Exploring the Experiences of Chlamydia-positive, Hiv-positive, and Hiv-tested Young Women and Men in Sweden What’s behind Sexual Risk Taking?

The overall aim was to explore the experiences of sexual risk taking among Chlamydia Trachomatis-positive (CT+), HIV-positive (HIV+), and HIV tested young women and men. The specific aims were to explore, from a gender perspective, the events, the norms, considerations and emotions involved in sexual risk taking in CT+, explore the perception of sexual risk taking in HIV+ youth, and their understanding of why they caught HIV and look at how the Law of Communicable Diseases Act influenced their sexuality. Moreover, to investigate why young adults test for HIV, how they construct the HIV risk, and what implications testing has for them. In total, 42 informants between 17-24 years of age were recruited from a youth clinic in Umeå and from three infection clinics for HIV patients in Sweden. In-depth interviews and focus group interviews were tape-recorded, transcribed verbatim, and analyzed using a grounded theory approach. In two of the studies, follow-up interviews were done. The findings revealed that sexual risk taking is influenced by the drive to go steady, where lust and trust guided whether sex would take place. For one-night stands, women were expected to be less forward than men. We found an uneven responsibility concerning condom use; men expected women to be “condom promoters.” When contracting CT, women experienced guilt, whereas men felt content through knowing “the source of contamination.” Among the HIV+ youth, socio-cultural factors–such as lack of adult supervision, naiveté, love, alcohol, drugs, the macho ideal, and cultures of silence–blinded the informants to the risks and made them vulnerable. By grouping narratives according to degree of consensus in sexual encounters, sexual risks seemed to be connected to gendered power relations where the informants had varied agency. The Law of Communicable Diseases Act implied both support and burden for these HIV+ youth. A lot of responsibility was put on them and to be able to handle the information duty they tried to switch off lust, switch off the disease, or balance lust and obedience. Among the HIV tested youth, HIV was seen as a distant threat. Many had event-driven reasons for testing for HIV, such as having multiple partners. Risk zones (e.g., bars) were perceived to be a milieu that often was expected to include one-night stands. Responsibility for testing was a gendered issue: “natural” for women although an escape from responsibility for men. Receiving a “green card” confirmed healthiness and provided relief and made the informants feel “clean.” They could restart with new ambitions, including reconsidering risk. The findings can be used in public health and in health care sectors that work with young people. We present suggestions on how to decrease the spread of STIs: to implement how men could play an equal part in sexual and reproductive health; to promote general CT screening for men; to encourage liberal HIV testing among both young women and men; to promote safer sex behavior by uninfected youth, especially focusing on men; to consider the role of gender and social background in the context of risky behaviors; to provide positive rewards for HIV disclosure; to diminish the risk for HIV transmission.