBC Press.Google Scholar
  81. Meston, C., & Trapnell, P. (2005). Development and validation of a five-factor sexual satisfaction and distress scale for women: The Sexual Satisfaction Scale for Women (SSS-W). Journal of Sexual Medicine, 2(1), 66–81. Scholar
  82. Miller, J. M. (2014). When love becomes dangerous: An in-depth look into heterosexual relationships in Saint Vincent and the Grenadines and their link to HIV transmission amongst Vincentian women. Birmingham, UK: University of Birmingham.Google Scholar
  83. Moran, C., & Lee, C. (2014a). Australian women talk about non-romantic sex. Psychology & Sexuality, 5(3), 210–231. Scholar
  84. Moran, C., & Lee, C. (2014b). Women’s constructions of heterosexual non-romantic sex and the implications for sexual health. Psychology & Sexuality, 5(2), 161–182. Scholar
  85. Msibi, T. (2011). They are worried about me: I am also worried. Agenda, 25(1), 22–28. Scholar
  86. Nelson, L. E., Morrison-Beedy, D., Kearney, M. H., & Dozier, A. (2011). Sexual partner type taxonomy use among black adolescent mothers in the United States. Canadian Journal of Human Sexuality, 20(1), 1–10.CrossRefGoogle Scholar
  87. Nevedal, A., & Sankar, A. (2015). The significance of sexuality and intimacy in the lives of older African Americans with HIV/AIDS. The Gerontologist, 56(4), 762–771. Scholar
  88. Nicholson, V., Sanchez, M., Webster, K., & Carter, A. (2016) Life and love after HIV: A woman’s sharing circle. In Positive Gathering Conference 2016, Vancouver, BC.Google Scholar
  89. Patel, S. N., Hennink, M., Yount, K. M., Wingood, G., Kosambiya, J., McCarty, F., & Windle, M. (2016). Relationship dynamics and challenges of safer sex in an HIV serodiscordant couple in India: A case review from the Positive Jeevan Saathi Study. Journal of HIV/AIDS & Social Services, 15(3), 319–329. Scholar
  90. Peltzer, K. (2011). Sexual dissatisfaction and associated factors in a sample of patients on antiretroviral treatment in KwaZulu-Natal, South Africa. South African Journal of Psychiatry, 17(3), 74–80.CrossRefGoogle Scholar
  91. Persson, A. (2005). Women, HIV, and the heterosexual encounter. Paper presented at The Pozhet Women’s Forum, Sydney, Australia.Google Scholar
  92. Peterson, Z. D., & Muehlenhard, C. L. (2007). What is sex and why does it matter? A motivational approach to exploring individuals’ definitions of sex. Journal of Sex Research, 44(3), 256–268. Scholar
  93. Petretti, S. (2017). Love positive women. Retrieved February 20, 2019 from
  94. Prevention Access Campaign. (2017). Undetectable = untransmittable. Retrieved February 20, 2019 from
  95. Psaros, C., Barinas, J., Robbins, G. K., Bedoya, C. A., Safren, S. A., & Park, E. R. (2012). Intimacy and sexual decision making: Exploring the perspective of HIV positive women over 50. AIDS Patient Care & STDs, 26(12), 755–760. Scholar
  96. Public Health Agency of Canada. (2014). HIV/AIDS epi updates: National HIV prevalence and incidence estimates for 2011. Retrieved February 20, 2019 from
  97. Pulerwitz, J., Gortmaker, S. L., & DeJong, W. (2000). Measuring sexual relationship power in HIV/STD research. Sex Roles, 42(7–8), 637–660. Scholar
  98. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. Scholar
  99. Reis, H. T., & Aron, A. (2008). Love: What is it, why does it matter, and how does it operate? Perspectives on Psychological Science, 3(1), 80–86. Scholar
  100. Rentsch, C., Bebu, I., Guest, J. L., Rimland, D., Agan, B. K., & Marconi, V. (2014). Combining epidemiologic and biostatistical tools to enhance variable selection in HIV cohort analyses. PLoS ONE, 9(1), e87352. Scholar
  101. Rheaume, C., & Mitty, E. (2008). Sexuality and intimacy in older adults. Geriatric Nursing, 29(5), 342–349. Scholar
  102. Rispel, L. C., Metcalf, C. A., Moody, K., Cloete, A., & Caswell, G. (2011). Sexual relations and childbearing decisions of HIV-discordant couples: An exploratory study in South Africa and Tanzania. Reproductive Health Matters, 19(37), 184–193. Scholar
  103. Robertson, A. M., Syvertsen, J. L., Amaro, H., Martinez, G., Rangel, M. G., Patterson, T. L., & Strathdee, S. A. (2013). Can’t buy my love: A typology of female sex workers’ commercial relationships in the Mexico–U.S. border region. Journal of Sex Research, 51(6), 711–720. Scholar
  104. Rodger, A., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., van Lunzen, J., & Beloukas, A. (2016). Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. Journal of the American Medical Association, 316(2), 171–181. Scholar
  105. Rule-Groenewald, C. (2013). “Just knowing you found the person that you’re ready to spend your life with”: Love, romance and intimate relationships. Agenda, 27(2), 30–37. Scholar
  106. Sanchez, M., Webster, K., Salters, K., Kaida, A., & Carter, A. (2017) Life, love and lunch: A pleasureful pre-positive gathering for women. In Positive Gathering Conference, Vancouver, BC.Google Scholar
  107. Sassler, S. (2010). Partnering across the life course: Sex, relationships, and mate selection. Journal of Marriage and Family, 72(3), 557–575. Scholar
  108. Schäfer, G. (2008). Romantic love in heterosexual relationships: Women’s experiences. Journal of Social Sciences, 16(3), 187–197. Scholar
  109. Schwarz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6(2), 461–464.CrossRefGoogle Scholar
  110. Sclove, S. L. (1987). Application of model-selection criteria to some problems in multivariate analysis. Psychometrika, 52(3), 333–343. Scholar
  111. Seeley, J., Russell, S., Khana, K., Ezati, E., King, R., & Bunnell, R. (2009). Sex after ART: Sexual partnerships established by HIV-infected persons taking anti-retroviral therapy in Eastern Uganda. Culture, Health & Sexuality, 11(7), 703–716. Scholar
  112. Siegel, K., & Schrimshaw, E. W. (2003). Reasons for the adoption of celibacy among older men and women living with HIV/AIDS. Journal of Sex Research, 40(2), 189–200. Scholar
  113. Siegel, K., Schrimshaw, E., & Lekas, H.-M. (2006). Diminished sexual activity, interest, and feelings of attractiveness among HIV-infected women in two eras of the AIDS epidemic. Archives of Sexual Behavior, 35(4), 437–449. Scholar
  114. Singh, S. (2013). Women want love, men want wives: The discourse of romantic love in young adults’ future marriage goals. Agenda, 27(2), 22–29. Scholar
  115. Somes, J., & Donatelli, N. S. (2012). Sex and the older adult. Journal of Emergency Nursing, 38(2), 168–170. Scholar
  116. Sontag, S. (1988). Illness as metaphor and AIDS and its metaphors. New York: Picador.Google Scholar
  117. Spielmann, S. S., MacDonald, G., Maxwell, J. A., Joel, S., Peragine, D., Muise, A., & Impett, E. A. (2013). Settling for less out of fear of being single. Journal of Personality and Social Psychology, 105(6), 1049–1073. Scholar
  118. Sprague, J. (2016). How feminists count: Critical strategies for quantitative methods. In J. Sprague (Ed.), Feminist methodologies for critical researchers: Bridging differences (pp. 94–143). London: Rowman and Littlefield.Google Scholar
  119. Squire, C. (2003). Can an HIV-positive woman find true love? Romance in the stories of women living with HIV. Feminism & Psychology, 13(1), 73–100. Scholar
  120. Sternberg, R. J. (1986). A triangular theory of love. Psychological Review, 93(2), 119–135. Scholar
  121. Taylor, B., & Davis, S. (2006). Using the extended PLISSIT model to address sexual healthcare needs. Nursing Standard, 21(11), 35–40. Scholar
  122. Taylor, T. N., Munoz-Plaza, C. E., Goparaju, L., Martinez, O., Holman, S., Minkoff, H. L., & Golub, E. T. (2016). “The pleasure is better as I’ve gotten older”: Sexual health, sexuality, and sexual risk behaviors among older women living with HIV. Archives of Sexual Behavior, 46(4), 1137–1150. Scholar
  123. Tiefer, L. (2001). A new view of women’s sexual problems: Why new? Why now? Journal of Sex Research, 38, 89–96. Scholar
  124. UCLA Institute for Digital Research and Education. (2015a). SAS data analysis examples: Logit regression. Retrieved February 20, 2019 from Archived at
  125. UCLA Institute for Digital Research and Education. (2015b). SAS data analysis examples: Mulitnomial logistic regression. Retrieved February 20, 2019 from Archived at
  126. van der Straten, A., Vernon, K. A., Knight, K. R., Gomez, C. A., & Padian, N. S. (1998). Managing HIV among serodiscordant heterosexual couples: Serostatus, stigma and sex. AIDS Care, 10(5), 533–548. Scholar
  127. VanDevanter, N., Thacker, A. S., Bass, G., & Arnold, M. (1999). Heterosexual couples confronting the challenges of HIV infection. AIDS Care, 11(2), 181–193. Scholar
  128. Vasilenko, S. A., Kugler, K. C., Butera, N. M., & Lanza, S. T. (2014). Patterns of adolescent sexual behavior predicting young adult sexually transmitted infections: A latent class analysis approach. Archives of Sexual Behavior, 44(3), 705–715. Scholar
  129. Vasilenko, S. A., Kugler, K. C., & Lanza, S. T. (2015). Latent classes of adolescent sexual and romantic relationship experiences: Implications for adult sexual health and relationship outcomes. Journal of Sex Research, 53(7), 742–753. Scholar
  130. Vermunt, J. K. (2010). Latent class modeling with covariates: Two improved three-step approaches. Political Analysis, 18(4), 450–469.CrossRefGoogle Scholar
  131. Vernazza, P., & Bernard, E. (2016). HIV is not transmitted under fully suppressive therapy: The Swiss Statement—Eight years later. Swiss Medical Weekly, 146(w14246), 1–6. Scholar
  132. Vernazza, P., Hirschel, B., Bernasconi, E., & Flepp, M. (2008). Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitement antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bulletin des Médecins Suisses, 89(5), 165–169.CrossRefGoogle Scholar
  133. Wamoyi, J., Mbonye, M., Seeley, J., Birungi, J., & Jaffar, S. (2011). Changes in sexual desires and behaviours of people living with HIV after initiation of ART: Implications for HIV prevention and health promotion. BMC Public Health, 11, 1–11. Scholar
  134. Webster, K., Carter, A., Proulx-Boucher, K., Dubuc, D., Nicholson, V., Beaver, K., & Kaida, A. (2018). Strategies for recruiting women living with human immunodeficiency virus in community-based research: Lessons from Canada. Progress in Community Health Partnerships, 12(1), 21–34. Scholar
  135. Welbourn, A. (2013). Desires denied: Sexual pleasure in the context of HIV. In S. Jolly, A. Cornwall, & K. Hawkins (Eds.), Women, sexuality and the political power of pleasure (pp. 142–161). London: Zed Books.Google Scholar
  136. Wentland, J. J., & Reissing, E. D. (2011). Taking casual sex not too casually: Exploring definitions of casual sexual relationships. Canadian Journal of Human Sexuality, 20(3), 75–91.Google Scholar
  137. Wentland, J. J., & Reissing, E. (2014). Casual sexual relationships: Identifying definitions for one night stands, booty calls, fuck buddies, and friends with benefits. Canadian Journal of Human Sexuality, 23(3), 167–177. Scholar
  138. Wessman, M., Aho, I., Thorsteinsson, K., Storgaard, M., Johansen, I. S., Lunding, S., & Weis, N. (2015). Perception of sexuality and fertility in women living with HIV: A questionnaire study from two Nordic countries. Journal of the International AIDS Society, 18(19962), 1–10. Scholar
  139. Whitbread, J. (2017). Love positive women. Jessica Whitbread. Retrieved February 20, 2019 from
  140. Williams, D. R., Yan, Y., Jackson, J. S., & Anderson, N. B. (1997). Racial differences in physical and mental health: Socio-economic status, stress and discrimination. Journal of Health Psychology, 2(3), 335–351. Scholar
  141. World Association for Sexual Health. (2014). Declaration of sexual rights. Retrieved February 20, 2019 from
  142. Wright, K., Naar-King, S., Lam, P., Templin, T., & Frey, M. (2007). Stigma scale revised: Reliability and validity of a brief measure of stigma for HIV+ youth. Journal of Adolescent Health, 40(1), 96–98. Scholar
  143. Zhang, W., O’Brien, N., Forrest, J. I., Salters, K. A., Patterson, T. L., Montaner, J. S., & Lima, V. D. (2012). Validating a shortened depression scale (10 item CES-D) among HIV-positive people in British Columbia, Canada. PLoS ONE, 7(7), e40793. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Allison Carter
    • 1
    • 2
    • 3
  • Saara Greene
    • 4
  • Deborah Money
    • 5
    • 6
  • Margarite Sanchez
    • 7
  • Kath Webster
    • 1
  • Valerie Nicholson
    • 1
  • Lori A. Brotto
    • 5
  • Catherine Hankins
    • 8
    • 9
  • Mary Kestler
    • 10
  • Neora Pick
    • 10
    • 11
  • Kate Salters
    • 1
    • 2
  • Karène Proulx-Boucher
    • 12
  • Nadia O’Brien
    • 12
    • 13
  • Sophie Patterson
    • 1
    • 14
  • Alexandra de Pokomandy
    • 12
    • 13
  • Mona Loutfy
    • 15
    • 16
  • Angela Kaida
    • 1
    Email author
  • the CHIWOS Research Team
  1. 1.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada
  2. 2.Epidemiology and Population HealthBritish Columbia Centre for Excellence in HIV/AIDSVancouverCanada
  3. 3.Kirby Institute, Faculty of MedicineUniversity of New South WalesSydneyAustralia
  4. 4.School of Social WorkMcMaster UniversityHamiltonCanada
  5. 5.Department of Obstetrics and Gynecology, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  6. 6.Department of Medicine, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  7. 7.ViVAPositive Living Society of British ColumbiaVancouverCanada
  8. 8.Amsterdam Institute for Global Health and Development (AIGHD), Department of Global HealthUniversity of AmsterdamAmsterdamThe Netherlands
  9. 9.Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of MedicineMcGill UniversityMontrealCanada
  10. 10.Division of Infectious Diseases, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  11. 11.Oak Tree ClinicBritish Columbia Women’s Hospital and Health CentreVancouverCanada
  12. 12.Chronic Viral Illness ServiceMcGill University Health CentreMontrealCanada
  13. 13.Department of Family MedicineMcGill UniversityMontrealCanada
  14. 14.Department of Public Health and PolicyUniversity of LiverpoolLiverpoolUK
  15. 15.Women’s College Research InstituteWomen’s College HospitalTorontoCanada
  16. 16.Department of MedicineUniversity of TorontoTorontoCanada

Personalised recommendations