BackgroundHIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women.MethodsIn this cross sectional study we interviewed 1951 postnatal women who tested positive and negative for HIV about IPV experiences following HIV test disclosure, using an adapted WHO questionnaire. Multivariate regression models assessed factors associated with IPV after disclosure and controlled for factors such as previous IPV and other known behavioural factors associated with IPV.ResultsOver 93% (1817) disclosed the HIV results to their partners (96.5% HIV− vs. 89.3% HIV+, p<0.0001). Overall HIV prevalence was 15.3%, (95%CI:13.7–16.9), 35.2% among non-disclosers and 14.3% among disclosers. Overall 32.8% reported IPV (40.5% HIV+; 31.5% HIV− women, p = 0.004). HIV status was associated with IPV (partially adjusted 1.43: (95%CI:1.00–2.05 as well as reporting negative reactions by male partners immediately after disclosure (adjusted OR 5.83, 95%CI:4.31–7.80). Factors associated with IPV were gender inequity, past IPV, risky sexual behaviours and living with relatives. IPV after HIV disclosure in pregnancy is high but lower than and is strongly related with IPV before pregnancy (adjusted OR 6.18, 95%CI: 3.84–9.93).ConclusionThe study demonstrates the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. Health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened.

Abstractobjective To describe the occurrence, dynamics and predictors of intimate partner violence (IPV) during pregnancy, including links with HIV, in urban Zimbabwe.

The links between gender roles, gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape, South Africa, constructed their gender identities and roles, how they understood gender-based violence, and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence, shifts in power between men and women were occurring. Also, gender-based violence was regarded as a major problem throughout communities, and was seen to be fuelled by unemployment, poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities, with strong themes of stigma, discrimination, and especially 'othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender, gender violence and HIV which emerged in the study.

The absence of biological fathers in South Africa has been constructed as a problem for children of both sexes but more so for boy-children. Arguably the dominant discourse in this respect has demonized non-nuclear, female-headed households. Fathers are constructed as either absent or ‘bad’. Thus it has become important to explore more closely how male care-givers have been experienced by groups of men in South Africa. This article examines discourses of fatherhood and fatherlessness by drawing on qualitative interviews with a group of 29 men who speak about their reported experiences and understandings of being fathered or growing up without biological fathers. Two major and intertwined subjugated discourses about adult men's experiences of being fathered that counterbalance the prevailing discourses about meaning of fatherhood and fatherlessness became evident, namely, ‘being always there’ and ‘talking fatherhood’. The importance of the experience of fatherhood as ‘being there’, which relates to a quality of time and relationship between child and father rather than physical time together, is illustrated. It is not only biological fathers who can ‘be there’ for their sons but also social fathers, other significant male role models and father figures who step in at different times in participants' lives when biological fathers are unavailable for whatever reason. Second, many positive experiences of fathers or father figures that resist a traditional role of authority and control and subscribe to more nurturant and non-violent forms of care, represented as ‘talking’ fathers, are underlined. If we are to better understand the impact of colonial and apartheid history and its legacy on family life in contemporary society, there is a need for more historically and contextually informed studies on the meaning of fatherhood and fatherlessness.