Literature on HIV status disclosure among persons living with HIV/AIDS (PLWHA) is dominated by research on the rates, barriers and consequences of disclosure to sexual partners because of the assumed preventive health benefits of partner disclosure. Disclosure of HIV status can lead to an increase in social support and other positive psychosocial outcomes for PLWHA, but disclosure can also be associated with negative social outcomes including stigma, discrimination and violence. The purpose of this article is to describe the HIV status disclosure narratives of PLWHA living in South Africa. Thirty in-depth interviews were conducted with 13 PLWHA (11 women, 2 men) over a three year time period. We explored disclosure narratives of the PLWHA through questions about who they chose to disclose to, how they disclosed to these individuals, and how these individuals reacted. Narratives focused on disclosure to family members and contained relatively little discussion of disclosure to sexual partners. Participants often disclosed first to one trusted family member, and news of the diagnosis remained with this person for a long period of time, prior to sharing with others. This family member helped the PLWHA cope with the news of their diagnosis and prepared them to disclose to others. Disclosure to one’s partner was motivated primarily by a desire to encourage partners to test for HIV. Two participants described overtly negative reactions from a partner upon disclosure, and none of the PLWHA in this sample described very supportive relationships with their partners after disclosure. The critical role that family members played in the narratives of these PLWHA emphasizes the need for a greater focus on disclosure to families for social support in HIV counseling protocols.

The high prevalence of asymptomatic STIs in pregnancy is compelling evidence that demands the development and validation of point-of-care tests for STIs be expedited. In addition, the high incidence of STIs 3 months postpartum suggests that women in this study setting resume unprotected sexual intercourse soon after delivery.

Objectives Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first nine months postpartum. Methods Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization’s IPV scale to estimate prevalence and rates of IPV during pregnancy, at four months postpartum and nine months postpartum and we used logistic regression to assess the correlates of IPV during this time. Results More than 20% of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first nine months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first four months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. Conclusions The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences.

Intimate partner violence (IPV) during pregnancy has been associated with multiple negative health outcomes for the mother, including emotional distress during pregnancy. However, little is known about IPV during pregnancy and its association with emotional distress among pregnant women in South Africa. The objectives of this study were to determine the prevalence of both emotional distress and IPV during pregnancy, to identify whether different exposures of violence and relational control were associated with emotional distress during pregnancy, and to assess whether social support attenuated the relationship between IPV and emotional distress in pregnancy. Pregnant women enrolled in the South Africa HIV Antenatal and Post-test Support Study (SAHAPS) who completed the baseline survey were included in this cross sectional analysis. We used logistic regression models to explore bivariate and multivariate relationships between the proposed covariates and emotional distress. Nearly a quarter of women reported experiencing some type of IPV during the current pregnancy, with psychological violence being the most prevalent. The odds of emotional distress was 1.41 times (95% CI: 1.26–1.57) higher for each additional episode of psychological violence and 2.01 times (95% CI: 1.16–3.77) higher for each additional episode of sexual violence during pregnancy, adjusting for other covariates. Physical violence was only marginally associated with increased odds of emotional distress (A.O.R.: 1.17, 95% CI: .99–1.38) after adjusting for other covariates. Finally, social support was also marginally significant as a main effect, but did not attenuate the relationship between IPV and emotional distress. The high prevalence of IPV among pregnant women in South Africa and its association with emotional distress during pregnancy suggest that interventions that reduce violence during or prior to pregnancy are needed. Such interventions can positively impact IPV and may also ameliorate poor mental health in pregnancy.

We explore race differences in how individuals experience mass incarceration, as well as in mass incarceration's impacts on measures of well-being that are recognized as major social determinants of health. We draw on baseline data from a sample of 302 men and women recently released from prison/jail or placed directly onto probation in New Haven, Connecticut (CT) for drug related offenses and followed at 6-month intervals for two years (2011-2014). We describe race differences in experiences of mass incarceration and in its impacts on well-being; and we conduct mediation analyses to analyze relationships among race, mass incarceration, and well-being. Blacks reported fewer adult convictions than whites, but an average of 2.5 more adult incarcerations. Blacks were more likely to have been incarcerated as a juvenile, spent time in a juvenile facility and in an adult facility as a juvenile, been on parole, and experienced multiple forms of surveillance. Whites were more likely to report being caught by the police doing something illegal but let go. Blacks were more likely to report any impact of incarceration on education, and dropping out of school, leaving a job, leaving their longest job, and becoming estranged from a family member due to incarceration. Whites were more likely to avoid getting needed health or social services for fear of arrest. Overall, Blacks reported a larger number of impacts of criminal justice involvement on well-being than whites. Number of adult incarcerations and of surveillance types, and being incarcerated as a juvenile, each mediated the relationship among race, mass incarceration, and well-being. Though more research is necessary, experiences of mass incarceration appear to vary by race and these differences, in turn, have implications for interventions aimed at addressing the impacts of mass incarceration on health and well-being.