Working with Women and AIDS: Medical, Social, and Counselling Issues

By Judy Bury; Val Morrison et al. | Go to book overview

9

Offering safer sex counselling to women from drug-using communities

Jane Wilson

The advent of HIV and AIDS has affected everyone. In drug-using communities the impact on women is particularly acute. They are especially vulnerable, as both users and sexual partners of users, and they also carry the burden of possibly passing on the virus to their children.

Initially it was hoped that education and information about the virus would activate changes in behaviour. It has become increasingly evident that, while the basic facts about HIV transmission are known, the expected corresponding behaviour changes, especially the adoption of safer sex practices by women, have not occurred.

Issues for women around sexuality, pregnancy, self-esteem, and control in their lives have undermined the efficacy and success of HIV/AIDS education in this arena (see Chapter 8). Many women have contradictory feelings about their sexuality, perhaps desiring sex but feeling that they should be passive in sexual relationships. Being prepared for sex by using contraception means accepting that they are sexual and interested in sex. Women often express ambivalence about pregnancy, seeing it as the only creative thing they can do, and therefore are swayed by other emotions that make pregnancy seem attractive despite the risks or sacrifices that may be involved. Along with this, many young women have low self-esteem and feelings of lack of control over their lives, which foster neither assertiveness in sexual relationships nor an ability to negotiate safer sex.

In counselling women about safer sex it would seem that counsellors have a dual role. They must not only provide education and information about HIV and AIDS but, more importantly, they need to address the complex task of engaging women in counselling in order to examine and address the psychosocial factors which often precipitate, sustain and reinforce their current unsafe, high risk sexual practices.

As yet, we can prevent very little if they’re not talking to us! Although most women approach our drug counselling service for help with their drug problems, they tend to focus initially on problems of a practical nature such

-110-

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Working with Women and AIDS: Medical, Social, and Counselling Issues
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Tables and Figures ix
  • Foreword xiii
  • Acknowledgements xv
  • Introduction 1
  • Part I - Background Issues 7
  • 1 - Women and the Aids Epidemic 9
  • 2 - Social Issues 23
  • 3 - Reflections on Women and Hiv/Aids in New York City and the United States 32
  • Part II - Contraception and Pregnancy 41
  • 4 - Pregnancy, Heterosexual Transmission and Contraception 43
  • 5 - Pregnancy and Hiv 58
  • References 68
  • Part III - Prostitution 69
  • 6 - Hiv and the Sex Industry 71
  • 7 - Developing a Service for Prostitutes in Glasgow 85
  • References 95
  • Part IV - Education and Counselling Issues 97
  • 8 - Education and the Prevention of Hiv Infection 99
  • 9 - Offering Safer Sex Counselling to Women from Drug-Using Communities 110
  • References 116
  • 10 - Women as Carers 117
  • Part V - Feelings and Needs 123
  • 11 - Feelings and Needs of Women Who Are Hiv Positive 125
  • 12 - Being Positive 135
  • 13 - Poems 142
  • Name Index 146
  • Subject Index 148
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