World Health Organization (WHO, 2002) defines sexual health as “A state of physical, emotional, mental and social wellbeing related to sexuality; it is not merely the absence of disease, dysfunction or infirmity…for sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.’ In other words, positive women have the same rights to a healthy sexual life as any other woman.

At the time of diagnosis with HIV many positive women may feel that they are now less able to have an active sexual relationship. However, studies have shown that most positive women continue to have sexual relationships after their diagnosis. There is some evidence that sexual activity is related to the fact that people who have access to ART are likely to live longer, more healthy lives than in the past and therefore they may have an increased desire for an active sexual life as it is known that ill-health can impact negatively on individual’s desire about sex. (Siegel and Schrimshaw 2003:189).

In common with the lack of prevention work for positive women there is a lack of evidence about what positive women hope for and experience in their sexual relationships. There are a lot of studies focussing on ‘sexual behaviours’ and ‘reproductive health’ but, in line with much of the research done for and about women with HIV these tend to focus on: how to prevent transmission to negative partners or to children; and the prevalence, treatment and prevention of sexually transmitted infections (STIs). While it important that these aspects of sexual activity are researched this focus reinforces stereotypes of positive women as being ‘vectors of transmission’ rather than infected people in their own right.

Positive women who choose to have an active sex life will probably want to consider: contraception and prevention of sexually transmitted infections, whether to disclose to a sexual partner, the risk of transmission to a sexual partner.