146 B. Dibb and T. Kamalesh getting malaria . . . I also make sure the water I drink, I boil it first which I never used to do. . . And I don’t just pick food and eat, just picking, I take precautions as well because I don’t want to affect that immune system that is already suffering. (Jennifer) Practising safe sex was another behavioural change mentioned byparticipants. Jessica was particularly forthright about this: For someone if theyaccept me that I’m HIV positive theywill be prepared to use condoms and if they’re not prepared theygo away. (Jessica) For Faith, not being married has given her more control over using condoms with her partner: If you are married you don’t have control over what your partner is doing so I actually feel like I’m clean because I’m in control of these condoms. (Faith) Violet, too, had become much more careful about practicing safe sex since her HIV diagnosis: But when I came into this countryseeing the symptoms [. . .] I started to think maybe my husband died of HIV, so when I met this guyI was so careful, we used condoms. (Violet) Super-ordinate theme-positive growth since the HIV diagnosis This super-ordinate theme shows how the partici- pants experienced positive growth in their lives since the onset of their HIV. Subtheme: changes in the value of life Participants had clearlyfound more meaning and value in life because of their HIV diagnosis. The burden of other life factors, above and beyond HIV, is likelyto have also influenced this discovery. Emma and Elizabeth talked of how their value of life had changed since being diagnosed with HIV; Emma now perceived her time to be limited: Before I was just living. There was no meaning to life . . . But now I know mytime is limited. I need to do things. I need to have an impact on some things. [. . .] before I wasn’t doing what I wanted, I was living for others. Right now I am living for me, me, me, me. Myself . . . I found who I am. I found out who I am. (Emma) Now I can think more about mylife, because of HIV. Back then, when I was not, I was not thinking about it. I could live, just like that, but now I am more careful . . . I think about mylife, I take mylife as very important . . . Living with HIV . . . I managed to value mylife. (Elizabeth) Subtheme: changes in goals and opportunities The participants reported that HIV had given them a new set of goals and newfound opportunities, largely related to helping those newlydiagnosed with HIV, or within the educational or care sector. Below Violet explained she now felt great empathywith children diagnosed with HIV, which she attributed to her own experience with HIV: I’ve got ambition to work in various areas, although I am targeting young children and HIV people, I’ve got experience with young children because before I had myown nursery. The most part of it that pains me is to see a young child being diagnosed with HIV so I need to be counsellor towards that. (Violet) After being diagnosed as HIV-positive, Jane could no longer work as a midwife but found a different wayof using her skills: There are manydifferent things you can do. You can divert to looking after special people with HIV. I think there’s manycourses which I can take, defi- nitelytake, when theygive me status. [ . . .] I have to [. . .] look after maybe people with the same condi- tion. Even if it’s in a hospital but on that ward I can work there. (Jane) Her comment ‘‘even if it’s in a hospital . . .’’ indicates the limitations she has experienced within her job since her HIV diagnosis, but she has found that she can work with patients living with HIV/AIDS. Although Emma said that prior to diagnosis she used to fear people living with HIV, she discovered a personal strength which she utilised in her voluntary work in the HIV community. She also acknowledged the satisfaction she experienced from helping others ‘‘I feel nice inside me because I’ve been there’’: Because of what I went through I feel so strengthened to support people. I feel nice when I am supporting somebodywho has just been diagnosed, who is really confused and, you know, I feel good to talk to her and give her, you know, strengthen her, you know. I feel nice inside me because I’ve been there. I have experienced what she’s talking about and I give them assurance ‘things will be okay, don’t worry’. (Emma) Discussion These results provide evidence of positive coping and growth experienced byAfrican women living with HIV in London. While all women had experienced negative consequences of HIV, such as stigma and psychological distress, all had also found that their diagnosis had contributed something positive to their lives as well.