AIDS Research and Treatment with an HIV-positive person, while nearly 18% indicated that they would not sleep in the same room with someone with AIDS [31]. Participants identiﬁed additional problems for women who disclosed their status to spouses and family members, as they could face divorce, being ejected from their home, or even subjected to violence: “When my partner discovered that he is also HIV-positive, he wanted to kill us both, he was devastated.” (FGD—HIV-positive mixed race, men and women) This was particularly problematic where the woman was ﬁnancially dependent on a male partner: “The ﬁrst thing you hear is ‘I am not working, maybe I am staying with this particular somebody, I don’t have a place to stay, I’m staying at his place or his shack or whatever, if I told him that I’m HIV- positive, I’m out of his place, so I won’t have anything to eat, and I’m not working’.” (KI— NGO counsellor coordinator) Also HIV-positive MSM can ﬁnd themselves vulnerable to rejection from family and friends when they have not disclosed their sexual preference: “90% of the men here haven’t even told their fam- ily members they were gay, never mind that they are positive . . . wow, you haven’t even told your family that you are gay, or your friends, so how can you open up and tell them that you’re positive?” (KI—Workplace AIDS education organisation) There was general agreement among participants in the study that it was necessary to disclose one’s status to a potential sex partner. However, across focus groups participants talked of their sex partners’ negative reactions and unwillingness to get tested: “When I found out that I am HIV-positive, I told my partner, my husband that I’m HIV-positive, then he said he is ﬁne, he won’t go for a test . . . and now he’s not here, he’s in Joburg with my children.” (FGD—HIV-positive mixed race men and women) “In some other cases our boyfriends run away, for instance mine ran away and I was having a baby child . . . and my boyfriend ran away when the child was six months.” (FGD—HIV-positive African women) VCT is the cornerstone of HIV prevention in South Africa, and is also necessary for directing HIV-infected people to risk reduction counselling, treatment, and care services [32, 33]. However stigmatising views of PLWHA may jeopardise people’s willingness to get tested [21]. Interestingly in this study, stories of acceptance by families and partners, and recognition of the value of disclosure in empowering and uniting PLWHA were also evident: 5 “I told my husband ‘Look here, I have AIDS’, he just sat down and said ‘Oh, no!’ . . . I was just crying and then he supported me . . . we went to the clinic together, and then he said he wants to know everything that is going on, what he is supposed to do.” (KI—PMTCT organisation) “What we ﬁnd also that with disclosure comes a lot of empowerment, as well as where people disclose and they feel good about themselves, they think they’re making a diﬀerence in other people’s lives, they go to clinics and give talks.” (KI— Community Muslim AIDS support group) Positive attitudes and perceptions towards PLWHA were also reported in the second South African national sero- prevalence study in 2005 [34]. 3.1.3. Risky Behaviour. Several concerns were raised relating to risk factors for HIV infection, such as revenge sex by those infected: “Then you get the one that tests positive again, and just sleeps with anybody and says ‘I’m going to infect as many people as I can’ . . . when someone is out for revenge.” (KI—Community AIDS support organisation) The role of alcohol and drugs in risk-taking behaviours also became evident in KI interviews and group discussions: “When you’re dealing with white urban moﬃes [35], one of the things that you need to look at is recreational drug use for instance.” (KI—Gay support NGO) Gender violence was also mentioned as a potential risk factor for women: “We do recognise that there’s a big problem in this community with violence against women and disempowerment of women . . . the women that we see don’t actually have a choice as to what happens with their own sexuality and sexual patterns, and that’s a problem.” (KII—public hospital ARV medical oﬃcer) These complex links between gender power relations, intimate partner violence, drug use especially among MSM [36, 37], and HIV/AIDS have been highlighted in a few local studies [38, 39]. Focus group participants felt that it was diﬃcult to change risky behaviours. The use of condoms remained problematic, especially for men, with myths and notions of cultural barriers prevailing. Disclosure for group participants was problematic, hence the negotiation of condom use also became challenging, particularly if HIV-positive status had not been disclosed: “When you tell him to use a condom, they ask ‘which means you don’t trust me/or are you sleeping around?’ ” (FGD—HIV-positive mixed race group—HIV-positive mixed race woman)