1 The impact of HIV diagnosis on gender identity and safer sex among HIV+ Sub- Saharan African migrants in the Netherlands 1 Joshua Maiyo* a , Nicole van Kesteren b and Laura Nunu Siya c a Vrije Universiteit (VU) Amsterdam, The Netherlands; b TNO (Netherlands Organization for Applied Scientific Research), Leiden, The Netherlands; c The Dutch HIV Association (HVN), Amsterdam, The Netherlands Abstract The aim of this study was to examine how a positive HIV diagnosis or longer-term experiences of living with HIV influences gender identity and safer sex attitudes and practices among migrant Sub-Saharan African People Living with HIV (SSA-PLWH) in The Netherlands. Data collected from individual in-depth face-to-face interviews with 21 participants was subjected to Interpretive Phenomenological Analysis (IPA) using qualitative coding with Atlas.ti. Results show that persisting traditional African gender norms and expectations interact with migrant socio- economic conditions to generate hybrid perceptions about gender role-expectations. Specifically, HIV+ diagnosis shapes individual masculine and feminine identities around sexuality through changing perceptions on sexual (dis)function, desirability, and ability to fulfil expected sexual roles. These perceptions in-turn affect choices about disclosure, condom use, partner selection, and childbearing. We conclude that appropriate health interventions should be based on critical understanding of how intersectional interactions between traditional African gender norms, socio- economic context of migration, and lived realities of HIV diagnosis generate new gender identities that shape attitudes towards safer sex. Key words: HIV, gender identity, safe sex, African migrants Introduction Power disparities in gender relations have been acknowledged as key drivers of HIV transmission. The social and economic status and cultural expectations of both women and men can increase the risk of HIV infection. A woman’s lower status can leave her more exposed to infection while men risk infection because of ideals of masculinity (Jewkes et al., 2003). Research has shown that women are more vulnerable to HIV than men because of biological and cultural factors. This is especially the case in many African societies where women have a lower social and economic status owing to their gender difference (Türmen, 2003). These disparities mean that women are in a more vulnerable position and may not be able to negotiate safer sex or make consensual choices whether or not they should have sex and how. Women’s vulnerability in situations of gender violence and forced or transactional sex significantly impacts their self-efficacy in negotiating condom use (Kippax et al., 1997; Parker, 2001). Similar studies also conclude that gender is a significant explanatory factor in the sexual transmission of HIV, as well as influencing treatment, care, and support (Gupta, 2001). While the concept of gender is derived from sexual identity, meaning the biological differences between men and women, ‘gender’ in this study is used to ‘denote the social construct that differentiates the power, roles, 1 Paper presented at the 7th South African AIDS Conference (SA AIDS), 9-12 June 2015 in Durban, South Africa