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Risk perception is embedded in attitudes and beliefs that determine how one ultimately behaves. In relation to HIV-risk behaviours, risk perception is a key dimension in most health behaviour models used to construct health promotion campaigns. This study aimed to understand HIV-risk perception and associated factors among men who have sex with men (MSM). The qualitative data used in this study came from 15 in-depth interviews with MSM studying at the University of KwaZulu-Natal in Durban, South Africa. The findings show that MSM perceive themselves to be at risk for HIV due to their awareness of the main routes of infection. This perception exists because HIV has affected them through the loss of close family members. With each sexual encounter, risk perception changed based on factors such as the sexual role being assumed (insertive versus receptive), the socio-economic status of the partner, perceived level of discriminatory dating patterns, and the use of preventive measures. High levels of risk perception among the men did not translate into positive attitudes towards condoms as many of them preferred to have unprotected sex with trusted partners. Despite perceiving their risk of HIV infection to be high, MSM continue to engage in multiple sexual partnerships and high partner turnover. However, the men in this study were keen to protect their health; with time, they have developed more positive attitudes towards HIV and they understand that it is possible to protect oneself before and after infection.

South Africa has the largest number of people living with HIV in the world. Of the nine provinces in South Africa, KwaZulu-Natal is the worst affected. HIV is largely transmitted through unprotected penetrative sexual intercourse. Male latex condoms are central to HIV prevention because of their effectiveness in preventing HIV transmission in almost all sexual encounters if used consistently and correctly. There are, however, various barriers to condom use. This study sought to unpack barriers to condom use in the context of ukujola (casual or informal sexual relationships) in a South African, isiZulu-speaking community. A generic qualitative approach was used, drawing on a range of methods - four focus groups and twenty in-depth interviews. The study was conducted exclusively with isiZulu-speaking African participants, aged 21-34 years, from the uMgungundlovu district in KwaZulu-Natal, South Africa. Ukujola relationships encompass all casual relationships, i.e. those in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a prerequisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. The interviews suggest the existence of various barriers to condom use, including lack of trust, sexual pleasure and alcohol. There is a need for increased HIV prevention campaigns with particular emphasis on consistent condom use.

Unprotected sexual activity increases the risk of pregnancy and HIV and AIDS. More than three decades into the AIDS pandemic, the condom remains the most effective strategy for protecting against the dual risks of pregnancy and HIV and AIDS, but data from national surveys suggest that condom use among young people aged 15-24 is on the decline in South Africa. This study uses qualitative data from 20 in-depth interviews and one focus group to examine the risk behaviours of university students aged 18-24 years old, with particular emphasis on understanding the decline in the use of condoms. It is well documented that South Africa has one of the highest prevalence rates of HIV and AIDS in the world, however the findings of this study suggest that even though students were well informed about the perceived risks associated with unsafe sexual behaviours, they continue to engage in risk behaviours including unprotected sexual intercourse, multiple sexual partners and the use of alcohol. Male students were more likely than female students to report risky sexual behaviours. Condom use is occurring but not consistently. The majority of students did not use condoms during their first sexual encounter because of a lack of preparedness. Negative attitudes towards condoms continue to discourage students from using them consistently, especially those provided by the government. In light of this, it is recommended that rigorous efforts are directed towards challenging inaccurate perceptions about, and attitudes towards, condom use to promote consistency.

HIV and AIDS continue to pose a global health and development challenge, particularly in sub-Saharan Africa. South Africa has the largest number of people living with HIV (PLHIV) in the world. In spite of the accelerated efforts to combat the HIV and AIDS epidemic, there still remains an unabated challenge, i.e. continuing new infections, particularly among young African adults. HIV is largely transmitted through unprotected vaginal and anal sexual intercourse. This study sought to unpack the meaning of ukujola (casual or informal sexual relationships) as socially constructed by Zulu people, and to identify underlying socio-economic factors for ukujola. This study uses a generic qualitative study approach in which 32 qualitative interviews (4 focus groups, 20 in-depth interviews and 8 key-informant interviews) were conducted with isiZulu-speaking participants (aged 21-34) from Umgungundlovu district, KwaZulu-Natal province. The study found that ukujola relationships are a relatively new phenomenon in Zulu society. Ukujola relationships encompass all "illegitimate" relationships, i.e. in which there has never been involvement of the families. The involvement of families in negotiating ilobolo (bride wealth) is a pre-requisite for legitimate relationships, particularly marriage. Multiple concurrent sexual partnerships typically exist in ukujola relationships, and unprotected sex is common. There is a need for a national dialogue on ilobolo in the context of HIV and AIDS.

This study explored the food challenges facing people living with HIV/AIDS in Tsholotsho, Zimbabwe. Tsholotsho is a socio-economically disadvantaged, rural district in Zimbabwe and has one of the highest HIV prevalence rates in the country. For this study, face to face in-depth interviews were held with men and women living with HIV/AIDS. The findings of the study indicate that the economic situation in the country coupled with the lack of adequate rainfall has posed challenges to the ability of HIV/AIDS patients to maintain a healthy diet. In addition, there were concerns about the departure of non-government organisations which used to provide them with food parcels. The interviews also reveal that indigenous foods are being replaced by processed foods that are less healthy. Lack of employment opportunities and safety networks were some of the other factors leading them to experience food challenges in their everyday lives particularly in terms of access. As food security and good nutrition are key for maintaining physical and emotional health, the cumulative effects of these factors create a difficult environment to access food.

Epidemiological evidence so far suggests that multiple sexual partnerships are an important factor driving the HIV epidemic. Recently, there has been renewed emphasis on fidelity and partner-reduction in preventing HIV infections. Like many countries in sub-Saharan Africa, Zambia is facing a severe HIV epidemic and young people are heavily affected. This study explores youths' perspectives on multiple sexual partnerships in the context of HIV and AIDS. The study draws on four focus group discussions and 10 in-depth interviews with university students in Lusaka, Zambia, in 2006. While the young people were generally aware of the HIV-related risk associated with multiple sexual partnerships, they felt several obstacles prevented them from changing their sexual behaviour. Of special interest are their perceptions related to socio-economic disadvantages and cultural factors.

The purpose of this paper is to understand how married and cohabiting men and women define risk and to identify the factors that influence risk perceptions in a setting with a high prevalence of HIV infection. A combination of qualitative and quantitative methods was used during a cross-sectional survey conducted among 248 men and 289 women in KwaZulu-Natal, South Africa. Forty in-depth interviews were conducted with sexually-active men and women in the same population. The majority of men and women perceived themselves at risk of HIV infection. Women were more likely than men to report a higher risk of HIV infection. Nearly 46% of women and 28% of men perceived themselves at medium or high risk of HIV infection. The qualitative and quantitative data show that perception of risk of HIV infection was influenced both by a person's own sexual behaviour and a partner's sexual behaviour. Men were significantly more likely to perceive themselves at risk because of their own risky sexual behaviour (P < 0.01). In general, few women reported engaging in risky sexual behaviour. However, women were more likely to report that their partners had other sexual partners. Thus, women were significantly more likely to perceive themselves at risk because of their partner's sexual behaviour (P < 0.05). Also, rural women were significantly more likely than urban women to perceive a high risk of HIV infection (P < 0.05). Prevention programmes have an important role to play in creating awareness of the risk of HIV, especially among men. The belief that they are not at risk of HIV infection may result in their failure to adopt self-protective behaviour.