This volume, third in a series of five on sexuality in later life, brings together the experiences of women, gay men, trans women and hijra from around the world as they describe what it means to live with HIV and navigate the often fraught areas of sex, sexuality, intimacy and relationships in later life. New drug treatments have transformed the lives and expectations of people living with HIV. In this book we hear from people living in Aotearoa New Zealand, Bangladesh, India, Kenya, Switzerland, Ukraine and the United Kingdom who are not only living with HIV but also facing stigma imposed on them by others. Too often they have learned to stigmatise themselves. Since no single approach or way of writing can capture the richly diverse experiences of people in later life living with HIV, the book includes a variety of empirical research as well as personal accounts, poetry and other forms of writing from an array of perspectives and academic disciplines. As always with HIV, we find that poverty challenges our notions about the length, expectations and quality of life.

References to endnotes show both the page number and the note number (231n3).

A

ACT UP 110
affective sexuality 13
aggression 115
AIDS see HIV/AIDS
AIDS-2 Generation 68, 86
AIDS Action Committee of Boston 191
al-Qaeda 161
Anglewicz, P. 48
Ansar al-Islam 161
anti-gay sentiments 115116
antiretroviral therapy (ART) 11, 15, 20, 46, 50, 54, 68, 141, 174
Aotearoa New Zealand 102113
experiences of HIV by indigenous people 84
New Zealand Homosexual Law Reform Act 87
‘apparatus of sexuality’ 176
askaris 144
AZT 85, 156

B

Bangladesh 159, 161
incidence of HIV in 166
National Women’s Development Policy 162
physical health problems of older people in 164
rights of women in 161162
sexuality as taboo in 160161
Bersani, Leo 139140
Beyond the Pleasure Principle (Freud) 156n14
Bilge, S. 72
biological clock 1213 see also women
biological determinism 12
biomedicalisation 4, 29, 42
defined 32
of HIV 3132
bisexual men 125127
and ageism 124
and chemsex 70
and filiality 119120
and heterosexist harassment 114, 115, 121122
with HIV and stigma 115116, 123
impact of lipodystrophy on 123
and youthfulness 115
Blixen, Karen 147148
body mapping 33, 34
Body Positive 109
Bonifas, R.P. 121
Bosnak, Robert 174
Bowden, P. 47
A Boy’s Own Story (White) 106
British Offences Against the Person Act of 1861 116
Butler, Judith 139n1, 177n2

C

Canada
Black migrants xxi, xxiii
blood donation xxi, xxiii
Chakrapani, V. 186n7
chemsex
cost 77
defined 67
framing 7377
intergenerationality 6972
intersectional perspective on 7779
and life course 7071, 7377
mediatic discourse on 68
research methods 7273
rise in London 70
and sociality 7377
childbirth, and women living with HIV 21
China 116, 119, 123, 6
cisgender, cisgenderism 102, 140, 162, 177
Collins, E. 123
Collins, P.H. 72
‘coming out’ 160
coming out HIV positive 147152 see also HIV/AIDS
community connection 9293
Confucian filial duty 118 see also filiality
Confucianism 116, 119, 120, 127
COVID-19 1, 166, 193
Crenshaw, Kimberlé 40, 71
Crossley, M.L. 94
cultural heterosexism 116, 125

D

Dancer from the Dance (Holleran) 105
Davis, T.E.K. 48
Deformity Lover and Other Poems, The (Picano) 103
Delphy, C. 21
Derricotte, Toi 142
DiClemente, R.J. 47
Dixit, Madhuri 183
‘double stigma’ 123, 126
drug(s)
antiretroviral 49
narratives around 68
and queer culture 67
recreational 67, 76, 7778
and sexual desire 53
for sexual pleasure 67, 75, 80
usage and HIV-positive population 48, 147
use as route of HIV infection 51
users as HIV population, Federal Office of Public Health (Switzerland) (FOPH) on 12

E

early-onset ageing 174175
Eighty-Sixed (Feinberg) 110
Elder, M.A. 48
Equality Generation 8687
essentialism 141, 177n2
European Union 47
Eyal-Lubling, R. 47

F

Faggots (Kramer) 106
Farewell Symphony, The (White) 110
Fawcett, B. 140141
Feinberg, David B. 110
filiality 114, 116
stigma 119120
Foucault, Michel 176
foundationalism 177n2
Fredriksen-Goldsen, K.I. 169
Freeman, E. 48
free sex 107
Freud, S. 156n14
The Front Runner 102, 103

G

Gany, M.Y.D. 163
Gay American History (Katz) 107
‘Gay Cultural Renaissance’ 105, 112
gay culture 74, 92, 106, 112
in Aotearoa New Zealand 102113
emphasis on youth 124
and older gay/ bisexual men 115
and sexual practices 97
gay(s)/gay communities 31, 70, 71, 84
and ageing 74, 112113, 123125
anti-gay sentiments 115116
in Aotearoa New Zealand 102113
in Bangladesh 161162
experiences of stigma among 115
hegemonic masculinities within 78
and India 181185, 187
living with HIV, case study 114128
notion of transgression 94
rights of 8687, 90, 96
sexual risk and desires 41
slut shaming 93
and social science scholarship 71
use of drugs for sexual pleasure within 67
use of PrEP within 75, 89, 97
writers 104106, 110
Gay Men’s Health Crisis (GMHC) 191
gender
and ageist stereotypes 12
-based violence 29, 56
diversity 160, 165
identity 29, 40, 42, 144, 160, 161
and intimacy 4243
nonconformity 121, 161, 163
norms 1314, 17
and property inheritance 162
roles and HIV 1314, 24
structural theory of 47
see also sex ; sexually diverse communities/people
Ghost Dance (Wright) 110
Gichia, Daniel Chege 145
Giovanni’s Room 102103
GIPA 181, 181n5
Global North 68, 102
Global South 102
Goffman, E. 115
group sex 175177
guilt, and PrEP 9395

H

Hakim, J. 68, 73
harassment
heterosexist 114, 115, 120122
indirect 5, 114, 121
verbal 115, 121
Hearn, J. 140141
heteronormative culture 125, 126, 127
heteronormativity 23, 126127
heterosexism 1226, 115, 116, 125
heterosexist harassment 114, 115, 120122
hidden lives 114, 122123
highly active antiretroviral therapy (HAART) 140, 140n4
hijra 165, 177178, 186187, 186n7, 191 see also transgender
HIV/AIDS 107, 110
biomedicalisation of 3132
categorisation of body with 1721
and chemsex 6780
gay/bisexual men living with 6780, 114128
and gay culture 102113
and intimacy issues see intimacy
long-term HIV survivors (HIVLTS) 139141, 148, 174177, 188
and Nairobi 139157
and queer population of Mumbai 174189
and Sanjeevani 174189
self-evaluation 5556
in Ukraine 4660
and women see women
HIV stigma 28, 39, 47, 74, 86, 117, 127128, 156, 187, 191192
and cultural values 114, 119
defined 116
forms of 115
institutional 54
and lipodystrophy 20
management 117, 126
and medical personnel 55
self-stigmatisation 5556, 60
see also stigma
HIV testing and counselling (HTC) 166167
Holleran, Andrew 105
Hollinghurst, Alan 110
homophobia 68, 115, 192
homosexuality 115, 144, 155, 180
decriminalising, in England and Wales 87
fundamentalist religious condemnation of 116
and gender nonconformity 121
see also gay(s)/gay communities
Humsafar Trust, The 177179, 181187

I

impulsive sexuality 13
Indian Penal Code 162
indirect harassment 5, 114, 121
injection drug users (IDUs) 166
intergenerationality
and chemsex 6972
and gay men 7576
internalised ageism 127
International Centre for Diarrhoeal Research Bangladesh 166
intersectionality
and chemsex 6972
experiences 4041
intersectional vulnerability 159170
intimacy 29, 3840, 94, 175176
barriers to 41
and discrimination 16
emotional 18, 104
and experience of being HIV-positive 18, 2843
and fear of HIV transmission 96
gay 68 see also gay(s)/gay communities
and gender 4243, 47
and menopause 41
and violence 42
Islamic State 161

J

Johnson, M.J. 125
Joy of Gay Sex, The 103

K

Kenya Human Rights Commission 144
Kong, T.S.K. 115
Krumer-Nevo, M. 47

L

Lagrave, R.- M. 20
Latour, B. 73
Lazarus syndrome 86
lesbian, gay, bisexual, transgender and queer (LGBTQ) 117, 125, 126
lesbians
and intersectional vulnerability 159170
and male-dominant values 159
and mental health 168169
and patriarchy 159, 161163
and religion 163164
and resilience 168169
and sexuality 164
Leyland, Winston 105, 112
Liberation Generation 86
Line of Beauty, The (Hollinghurst) 110
lipodystrophy 2021, 123

M

Malik, Zahid 166
Mannan, Xulhaz 161
menopause 1213
and intimate partnerships 41
in older women 21, 23
physiological changes in women due to 48
symptoms of 52
mental health 117, 159, 164
and lesbians 168169
and older women living with HIV 30
and sexual minorities 126
men who have sex with men (MSM) 145, 148, 155, 157, 177178, 181182, 185, 187
see also gay(s)/gay communities
Mitchell, Joni 102
Mitha, Madhu J. 178n4
Moller, K. 68
Mummery, J. 47
Mutua, Ezekiel 145

N

Namiba, Angelina 35
National Gay Rights Coalition (NZ) 87
New Zealand see Aotearoa New Zealand
New Zealand Homosexual Law Reform Act 87
Ng, C.H. 169
Ngengi, Charles 145

O

Orgasms of Light 105
Orthodox Judaism 163
Out of Africa (Blixen) 147

P

participatory analysis 3536, 42
Pascal, J. 49
Patton, C. 59
Petretti, Silvia 35
physical aggression 115
Picano, Felice 103
pre-exposure prophylaxis (PrEP) 75, 140
and community connection 9293
and generational approach 8588
and generational breakthroughs 8896
and guilt 9395
and sexual well-being of gay men 9697
and shame 9395

Q

al-Qaradawi, Yusuf 163
queer 110, 117, 141, 145, 156, 148, 175, 177, 179, 184, 187, 188

R

Rabbi, Mahbub 161
Race, Kane 67, 70, 73
Report of the Departmental Committee on Homosexual Offences and Prostitution (NZ) 87
resilience, and older lesbians 168169
Rofes, E. 94
Roman Catholic theology 163
Rosenfeld, D. 71
Row Kavi, Ashok 177
Ruault, L. 1213

S

Sachikonye, Memory 35
Sanjeevani 174189
Sati 161
secrets and intimacy 3840
self-stigmatisation 5556, 60 see also stigma
serosorting 95
sex 3638
and age 1214
bareback 93, 95
and gender 1214
and gender norms 4243
group 175177, 188
and negative social attitudes 4243
oral 163, 185
recreational drugs, use of 67
safe 17, 111, 125, 134, 186187
unprotected 19, 53, 9297
see also gender ; sexuality ; sexual pleasure
sexual abstinence 1617, 20
sexually diverse communities/people
and Bijito 160
awareness-building workshops for 169
healthcare experiences of 159160
and HTC units 167
and male-dominant values 159
oppression of 159
and patriarchy 159, 163164
and religion 162163
sexuality 13, 114115, 165, 180
affective 13
impulsive 13
and menopause 48
pleasure-oriented 94
related to older people as taboo 12, 23
and religious attitudes 163
as taboo in Bangladesh 160
women avoidance of discussing 53
women’s ‘normal’ expectations 13
sexual norms and gender 1314
sexual pleasure 43, 79, 156
and chemsex 69, 7377
use of drugs for 67
shame
and HIV contraction 55, 56, 58, 91, 114, 119
and PrEP 91, 9395, 96
and trans/fem men 181
see also stigma
Sharp, S. 121
Shepherd, Jane 35
Sickness Generation 86
Simmel, G. 73
slut shaming, 93
Smith, P. 121
social isolation 31, 164
stigma
defined 115
experienced by older lesbians in Bangladesh 159
experienced by trans or fem men in India 181, 187
management 117
queer 147
sexual 123
social 165
towards gender and sexually diverse populations 167, 169
see also HIV stigma ; shame
Stoler, A.L. 161
Subhi, N. 163
Summer Literary Seminars 139, 142, 142n6

T

transgender 165, 186n7, 186n8
and stigma 187
women 165, 177, 191
transgression 13, 22, 24, 94, 97
trauma
of AIDS crisis and gay men 8485, 8788, 9092
cultural 127
of diagnosis 174
of early-onset ageing 175
of HIV 156
Trust for Indigenous Culture and Health (TICAH) 149, 152, 154156
tuberculosis 154, 154n13, 180, 183

U

Ukraine 4660
experiences of HIV-positive older women in 4748
government programmes 5758
HIV prevention programmes in 4951
Stigma Index 58
UNAIDS 60
United Kingdom 2843
biomedicalisation of HIV 3132
intersectional experiences 4041
participants in research methods 3235
participatory analysis 3536
research methods 3236
women ageing and HIV 3031
United Nations 181
United Nations International Children’s Emergency Fund (UNICEF) 166
United States President’s Emergency Plan for AIDS Relief 141
University of Greenwich Research Ethics Committee 32

V

verbal harassment 115, 121

W

Wang, Y. 123
Warren, C.A.B. 117
White, Edmund 106, 110
Williams, M.E. 169
Wingood, G.M. 47
women
affective sexuality for 13
avoidance of discussing sexuality 53
childbirth, and HIV-positive status 21
experiences living with HIV 1112, 1622, 3031, 4660
healthcare providers, trusting relationships with 5455, 5859
innovative empowering programmes for 60
learning about HIV status 5152
middle-aged heterosexual 112
‘normal’ expectations in relation to sexuality 13
and normative life events 23
relations within immediate environment 5556
researchers’ empathy towards 59
rights of 161162
and self-esteem 55, 60
self-evaluation of 5556
and self-stigmatisation 55
sexual behaviours after learning about HIV 5253
sexualities, in Western countries 1213
sexual lives of 1213, 23
and sexual norms 1314
socially imposed roles of 14
transgender 165, 177, 191
World Health Organization 60, 191
Wright, Douglas 110

Z

zidovudine see AZT

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