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Lack of condom use by married or cohabiting couples in populations with high rates of HIV infection has become a significant public health issue. This study investigated whether an HIV risk-reduction intervention (RRI) would increase condom use when delivered to serodiscordant couples as a unit. Of the 62 couples that were screened, 30 serodiscordant couples were enrolled in the study, and randomized 2:1 to an immediate intervention-waitlist control study. The 12-week intervention focused on communication, problem-solving, and negotiation skills. Participants were assessed at baseline, three and six months after the intervention. The main outcome measures were consistent condom use, HIV seroconversion and fidelity to the programme. The use of condoms increased for both the intervention and control groups after receiving a 12-week RRI. Group comparisons showed a significant difference at three months, with a significantly higher mean proportion of condom-protected sex acts (p = 0.0119) between the control and intervention groups, the later showing an increase in condom use. No seroconversion was detected, and the overall retention rate of participants was 83.33%. Counselling heterosexual couples as a unit prompted an increase in condom use, but sustained condom use remains a challenge. [ABSTRACT FROM AUTHOR]

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Background: Zimbabweans are immigrating to South Africa with a commonly cited reason being economic opportunities. Prospects of finding employment may be a significant reason to leave behind family, friends, and community, sources that buffer and offer social support against life's challenges. Currently, there is a dearth of research examining the motivators for Zimbabweans immigrating and the experiences encountered along the way and after arrival in South Africa. Such research is essential as large numbers of Zimbabweans may be at risk for emotional and physical trauma during this process. Methods: Two gender specific focus group discussions, each lasting 90-minutes and consisting of homeless Zimbabwean refugees, were conducted in the Limpopo Province of South Africa. A semi-structured interview assessed for experiences in and reasons for leaving Zimbabwe, as well as experiences en-route and within South Africa. Discussions were audio-recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Results: Three temporal themes were identified and included challenges and trauma experienced in Zimbabwe (pre-migration), during the immigration journey (mid-migration), and upon arrival in South Africa (post-migration). While there were some experiential differences, Zimbabwean men and women shared numerous traumatic commonalities. In addition to the themes, three subthemes contributing to reasons for leaving Zimbabwe, two subthemes of negative and traumatic experiences incurred mid-migration, and two post-migration subthemes of challenges were identified. Conclusion: Despite the difficulties encountered in their homeland, newly arrived Zimbabweans in South Africa may be exchanging old struggles for a new array of foreign and traumatic challenges. Reasons to immigrate and the psychological and physical toll of migration exacted at the individual and community levels are discussed. Recommendations advocating for culturally congruent mental health research, the training of culturally competent researchers and clinicians, and the development of policies that could influence the quality of life of Zimbabwean refugees are provided. [ABSTRACT FROM AUTHOR]

Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aimed to improve condom use and reduce the spread of HIV. Methods: A Total of 30 couples completed a paper-based questionnaire on their demographics and general health at baseline and 3 months, plus a semi-structured questionnaire with four domains. An analysis of HIV knowledge, condom use, condom use attitudes and protection perceptions about how other serodiscordant couples behave was conducted following a 12-week HIV risk reduction intervention. Participants were randomised 2:1 into intervention and control groups. Results: Condom use increased from 55% at baseline to 73.7% ( p = .0047) at 3 months for the intervention group and condom use in the last 7 days increased from 53% to 86% ( p = .0117). For the control group, condom use remained low at the 3 months follow up period ( p = .625). HIV knowledge improved significantly from baseline to 3 months for the intervention group ( p < .0001), as well as the control group ( p = .0005). Negative HIV condom use attitude scores in both groups decreased significantly from baseline to 3 months; intervention group ( p = .0059) and control group ( p = .0007). Conclusion: HIV knowledge and condom use improved significantly, while negative condom use attitudes and HIV protection perceptions decreased significantly following exposure to a risk-reduction intervention, suggesting that HIV preventive interventions should focus on partnership interventions.

Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2  = 0.14 (adjusted r2  = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.