Hindawi Publishing Corporation AIDS Research and Treatment Volume 2010, Article ID 420270, 8 pages doi:10.1155/2010/420270 Research Article Challenges Faced by People Living with HIV/AIDS in Cape Town, South Africa: Issues for Group Risk Reduction Interventions Allanise Cloete, Anna Strebel, Leickness Simbayi, Brian van Wyk, Nomvo Henda, and Ayanda Nqeketo Social Aspects of HIV/AIDS and Health, Human Sciences Research Council, Cape Town 8000, South Africa Correspondence should be addressed to Allanise Cloete, acloete@hsrc.ac.za Received 2 February 2010; Revised 7 June 2010; Accepted 16 July 2010 Academic Editor: Soraya Seedat Copyright © 2010 Allanise Cloete et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This paper presents the ﬁndings of an exploratory study to investigate the challenges faced by people living with HIV/AIDS (PLWHA) in communities in Cape Town, South Africa. The primary goal of the study was to gather data to inform the adaptation of a group risk reduction intervention to the South African context. Qualitative methods were used to examine the experiences of PLWHA. Eight focus group discussions (FGDs) were conducted with 83 HIV-positive participants and 14 key informants (KIs) involved in work with PLWHA were interviewed. Findings revealed that AIDS-related stigma was still pervasive in local communities. This was associated with the diﬃculty of disclosure of their status for fear of rejection. Also notable was the role of risky behaviours such as lack of condom use and that PLWHA considered their HIV/AIDS status as secondary to daily life stressors like poverty, unemployment, and gender-based violence. These ﬁndings have implications for the adaptation or development of behavioural risk reduction interventions for PLWHA. 1. Introduction As people living with HIV/AIDS (PLWHA) now live longer and healthier lives due to the greater availability of antiretro- viral (ARV) treatment, the urgency of including behaviour change strategies for PLWHA into the public health system becomes an imperative to curb the further spread of the disease and also to prevent reinfection [1]. Moreover, where ARV treatment is readily available decreasing HIV/AIDS morbidity has been paralleled by increasing HIV/AIDS infec- tion rates suggesting that prevention programmes targeting only HIV-negative persons may be inadequate to curb the HIV epidemics [2]. Behaviour change strategies tailored to the speciﬁc needs of PLWHA are termed positive prevention. In the United States of America (USA), positive prevention is now the standard for HIV prevention and many of the intervention models that have shown eﬃcacy in reducing unsafe behaviour are being replicated in South Africa [3]. South Africa is currently estimated to have amongst the most PLWHA globally [4]. Addressing the HIV/AIDS prevention needs of PLWHA becomes even more of a priority in the light of studies illustrating that a signiﬁcant minority of PLWHA in South Africa are still engaging in risky behaviour [5–8]. Hence, a public health imperative is created to address the HIV risk reduction needs of PLWHA. Risk reduction interventions designed to reduce HIV transmission risk behaviours in people who know they are HIV-positive have demonstrated risk reduction beneﬁts in several studies conducted in the USA [9–13]. Within African contexts, the massive roll out of ARV treatment, presented an excellent opportunity for healthcare providers to link prevention with care for PLWHA. A risk reduction intervention, known as Options for Health, is one of the ﬁrst USA-developed interventions [14] which was adapted in South Africa and shown to be eﬃcacious in reducing the HIV risk behaviour of HIV-positive people on ARV treatment in Durban, KwaZulu-Natal (KZN), South Africa [15]. Whilst Options for Health had promising results, other interventions that can be delivered in the group format, thus