AIDS Research and Treatment especially vulnerable to rejection by partners and family, or being ejected from their home, or even being subjected to violence; thirdly, given prevailing gender power relations it was diﬃcult for women to negotiate condom use with their male partners; ﬁnally, men were seen as reluctant to own the issue, by going for testing, using condoms, or attending support groups. Hence, sensitivity to gender relations during intervention adaptation is an important aspect. Gender relations should also be dealt with in relation to condom use speciﬁcally where women found it diﬃcult to negotiate condom use in certain cultures. The dominant theme of gender power relations where women remained vulnerable and subordinate to their male counterparts manifested in women being subjected to rejection and outright violence by their partners. During the ﬁve day training, group facilitators were made aware of these gender relations in dealing with HIV-positive status. In addition to this we also compiled a resource list of available support centres for women who experienced gender based violence, and provided a list of nearest HIV testing centres for their male partners who are reluctant to test. Lastly, we also made female condoms available to the women who participated in our study, but acknowledged that this was a short-term solution. Even though Healthy Relationships is primarily an HIV risk reduction intervention for PLWHA another important consideration arising out of the KI interviews and FGDs was the imperative to take the broader socioeconomic context of the lives of PLWHA into account. Speciﬁc issues such as psychosocial needs and the community context need to be considered. More recently, positive prevention has been criticized for its narrow focus on risk reduction, instead of following a more holistic approach that includes issues of nutrition and other aspects that impact on living positively for the person living with HIV. These ﬁndings demonstrate the importance of taking the broader socioeconomic context of PLWHA into consideration in the design of risk reduction interventions. In view of this, with regards to design and implementation of risk reduction interventions for PLWHA, collaboration with all service providers for PLWHA is integral to the implementation of the intervention in the next phase of the study [43]. 4. Conclusions The data presented in this study was the ﬁrst part of a larger research project to evaluate the eﬃcacy of a culturally adapted Healthy Relationships risk reduction intervention in Southern Africa. The next phase of the study will determine the feasibility of the implementation of Healthy Relation- ships and will assess the acceptability of the intervention protocol to both group facilitators and participants. Hence, this study did not examine whether some of the concepts used in Healthy Relationships (e.g., assertive listening) is appropriate for use in South African context. This will be determined in the next phase of the study. Nevertheless, this qualitative study of the challenges faced by PLWHA has highlighted the ongoing role of AIDS-related stigma in local communities, as well as the impact of such 7 stigma on decisions to disclose HIV status and negotiate safer sex. Our ﬁndings also pointed to the broader social context of factors like poverty and prevailing gender relations which may contribute to infection and reinfection among PLWHA and their partners. These ﬁndings thus indicate the strong need for HIV risk reduction interventions with those who know that they are living with HIV/AIDS. 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