The purpose of this study was to investigate family planning needs, knowledge of HIV transmission and HIV disclosure in a cohort sample that had undergone PMTCT in a resource poor setting. Five public clinics implementing PMTCT from Qaukeni Local Service Area, O.R. Tambo District in the Eastern Cape. The sample at postnatal care consisted of 758 women with known HIV status. From 116 HIV positive women 76.3% and from 642 HIV negative women 85.2% got counseling on safe sex during pregnancy but only 65.8% and 62.3% of the women respectively practiced safe sex during pregnancy, which did not differ by HIV status. Postnatally, almost all women received counseling on family planning, yet use of contraceptives and condoms were low. Among HIV positive women PMTCT knowledge and younger age of the mother were associated with pregnancy desire, and among HIV negative women HIV disclosure to the partner, younger age of the mother and having a lower number of children were associated with pregnancy desire. High pregnancy desires (yet lower than for HIV negative women); low contraceptive and condom use were found among HIV positive women. HIV prevention and family planning must acknowledge the reproductive desires of HIV positive women and men.

The aim of this study was to investigate the implementation of a prevention of mother-to-child transmission (PMTCT) program and to evaluate the uptake and adherence to single-dose nevirapine in a cohort sample that had undergone PMTCT in five public clinics in a resource-poor setting, Quakeni Local Service Area, O.R. Tambo District in the Eastern Cape, South Africa. Results indicated that 116 women (15.3% of the sample) were infected with HIV, 642 (84.7%) were uninfected, and 552 (42.1%) had an unknown HIV status. Almost all of the women had received information about HIV and HIV testing prenatally, but 552 (42%) had not been tested for HIV, and their HIV status was unknown. Only 66 (57%) of the HIV-infected pregnant women had been provided with nevirapine. It is recommended that the quality of HIV counseling be improved and the program of maternal self-medication with nevirapine tablets at onset of labor and maternal provision of nevirapine syrup to newborns be encouraged.

The study investigates the risk exposure to HIV infection among South African children aged 2-9 years served by public health services. Together with their biological mothers, 3471 children and were recruited from inpatient and outpatient children in the Free State Province. Blood samples were taken by professional nurses and a history taken of exposure factors associated with HIV transmission. DNA testing was used to confirm biological maternity where the child was HIV-positive and the mother HIV-negative. Mother-child pairs were stratified by mother's HIV status. Exposure factors related to the child's HIV status were examined in each stratum using a chi-square test. Independent factors were then included in a multiple logistic regression model. Having an HIV-positive mother was strongly related to HIV infection in children (OR: 310; 95%CI: 148-781). However, seven HIV-positive children had HIV-negative mothers. Transmission in this group was significantly associated with breastfeeding by a non-biological mother (OR: 437; 95%CI: 53-5020), being fed with expressed breast milk from a milk room (OR: 37.6; 95%CI: 6.2-259.0), dental injection history (OR: 31.5; 95%CI: 4.5-189.4) and visits to a dentist (OR: 26.9; 95%CI: 4.4-283.5). Although mother-to-child-transmission is shown to be the primary mode of HIV transmission in South African children, the few HIV-positive children infected by other modes of transmission suggest a potential risk of non-vertical HIV infections. These infections can be prevented through education and improved infection-control procedures.

The prevalence of HIV&AIDS is embedded in social and economic inequity and the relationship between social determinants and HIV incidence is well established. The aim of this study was to determine which socio-economic and demographic factors are related to HIV status in the age group 18 to 49 years in informal settlements in the Eastern Cape, South Africa. This cross-sectional study was conducted in 3 informal settlements (n = 752) during March 2013 within the Nelson Mandela Bay and Buffalo City districts. A proportional cluster sample was selected and stratified by area and formal plot/squatter households in open areas. Respondents who volunteered to participate had to provide informed written consent before trained, bilingual peer educators interviewed them and completed the structured questionnaire. HIV status was determined and information on demographic and socio-economic variables was included in the bivariate analysis. The prevalence of HIV was higher, at 17.3%, than the 2011 estimated national prevalence among the general population in South Africa. The level of education (χ(2) = 5.50, df = 1, p < 0.05), geographical site (χ(2) = 7.41, df = 2, p < 0.05), gender (χ(2) = 33.10, df = 1, p < 0.0005), household food insecurity (χ(2) = 4.77, df = 1, p < 0.05), cooking with cast iron pots (χ(2) = 15.0, df = 3, p < 0.05) and availability of perceived 'wealth' indicators like mobile telephones and refrigerators (χ(2) = 9.67, df = 2, p < 0.05) were significantly associated with HIV-status. No significant associations could be demonstrated between household income, the number of people living in the household and the availability of electricity/water and HIV status. As the observed levels of HIV prevalence underlined gender bias and failure to graduate from high school, future interventions should focus on HIV prevention in female schoolchildren. However, HIV infection is also prevalent among wealthier individuals in informal settlements, which indicates that renewed efforts should be made to improve sexual risk behaviour within this group.

HIV prevalence among women in South Africa continues to be high despite the availability of a comprehensive plan for the control of HIV/AIDS and a plethora of prevention programmes. Any explanation for the ongoing high HIV prevalence continues to be elusive. The objective of this study was to understand the relationship between HIV, gender, race and socioeconomic status among South African public sector educators in order to inform prevention programmes. A cross-sectional survey involving a probability sample of 1,766 schools out of 26,713 in the Department of Education Register of School Needs was selected. A sample of 24,200 respondents out of 356,749 public sector educators participated in the study. Nurses registered with the South African Nursing Council were recruited, trained to conduct interviews and to collect specimens for HIV testing. The study found an association between HIV, gender, race and socioeconomic status among educators. African educators showed a higher HIV prevalence than other race groups. Among females, the highest HIV prevalence was among educators aged 25-35 years and in males aged 36-49 years. Further, educators with a high income and educational qualifications had a lower HIV prevalence compared to educators with low income and low educational qualifications, regardless of sex. Migration and marital factors were also found to play a role in HIV infection. The results suggest that HIV prevention needs to take into account critical issues around empowerment of vulnerable groups such as women and certain race groups to be able to implement safe sexual practices and therefore reduce HIV infections.